Variations and thicknesses of anterior belly of the digastric muscle: an ultrasonographic study.

PURPOSE: This study aims to evaluate the anatomy and anatomical variations of the anterior belly of the digastric muscle. METHODS: Hundred and fifty one ultrasonographic images of the digastric muscle pairs were evaluated in Near East University Faculty of Dentistry Department of Dentomaxillofacial Radiology. Morphological variations were recorded using the classification of the digastric muscle into 12 types by Kim et al. For the analysis, the Mann-Whitney U test and Chi-square test were used, and for the correlational analysis, Spearman's rho test was applied. P < 0.05 was considered statistically significant in all tests. RESULTS: Seventy female and 81 male patients aged 19-60 years were evaluated. Type 1 digastric muscle was observed in 145 of 151 patients, Type 2 in 3 patients, and Type 7 in 3 patients. The thicknesses of the right and left digastric muscles were measured, and a statistically significant difference was observed between the groups when the genders were compared. It was observed that both right and left digastric muscle thicknesses were higher in males than females. There was a statistically significant positive high correlation between right and left digastric muscle thicknesses (p = 0.000; r = 0.736). No statistically significant difference was found between genders (p = 0.596) in terms of anatomical variations. CONCLUSION: Considering that the variations of the digastric muscle may have a clinical significance role, the normal anatomy and variations of this muscle should be well known by maxillofacial surgeons and radiologists.

Is There a Relationship Between Maxillary Sinus's Inferior Pneumatisation and Sinonasal Variations? A Retrospective CBCT Study.

Objectives: This retrospective study aims to analyse alveolar and palatal process pneumatisation and their relationships with sinonasal variations using cone-beam computed tomography. Material and Methods: The study included 500 patients aged 18 to 87 years, involving 1000 maxillary sinuses with cone-beam computed tomography scans. We examined the relationship between inferior maxillary pneumatisation and the following anatomic variations: Haller cell, concha bullosa, paradoxical concha, bifid concha, and septal deviation. Results: Among the 1000 maxillary sinuses assessed, we found 223 (22.3%) with alveolar process pneumatisation (APP), 37 (3.7%) with palatal process pneumatisation (PPP), and 23 (2.3%) with the presence of both APP and PPP. Significant relationships were observed between the Haller cell (P = 0.005), nasal septum deviation (P = 0.000), and middle concha bullosa (P = 0.01) with APP. However, there were no significant relationships between the paradoxical middle concha (P = 0.07), bifid middle concha (P = 0.74), and APP. Similarly, significant relationships were observed between the Haller cell (P = 0.001), paradoxical middle concha (P = 0.009), bifid middle concha (P = 0.000), and PPP. However, there were no significant relationships between concha bullosa (P = 0.799) and PPP. Additionally, we found significant relationships between the Haller cell (P = 0.003) and the presence of both APP and PPP. Conclusions: This study provides an anatomical basis for imaging diagnosis by investigating the frequency of inferior pneumatisation of the maxillary sinus and its relationship with certain sinonasal variations.

Sphenoid Sinus Volumes of Patients with Unilateral Cleft Lip and Palate.

OBJECTIVE: There is only one study in the literature in which 3D evaluation of sphenoid sinus volume in patients with cleft lip and palate was used. This shows that this issue has not been adequately evaluated. The present study aimed to compare the volume of the sphenoid sinuses in patients with cleft lip and palate on cone-beam computed tomography images, and to compare them with healthy controls. The high variability of sphenoid sinus volumes poses a risk for iatrogenic lesions during surgical procedures. Because the degree of pneumatization due to increased volume increases the likelihood of exposure of vital neurovascular structures such as the internal carotid artery, maxillary nerves, and optic nerves. DESIGN: Retrospective cohort study. SETTING: University Hospital. PATIENTS: A total of 64 patients (32 cleft palate, 32 controls) over 18 years of age who had sphenoid sinuses in the image area were included in our study. OUTCOMES: Sphenoid Sinus Volume. RESULTS: When the groups were compared in terms of total sinus volume, there was a statistically significant difference between them. Total sinus volume was significantly mean 2.806,87 mm lower in patients with cleft lip and palate compared to the healthy group (P = .015). CONCLUSION: To be aware this lower volume of the sphenoid sinus in cleft lip and palate patients will be useful for the surgical approach to sphenoid sinus. However, the literature on the subject is insufficient, more comprehensive clinical and radiological studies are needed on a larger sample.

Association of accessory sphenoidal septum with protrusions of sphenoid sinus.

PURPOSE: Accessory sphenoidal septum (ASS) is a septal variation that exists in addition to the primary septum of the sphenoid sinus and can be found in or near anatomically essential structures. This study aimed to investigate the relationships between protrusions of vital structures around the sphenoid sinus and the ASSs. METHODS: This cross-sectional retrospective study is based on the analysis of CBCT scans of 314 patients in axial, coronal, and sagittal planes with 0.2-0.3 slice thicknesses. Optic nerve (ON), internal carotid artery (ICA), both ON and ICA, maxillary nerve (MN), vidian canal (VN) and ASSs were detected, and the relationship between protrusions of these vital anatomical structures and ASS was evaluated. RESULTS: Statistically significant relationship was observed between the right Type 1 ON protrusion (p < 0.05) and left Type 1 ON protrusion (p = 0.001); left Type 3 ON protrusion (p < 0.05); right Type 4 ON protrusion (p < 0.05) and ASS. Statistically significant relationship was also observed between the right ICA protrusion and ASS (p < 0.05). The right Type 1 VN protrusion (p = 0.001); left Type 2 VN protrusion (p < 0.001); right and left Type 3 VN protrusions (p < 0.001) were found to be significantly associated with the ASS. CONCLUSIONS: ASSs have significant associations with some protrusions, and they tend to cause potentially severe complications in endoscopic sinus surgery. This variability requires a comprehensive understanding of regional sphenoid sinus anatomy with detailed three-dimensional tomographic imaging.

Multiheaded mandibular condyles.

OBJECTIVES: This study aimed to evaluate the prevalence of multiheaded condyles (MHC) in a group of Turkish subjects using cone-beam computed tomography (CBCT). METHODS: In this retrospective study, CBCT scans of 975 patients (546 female, 429 male; age 15-89 years, mean age 42.46 years) who were referred to Istanbul University Faculty of Dentistry, Department of Dentomaxillofacial Radiology between 2015 and 2021 were evaluated. Bifid and trifid mandibular condyle cases were analyzed according to the patients' age, gender, and laterality, and their frequencies were determined statistically. RESULTS: A multiheaded mandibular condyle (MHC) was detected in 57 of the 975 patients (546 female, 429 male). MHC was diagnosed unilaterally in 49 patients; in 8 patients, it was observed bilaterally. A bifid mandibular condyle (BMC) was detected in 54 patients. A trifid mandibular condyle (TMC) was found in 2 women, and one tetrafid mandibular condyle was seen in 1 woman. CONCLUSIONS: The prevalence of MHC was 5.84% in our proband, which is higher than in previous studies. There was no statistically significant difference between the prevalence of MHC in males or females.

A CBCT Study for Anatomic Variations of Osteomeatal complex in Patients With Cleft Lip and Palate.

OBJECTIVE: To evaluate the anatomy and variations of osteomeatal complex (OMC) by comparing patients with nonsyndromic cleft lip and palate (CLP) and control group. DESIGN: This case-control study was retrospectively analyzed using cone-beam computed tomography data. SETTING: Istanbul University Faculty of Dentistry Department of Dentomaxillofacial Radiology. PATIENTS: The study was conducted with 100 patients (44 females, 56 males) with CLP and 100 patients in the control group, which matched gender and age (with a maximum difference of 3 years). VARIABLES: OMC variations are grouped as follows: ethmoidal, conchal, uncinate process, and septal variations. Then, we evaluated the presence of these OMC variations and compared them between the two groups. STATISTICAL ANALYSIS: The McNemar's test was used to determine any significant differences between the groups for all indices at the 95% confidence level. RESULTS: The most common anatomic variation in this study was Agger nasi cell (97%) and concha bullosa (97%) in the patients with CLP, while Agger nasi cell was the most common variation (99%) in the controls. Moreover, the atelectatic uncinate process was the least observed variation in both groups (1%). The incidences of paradoxical concha (58%;42%), bifid concha (29%;11%), deviated nasal septum (92%;80%) were significantly higher in the CLP group (p < 0.05). CONCLUSIONS: The statistically significant results found when comparing OMC anatomy between the two groups reveal the importance of three-dimensional evaluation before functional endoscopic sinus surgery in patients with CLP.

Prevalence, classification and dental treatment requirements of dens invaginatus by cone-beam computed tomography.

Background: This study aimed the evaluation of the prevalence, characteristics, types of dens invaginatus (DI) and co-observed dental anomalies to understand dental treatment requirements in anterior teeth that are susceptible to developmental anomalies by using cone-beam computed tomography (CBCT). Methods: In this retrospective study, the anterior teeth of 958 patients were evaluated by using CBCT for the presence of DI. The demographic features, types of DI and treatment requirements were also recorded. The association between sex and the presence of DI was evaluated using chi-squared test. Results: Seventy-three DI anomalies were detected in the anterior teeth of 49 patients (18 females, 31 males). The frequency of DI was 5.11% and the most frequently involved teeth were lateral (57.53%). Forty-six teeth were classified as Type I (63.01%), 24 as Type II (32.87%), and three as Type III (4.10%). Apical pathosis was found to be 20.54% in all DIs detected and accounted for all Type III and one-third of Type II. Conclusions: CBCT imaging can be effective in the detection of dental anomalies such as DI and planning for root canal therapy and surgical treatments. Prophylactic interventions might be possible to prevent apical pathosis with the data obtained from CBCT images.

CBCT analysis of haller cells: relationship with accessory maxillary ostium and maxillary sinus pathologies.

OBJECTIVES: The purpose of this study is to evaluate the prevalence of Haller Cell (HC) in a group of the Turkish population and to evaluate its relationship with accessory maxillary ostium (AMO) in presence of maxillary sinusitis. METHODS: 621 CBCT images which were performed for various dental complaints between December 2015 and December 2017 were evaluated retrospectively. Presence of HC, AMO and maxillary sinus pathologies was analyzed. The Pearson's Chi-square test was used between the groups. RESULTS: The incidence of HC in our patients was 7.73%. 36 female and 12 male patients with HC were found; thus, the female:male ratio was 3:1 (p < 0.05). Among 1242 maxillary sinuses, 61maxillary sinuses have HC (4.9%) which makes 27.1% of the HC as unilateral cases. 307 of the 1242 maxillary sinus had AMO (24.7%). The relationship between the presence of AMO and maxillary sinus pathology was found significant (p < 0.05); however, the relationship between HC and maxillary sinus pathology was not significant (p > 0.05). CONCLUSION: Although HC is a possible predisposal factor, it is not a determinant for maxillary sinus pathologies per se.

Clinical and radiological evaluation of cherubism: A rare case report.

Cherubism is a rare, non-neoplastic, genetic disorder, characterized by painless bilateral swelling of the jaws. A 5-year-old girl presented with a painless, bilateral symmetrical swelling of both mandible and maxilla. Intraoral examination revealed malocclusion with displacement of teeth and expansion of the alveolar ridges. There was a bilateral expansion of the jaws. In conclusion, cherubism is a genetic disorder that has non-neoplastic bone lesions that affect the jaws. If there is a functional or esthetic problem, it should be treated surgically. The surgical treatment is usually delayed until after puberty.

Evaluation of Prevalence and Positions of Mesiodens Using Cone-Beam Computed Tomography.

OBJECTIVES: The aim of this retrospective study is to investigate the prevalence, three-dimensional positions and supplementary findings of the presence of a mesiodens by using cone-beam computed tomography. MATERIAL AND METHODS: A total of 5000 cone-beam computed tomography (CBCT) scans, taken between December 2015 and March 2018, from the archive of Istanbul University Faculty of Dentistry Department of Oral and Maxillofacial Radiology, were screened. In sum, 2003 CBCT scans fulfilled inclusion criteria in this study. In addition to number of mesiodens, age and sex of the patients, shape, eruption status and direction, findings of the presence of a mesiodens were also recorded. Mesiodentes were classified according to their positions in frontal, sagittal and axial planes. RESULTS: In this study, the prevalence of mesiodens was found 5.04% and to be more frequent in males than in females with the ratio of 1.9 : 1. One hundred thirty maxillary mesiodentes were detected in 101 cases out of 2003 CBCT scans. In 77 cases (76.2%), single mesiodens; in 19 cases (18.8%), two mesiodentes; and in 5 cases (4.9%), three mesiodentes were found. According to our classification, mesiodentes were mostly found in between midlines of central incisors (both the crown and root of mesiodens) in frontal plane, impacted and in contact with central incisors in sagittal plane, anterior to nasopalatine canal and in contact with nasopalatine canal in axial plane. CONCLUSIONS: Cone-beam computed tomography provides more detailed information about position, neighbouring anatomic structures, and local findings of the presence of mesiodentes in multiplanar sections.