How Effective Is Radiotherapy in the Ultrasonographic Structural Characteristics of the Submandibular Glands?

Radiotherapy affects salivary glands more intensely than it does other organs, and salivary gland dysfunction can continue during or after treatment. The aim of this study was to examine structural alterations in submandibular glands through ultrasonography following head-neck radiotherapy in patients and to evaluate the impact of radiation dose on these modifications. Forty-six submandibular glands were assessed ultrasonographically for the changes in echogenicity, echotexture, and margin and the influence of the radiation dose on these changes before radiotherapy at 3 time points: the second and sixth months following starting treatment. Statistical analysis of the data was performed using a chi-square test. Significant relationship in 3 ultrasonographic structural characteristics-echogenicity, echotexture, and margin- of submandibular glands (P < .001, P < .001, and P < .001, respectively) were observed before and at the second and sixth months after radiotherapy. There was found a significant correlation between the radiation dose groups in the change of echotexture at 2 different time periods after radiotherapy (P < .001, P < .05, respectively) and in the change of margin at the second month after radiotherapy onset (P < .05). Preceding radiotherapy, submandibular glands typically exhibited hyperechoic echogenicity, homogeneous ecotextures, and regular margins. However, after radiotherapy, there was an observable transformation characterized by isoechoic/hypoechoic features, heterogeneous textures, and irregular margins. With the passage of time following radiotherapy, there was a tendency for the parenchyma structure to gradually revert to a normal state. Also, the radiation dose generally has an effect on the structural changes of the submandibular glands.

Assessment of Dimensional Changes in Submandibular Glands in Head-Neck Radiotherapy Patients by Ultrasonography.

OBJECTIVES: The present study investigated the dimensional changes in the submandibular glands following radiotherapy using ultrasonography. METHODS: Twenty-three patients planned to receive head-neck radiotherapy were included in this study. The anteroposterior, superoinferior, mediolateral length, and volumes of 46 submandibular glands were measured by ultrasonography at 3 different time periods (before radiotherapy and in the second and sixth months after the radiotherapy onset) and evaluated in terms of dimensional changes and the effect of the radiation dose on these changes. The data were statistically analyzed using repeated measures analysis of variance (ANOVA) and 2-factor repeated measures ANOVA. RESULTS: Before radiotherapy and in the second and sixth months after the radiotherapy onset, mean anteroposterior length of the submandibular glands was 32.39 ± 4.55, 30.38 ± 4.80, and 31.50 ± 3.68 mm, respectively; mean superoinferior length was 9.96 ± 1.54, 8.76 ± 1.26, and 9.08 ± 1.01 mm, respectively; mean mediolateral length was 24.66 ± 3.77, 22.03 ± 3.73, and 21.76 ± 4.01 mm, respectively; and mean volume was 4.21 ± 1.01, 3.08 ± 0.77, and 3.32 ± 0.63 cm3 , respectively. Moreover, there were significant differences in the anteroposterior (P < .01), superoinferior (P < .001), and mediolateral lengths (P < .001), as well as the volumes (P < .001) of the submandibular glands measured at the 3 different time periods. CONCLUSION: In the second and sixth months after the radiotherapy onset, the sizes of the submandibular glands were markedly reduced, but it partially recovered to normal as more time elapsed after radiotherapy.

Evaluation of saliva glutathione, glutathione peroxidase, and malondialdehyde levels in head-neck radiotherapy patients

Background/aim: It is believed that radiotherapy has important effects on oxidant/antioxidant systems. Oxidative stress occurs when the balance between oxidant formation and antioxidant defense is disrupted in favor of oxidants. The aim of this study was to determine the biochemical changes in saliva pre- and postradiotherapy in head-neck radiotherapy patients and to find out the effects of radiation on glutathione (GSH), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) levels in saliva. Materials and methods: This study included 16 patients undergoing head-neck radiotherapy in Atatürk University Research Hospital. The levels of GSH, GSH-Px, and MDA were measured in saliva samples taken from the patients pre- and postradiotherapy. The same biochemical parameters were also measured in saliva samples from 30 healthy individuals who did not undergo head-neck radiotherapy. The data obtained were analyzed using the paired t-test and the Mann­Whitney U test. Results: When the levels of GSH (P > 0.05), GSH-Px (P > 0.05), and MDA (P < 0.05) in saliva were compared pre- and postradiotherapy in the patient group, the only significant increase was detected in the MDA level postradiotherapy. When the pre- and postradiotherapy levels of saliva GSH (P < 0.01, P < 0.001, respectively), GSH-Px (P > 0.05, P < 0.05, respectively), and MDA (P < 0.01, P < 0.001, respectively) were compared with those of the control group, it was revealed that the GSH level was significantly lower and the MDA level was significantly higher in both pre- and postradiotherapy compared to the control group. Also, only the postradiotherapy saliva GSH-Px level was found to be significantly lower than the control group. Conclusion: These findings show that the changes in saliva GSH, GSH-Px, and MDA levels in patients with head-neck malignity intensified due to radiation.

Papillon-Lefevre Syndrome: A case report / Síndrome de Papillon-Lefevre: descripción de un caso

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A stereological study of the effects of mercury inhalation on the cerebellum.

Mercury in the environment that arises from organic and inorganic sources can cause irreversible damage to the nervous system. Toxicity may be direct or may arise from interactions with other metals in the environment. We evaluated the possible effects of mercury vapor on rat cerebellum. Twelve adult female rats were divided into control and experimental groups. The rats in the experimental group were exposed to mercury vapor for 9 h/day for 45 days. Cerebellar tissue samples were evaluated using stereology and for histopathology. The total number of Purkinje cells was estimated using a physical disector method. We found that in the experimental group, overall volume decreased and the number of Purkinje cells was reduced. We also found cellular damage including pycnotic nuclei, eosinophilic cytoplasm and vacuolization; these features were absent in the control group. We found that chronic exposure to inorganic mercury vapor is toxic to the cerebellum.

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 cone-beam computed tomography evaluation of the osseous morphology of the temporomandibular joint in temporomandibular dysfunction patients and asymptomatic individuals.

OBJECTIVE: We examined the bone components of the temporomandibular joint (TMJ) in asymptomatic individuals and patients with temporomandibular dysfunction (TMD) using cone-beam computed tomography (CBCT). METHODS: Two hundred asymptomatic individuals and 200 patients with TMD were included in this study. Condyle position, eminence height, eminence inclination, condyle shape, and fossa shape were assessed on CBCT images of the 800 temporomandibular joints. RESULTS: The eminence inclination (P < 0.05), eminence height (P < 0.0001), mediolateral width of condyle (P < 0.0001), and anterior joint space (P < 0.0001) were significantly greater in male subjects compared with female subjects in both the asymptomatic group and TMD group. Comparisons of the asymptomatic group and TMD group revealed significant differences in the anterior joint space (P < 0.0001), ratio of anterior joint space to posterior joint space (P < 0.001), posterior joint space (P < 0.05), eminence inclination (P < 0.05), eminence height (P < 0.05), condyle shape (P < 0.0001), and fossa shape (P < 0.05). CONCLUSIONS: As a result of our analysis, we concluded that a low eminence angle may be risk factor for TMD. The presence of TMD was associated with the condyle position in the TMJ.

Correction to: Comparative cone-beam computed tomography evaluation of the osseous morphology of the temporomandibular joint in temporomandibular dysfunction patients and asymptomatic individuals.

In the original publication of the article in "Abstract", the sentence that reads as "The present analyses suggest that a steeper articular eminence inclination may be risk factor" should read as "As a result of our analysis, we concluded that a low eminence angle may be risk factor".

Garre's Osteomyelitis of the Mandible Caused by Infected Tooth.

AIM: Garre's osteomyelitis is a local thickening of the periosteum caused by a slight irritation or infection. We aimed to present the extraoral, intraoral, and radiographic findings and postoperative pursuits of two patients diagnosed with Garre's osteomyelitis. In this case report, although clinical findings indicate infection source, these clinical findings are strongly supported by cone-beam computed tomography images. In addition, it can be seen that when we have followed the case I, we have chosen the right path in treatment. CASE REPORTS: Two patients presented to our clinic due to severe swelling and facial asymmetry in the right and left mandibular region. As a result of the clinical and radiological examinations, the patients were diagnosed with Garre's osteomyelitis. Infected teeth that were responsible for the formation of Garre's osteomyelitis were extracted under antibiotic treatment in both cases. A complete improvement in postoperative control was observed in case I. On the other hand, the other case could not be followed up postoperatively. CONCLUSION: In Garre's osteomyelitis, new bone formation can occur in many pathological conditions. Therefore, it should be distinguished from other pathologies that cause new bone formation, such as Ewing's sarcoma, Caffey disease, and fibrous dysplasia.

Comparison of radiopacity of different composite resins.

BACKGROUND: The radiopacity of composite resins has been considered as an important requirement, improving the radiographic diagnosis. AIM: The present study aimed to compare the radiopacity of eight different composite materials using an aluminum step wedge. MATERIALS AND METHODS: Eight different composite resins were used in this study. The samples were prepared using a stainless steel mold (2 × 8), and a 2-mm-thickness horizontal section was obtained from the freshly extracted molar tooth. Three different radiographs were taken by establishing standard conditions. Mean gray values were obtained by taking three measurements from each step of both the tooth and the aluminum step wedge, and the aluminum thickness equivalents were calculated. Statistical analysis was performed using one-way variance analysis and Tukey's test (P < 0.05). RESULTS: All aluminum thickness equivalents were found to be higher than those of the enamel and dentin, except Clearfil Majesty Esthetic (2.23 mm ± 0.52 mm) and Filtek Silorane (3.67 mm ± 0.15 mm) (P < 0.05). The Clearfil Majesty Posterior (8.50 mm ± 0.10 mm) and Arabesk Top (8.17 mm ± 0.06 mm) were found to be the most radiopaque composites. CONCLUSION: All composite resin materials tested in this study were confirmed to the International Standards Organization 4049 standards. However, since radiopacity is not the only criterion for clinical use, it is a better approach to take all other properties of the materials into consideration.

Inhalation of mercury vapor can cause the toxic effects on rat kidney.

Dental amalgam has been used in dentistry as a filling material. The filler comprises mercury (Hg). It is considered one of the most important and widespread environmental pollutants, which poses a serious potential threat for the humans and animals. However, mercury deposition affects the nervous, cardiovascular, pulmonary, gastrointestinal, and especially renal systems. In most animals' species and humans, the kidney is one of the main sites of deposition of mercury and target organ for its toxicity. In this study, the effects of mercury intake on kidney in rats were searched. For the this purpose; we used 24 adult female Wistar albino rats (200 g in weight) obtained from Experimental Research and Application Center of Atatürk University with ethical approval. Besides, they were placed into a specially designed glass cage. Along this experiment for 45 days, subjects were exposed to (1 mg/m(3)/day) mercury vapor. However, no application was used for the control subjects. At the end of the experiment, kidney samples were obtained from all subjects and processed for routine light microscopic level and stereological aspect were assessed. Finally, according to our results, mercury affects the histological features of the kidney. That means, the severe effects of mercury has been shown using stereological approach, which is one of the ideal quantitative methods in the current literature. In this study, it was detected that chronic exposure to mercury vapor may lead to renal damage and diseases in an experimental rat model.

Effect of mercury vapor inhalation on rat ovary: Stereology and histopathology.

AIM: Mercury, an environmental contaminant, is a risk factor for health in whole living organisms. In this study, we investigated whether mercury vapor (HgO) inhalation has an effect on rat ovary. METHODS: Twelve Wistar albino rats were divided equally into experimental (Hg) and control groups (n = 6). Animals in the Hg group were exposed to HgO for 45 days at a dose 1 mg/m(3)/day, after which, histological and stereological assessment were carried out. RESULTS: Ovaries exposed to HgO had histo-morphometric alterations. HgO inhalation resulted in reduction of the total number of primordial, primary and Graaf follicles. Also, mean volume of ovary, medulla and cortex, corpus luteum (c. luteum) and Graaf follicles was decreased in the Hg group. Moreover, there was a significant increase in total volume of the atretic follicles. On light microscopy, thickening of tunica albuginea, increase of fibrils within the connective tissue, congestion of the capillaries and venous vessels, thinned walls and fibrin deposition in some large blood vessels, and edema were seen. Also, irregular follicle and oocyte borders, and hydropic degeneration in follicular granulosa cells were detected. CONCLUSION: Structural alterations could be attributed to the toxic influence of HgO on rat ovary. The use of Hg should therefore be more controlled to minimize its toxic effect.

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.

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)

Generalized familial crown resorptions in unerupted teeth.

This paper reports the case of 2 sisters with generalized familial crown resorptions, including co-occurrence of familial dental abnormalities of severe crown resorption, failure of eruption, and congenitally missing teeth, which have not been described earlier in the literature.

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.

Comparison of diode laser and Er:YAG lasers in the treatment of ankyloglossia.

OBJECTIVES: The purpose of this study was to compare the tolerance of lingual frenectomy with regard to a local anesthesia requirement and comparison of postsurgical discomfort experienced by patients operated on with both diode and erbium:yttrium-aluminium-garnet (Er:YAG) lasers. BACKGROUND: Ankyloglossia, commonly known as tongue-tie, is a congenital oral anomaly characterized by a short lingual frenulum. A short lingual frenulum may contribute to feeding, speech, and mechanical tongue problems. METHODS: Sixteen referred patients with tongue mobility complaints were included in this study. A GaAlAs laser device with a continuous wavelength of 808 nm was used in the diode group. Frenulums were incised by applying 2 W of laser power. The Er:YAG laser device with a continuous wavelength of 2940 nm was used in the Er:YAG group. Frenulums were incised by applying 1 W of laser power. The acceptability of the lingual frenectomy without local anesthesia and the degree of the postsurgical discomfort were evaluated. RESULTS: Although the majority of patients (six) could be operated on without local anesthesia in the Er:YAG group, all patients could not be operated on without local anesthetic agent in the diode group. There were no differences between the two groups with regard to pain, chewing, and speaking on the first or seventh day after surgery, whereas patients had more pain in the Er:YAG group than in the diode group the first 3 h after surgery. CONCLUSIONS: The results indicate that only the Er:YAG laser can be used for lingual frenectomy without local anesthesia, and there was no difference between the two groups regarding the degree of the postsurgical discomfort except in the first 3 h. In conclusion, these results indicate that the Er:YAG laser is more advantageous than the diode laser in minor soft-tissue surgery because it can be performed without local anesthesia and with only topical anesthesia.

Effectiveness of surface protection for glass-ionomer, resin-modified glass-ionomer and polyacid-modified composite resins.

The purpose of this study was to evaluate the effectiveness of several surface protectors for a glass-ionomer, a resin-modified glass-ionomer, and a polyacid-modified resin cement by determining dye uptake spectrophotometrically. 378 samples, made up of Ionofil U, Vitremer, and Dyract, were prepared and divided into groups of seven each. Positive and negative control specimens remained unprotected while the experimental specimens were protected with Finishing Gloss, Protect-It, LC Varnish, Adper Single Bond, or a nail varnish. The experimental groups and positive controls were immersed in 0.05% methylene blue solution, while the negative controls were immersed in deionized water. Results were evaluated using variance analysis. Of the Ionofil U group, Adper Single Bond exhibited the least effective surface coating among the materials tested, while the best surface protection was obtained with LC Varnish in the Dyract group. However, no statistically significant differences were observed in the Vitremer group.