Sex estimation by volumetric evaluation of the maxillary canine using cone-beam computed tomographic images.

BACKGROUND: Teeth can be a reasonable part of sex estimation in case of being the single evidence available or in doubt although they are not as accurate as bones in sex estimation. The size of teeth is greater in males than in females. In this study, it was aimed to determine cut-off values of the tooth volume (TV) and root volume (RV) of the maxillary canines and to evaluate the validity of the method for discriminating between males and females. METHODS: Cone beam computed tomography (CBCT) images of 250 individuals aged 18 to 63 years with equal age and sex distribution were assessed retrospectively. The sample divided into reference set including 168 images of 84 females and 84 males and validation set including 82 images of 48 females and 34 males. Receiver operating characteristic (ROC) curve analysis, and Youden's index were used to determine cut-off values of the volumetric measurements and to test the discriminative performance of the method. RESULTS: The optimal cut-off values of TV ≥ 581 mm3 and RV ≥ 334 mm3 for estimating sex were established from the reference set. The sensitivity (Se), specificity (Sp), and accuracy (Ac) were 0.77 for TV ≥ 581 mm3 while they were 0.82, 0.77, and 0.79 for RV ≥ 334 mm3. When we tested the previously derived cut-off values of TV of the maxillary canine, the Se, Sp, and Ac were found to be respectively 0.71, 0.90, and 0.82 for TV ≥ 619 mm3 and 0.97, 0.27, and 0.56 for TV ≥ 510 / 460 mm3 (right/left). CONCLUSIONS: The identified cut-off values of TV and RV of the maxillary canines can be used to estimate sex with moderate accuracy when the only evidence available is teeth or in case of doubt. The method's applicability should be assessed for different populations.

A rare case of two Stafne bone cavities in the ipsilateral mandible with bicortical bone perforation.

Stafne bone cavity (SBC) is a bone defect which appears unilaterally round or oval shaped radiolucent area with well-defined border. The most common location of the defect is the mandibular molar area at the lingual side of the mandible, below the mandibular canal. Additionally other rarer variants of SBC, anterior lingual, buccal aspect of ascending ramus, and lingual aspect of ascending ramus are also reported. In this paper, a rare case of posterior and anterior variant of double SBCs with buccal cortical bone perforation was presented. An 83-year-old male patient was referred to our clinic for a routine dental examination. Panoramic examination presented two well-defined radiolucent areas. One was located at the right posterior region of the mandible, below the inferior alveolar canal and the second in the region of right canine-premolar area, anterior of the mental foramen. Cone beam computed tomography also confirmed the defects. Magnetic resonance imaging of patient showed that posterior variant was filled with part of submandibular gland and anterior variant was filled with part of sublingual gland. The diagnosis was made as double SBCs and the patient was informed about the lesions.

Assessment of dental anxiety levels among dental emergency patients during the COVID­19 pandemic through the Modified Dental Anxiety Scale.

BACKGROUND: Coronavirus disease 2019 (COVID­19) continues to affect dental emergency services worldwide. Dental anxiety (DA) is described as a common and distressing problem in terms of oral health maintenance. OBJECTIVES: The present study aimed to evaluate DA levels as well as the COVID­19 fear and perception of control (COVID­19 FPC) in patients attending dental emergency clinics during the COVID­19 pandemic. MATERIAL AND METHODS: Sociodemographic, dental and medical data was obtained from the participants. A face-to-face questionnaire with questions referring to the reasons for the emergency dental visit, the visual pain scale, the Modified Dental Anxiety Scale (MDAS), and the COVID­19 Fear and Perception of Control Scale (COVID­19 FPCS) as well as additional questions concerning bruxism and a previous diagnosis of anxiety/panic attacks or depression was administered. The χ2 test was used to analyze the data. RESULTS: A total of 1,439 patients were included in the study. The most common reason for the dental visit was pain (47.5%). The prevalence of DA was 5.1% (74/1,439). A significant association was found between DA and gender (p = 0.020). The incidence of severe pain was higher in patients with DA than in those without DA (p = 0.002). No significant differences in the MDAS scores were found between patients with and without a chronic disease (p = 0.804), with regard to the educational status (p = 0.364), or between the age groups (p = 0.600). The prevalence of a 'strongly agree' response to all questions in COVID­19 FPCS was higher in patients with DA as compared to those without DA. CONCLUSIONS: Females and patients with severe pain were more likely to exhibit DA. In general, patients with DA strongly agreed with the statements of COVID­19 FPCS, which may indicate a correlation between the 2 scales.

The influence of voxel size and artifact reduction on the detection of vertical root fracture in endodontically treated teeth.

OBJECTIVE: The aim of this study was to evaluate the effect of voxel size and artefact reduction (AR) on the identification of vertical root fractures (VRFs) in endodontically treated teeth. METHODS: A total of a hundred sound, extracted human mandibular single-rooted premolars were decoronated, after which root canal preparation was performed, canals were filled with gutta percha by single cone technique. Randomly selected fifty specimens were fractured, repositioned and glued together. The teeth were examined with cone beam computed tomography (CBCT) in five different voxel sizes (0.125, 0.200, 0.250, 0.300, and 0.400 voxels). Two scans were performed for each tooth, one with AR and one without AR. Two radiologists evaluated the CBCT scans. RESULTS: All voxel dimensions were successful in detecting VRFs in CBCT scans. But as the voxel size increased, the percentage of detecting VRFs decreased. High accuracy, sensitivity, specificity and predictive values were found for VRF detection on CBCT scans. Accuracy and sensitivity values decreased (from 100 to 82) while voxel dimensions increased (from 0.125 to 0.400). High-resolution images (0.125, 0.200, and 0.250 voxels) caused an increase in sensitivity for detection of VRFs. AR did not affect the accuracy, sensitivity, specificity and predictive values for VRF detection on CBCT scans. CONCLUSIONS: High-resolution CBCT images resulted in an increase in sensitivity and specificity for detection of VRFs compared with lower-resolution CBCT images. The use of AR did not further improve its diagnostic potential.

Is the diagnosis of calcified laryngeal cartilages on panoramic radiographs possible?

PURPOSE: Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard. MATERIALS AND METHODS: A total of 312 regions (142 bilateral, 10 left, 18 right) in 170 patients (140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient (κ) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators (sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values <.05 were considered to indicate statistical significance. RESULTS: Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P<.05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (κ=0.684 and P<.05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively. CONCLUSION: In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.

Evaluation of the fungiform papillae number in Behçet's disease.

OBJECTIVES: The aim of this study was to evaluate the number, area, circumference, and circularity of lingual fungiform papillae and taste sensitivity in Behçet's disease (BD) and the correlation with the disease. MATERIALS AND METHODS: Eighty-six Behçet's patients and 78 healthy control subjects were examined. After taking digital photographs from the tongue, the fungiform papillae evaluations were performed for the right and left tongue tip sites separately. Taste sense was evaluated with an electrogustometer (EG) from the same sites. RESULTS: The ANOVA test was used to evaluate the fungiform papillae number difference between BD and control groups, and the difference was statistically significant. The fungiform papillae number was significantly reduced in BD, 37.93% at the left site and 40.13% at the right site compared to controls. There was no significant difference in papillae area, circumference, circularity, and EG measurements between BD and control group. CONCLUSION: According to these findings, it is conceivable that the reduction of the fungiform papillae number could be a sign of BD. CLINICAL RELEVANCE: BD has different clinical features that are used for the diagnosis. This study provided a new possible clinical feature. Further studies should be carried out to investigate the usability of this new clinical feature for the diagnosis of BD.

Large arteriovenous malformation of the oromaxillofacial region with multiple phleboliths.

Vascular tumors are the most common benign tumors of the head and neck in infancy and childhood. Vascular anomalies of the head and neck were divided into 2 categories including hemangiomas and vascular malformations. Oral and maxillofacial hemangiomas and vascular malformations are congenital lesions with various clinical characteristics, manifestations, indications, and possibilities for treatment. This paper reports a case of large arteriovenous malformations including a description of the features demonstrated by panoramic radiography, cone beam computed tomography, and magnetic resonance imaging. The differential diagnosis and treatment modalities (including embolization with N-butylcyanoacrylate in this case) are also discussed following the case presentation, along with the available literature review.