Five-year change of panoramic radiomorphometric indices and fractal dimension values in type 2 diabetes patients.

OBJECTIVES: Diabetes mellitus is a chronic disease characterized by dysregulation of glucose metabolism, with characteristic long-term complications accompanied by changes in bone quality. The purpose of this study is to compare the results with a control group by performing radiomorphometric analyses on panoramic radiographs obtained 5 years apart to examine changes in the mandibular bone cortex and microstructures of type 2 diabetes mellitus (T2DM) patients. METHODS: Two panoramic radiographs that were taken 5 years (mean 5.26 ± 0.134) apart from 52 patients with T2DM (n:26) and a control group (n:26) were used. A total of 104 images were evaluated. Analyses were done from the condyle (FD1), angulus (FD2), distal second premolar apex (FD3), and anterior to the mental foramen (FD4) for fractal dimension (FD) in the mandible. Symphysis index (SI), anterior index (AI), molar index (MI), posterior index (PI), and panoramic mandibular index (PMI) measurements were taken for cortical analysis. Three-way ANOVA, three-way robust ANOVA, two-way ANOVA, and two-way robust ANOVA tests were used for statistical analysis (p < 0.05). RESULTS: After a 5-year period, there was a significant decrease in all FD measures of the mandible in both T2DM and control groups (p < 0.05). This resulted in a statistical difference in the main effect of time. After a 5-year period, no significant difference in mandibular cortical measures was identified between the T2DM and control groups (p > 0.05). CONCLUSION: According to panoramic radiography, the mandibular trabecular structure deteriorated after 5 years, whereas cortical values remained the same. It concluded that T2DM had no effect on these results.

Evaluation of bone area in the posterior region for mandibular molar distalization in class I and class III patients.

OBJECTIVES: The aim of this study was to investigate the bone area in the posterior region, which is important for mandibular molar distalization in skeletal class I and class III individuals with normodivergent and hyperdivergent vertical growth patterns. MATERIALS AND METHODS: In this retrospective study, cone-beam computed tomography (CBCT) scans of 120 individuals divided into 4 groups as class I normodivergent (group-I), class I hyperdivergent (group-II), class III normodivergent (group-III), and class III hyperdivergent (group-IV). Retromolar area at crown level measurements was performed on CBCT-derived panoramic radiographs and axial sections. Retromolar area at the root level was measured 2 mm, 4 mm, 6 mm, 8 mm, and 10 mm apical to cemento-enamel junction at CBCT axial sections. RESULTS: Retromolar area decreased towards the root apex in all groups and smallest retromolar area was level of CEJ10mm in all groups. At any root level, the distal root of the mandibular second molar tooth was in contact with the mandibular inner or outer lingual cortex; 50% in group-I, 46.7% in group-II, 23% in group-III, and 23% in group-IV. CONCLUSIONS: In normodivergent individuals, the retromolar area length at the root level is observed to be higher in class III than in class I at almost every level. In hyperdivergent individuals, on the other hand, only at CEJ10mm level, it is higher in length in class III than in class I. Vertical growth pattern has no effect on the root and crown level retromolar area in class I and class III individuals. CLINICAL RELEVANCE: CBCT provides more useful information than panoramic radiographs for patients who are scheduled for large mandibular molar distalization.

Ultrasonographic evaluation of the masseter muscle in patients with temporomandibular joint degeneration.

Purpose: Sonographic elastography can be used to evaluate the hardness of muscle tissue through the application of compression. Strain elastography gauges hardness through the comparison of echo sets before and after compression. This study utilized ultrasonography to measure the thickness and hardness of the masseter muscle in individuals with temporomandibular joint (TMJ) osteoarthritis. Materials and Methods: This study included 40 patients who presented with joint pain and were diagnosed with TMJ osteoarthritis via diagnostic cone-beam computed tomography, along with 40 healthy individuals. The thickness and hardness of each individual's masseter muscle were evaluated both at rest and at maximum bite using ultrasonography. The Mann-Whitney U test and the chi-square test were employed for statistical analysis, with the significance level set at P<0.05. Results: The mean thickness of the resting masseter muscle was 0.91 cm in patients with osteoarthritis, versus 1.00 cm in healthy individuals. The mean thickness of the masseter muscle at maximum bite was 1.28 cm in osteoarthritis patients and 1.36 cm in healthy individuals. The mean masseter elasticity index ratio at maximum bite was 4.51 in patients with osteoarthritis and 3.16 in healthy controls. Significant differences were observed between patients with osteoarthritis and healthy controls in both the masseter muscle thickness and the masseter elasticity index ratio, at rest and at maximum bite (P<0.05). Conclusion: The thickness of the masseter muscle in patients with TMJ osteoarthritis was less than that in healthy controls. Additionally, the hardness of the masseter muscle was greater in patients with TMJ osteoarthritis.

In vitro Comparison of Cone Beam Computed Tomography and Ultrasonography Imaging Methods in the Evaluation of Artificial Mandible Intraosseous Lesions.

STATEMENT OF THE PROBLEM: Intraosseous lesions of jaws can be imaged by cone beam computed tomography (CBCT) and ultrasonography (USG). The knowledge of imaging features of these two methods about intraosseous jaw lesions is important for dental radiology. PURPOSE: The aim of this study is to evaluate artificial mandible intraosseous lesions by using CBCT and USG. MATERIALS AND METHOD: In this in vitro study, intraosseous lesions containing water, milk, olive oil, and liver were evaluated in 60 artificial mandibles by using CBCT and USG. Lesion sizes were compared between CBCT and USG. Lesion sizes were measured on the anterior-posterior, bucco-lingual, and superior-inferior sides. Hounsfield unit (HU) values of the lesions in CBCT images were compared between different materials. Echogenicity of the lesions were evaluated in USG images. One sample t and one-way Anova tests were used for the statistical analysis of the study (p< 0.05). RESULTS: In all size measurements of the lesions, mean CBCT values were statistically higher when compared with USG. In CBCT images, statistically difference was found between the HU values of lesions containing olive oil and other lesion contents. In USG images, echogenicity of water, milk and olive oil was found to be anechoic and the echogenicity of liver was found to be hypoechoic. CONCLUSION: CBCT was found to be more accurate than USG in measurement of the size of mandibular intraosseous lesions. According to the results of our study, it was thought that only oil content could be differentiated by using CBCT HU values. It was found that lesions with liquid and non-liquid contents could be differentiated with their echogenicity difference in USG images.

Morphometric Analysis of Cleft Lip Palate and Prognathic Mandibles in Relation to Mandibular Canal Course.

INTRODUCTION: This study aimed to evaluate the mandibular canal course in individuals with cleft lip palate (CLP) and mandibular prognathism in terms of the sagittal split-ramus osteotomy using cone-beam computed tomography. MATERIALS AND METHODS: Individuals with CLP older than 16 years of age and planned to undergo Le fort I + SSR osteotomies and those with class III occlusion planned to undergo Le fort I + SSR osteotomies were included. The measurements on the cleft side of CLP patients were compared with both their noncleft sides and those with class III occlusion. The course of the inferior alveolar nerve and its position in the mandible were evaluated starting from the mandibular foramen, the first entrance to the mandible, to the mental foramen, the exit from the mandible. RESULTS: The distance between the mandibular canal and the buccal surface of the mandible (B3) on the plane tangent to the distal of the mandibular first molar and perpendicular to the occlusal plane was found to be greater in individuals with CLP (P = 0.011). Buccal cortex thickness (C4) at the level of the mandibular canal on the plane tangent to the distal of the mandibular second molar and perpendicular to the occlusal plane was found to be lower in individuals with CLP (P = 0.021). CONCLUSIONS: The buccal cortex thickness of the mandible corpus and the distance of the mandibular canal to the buccal surface is different in patients with CLP compared to class III individuals' posterior to the mandible. Surgeons should take these differences into consideration during mandibular osteotomy.

Sphenoid sinus agenesis and sella turcica hypoplasia: very rare cases of two brothers with Hamamy syndrome.

Hamamy syndrome (HS) is an autosomal recessive syndrome with a genetic origin that is very rarely observed. The syndrome with craniofacial dysmorphisms, including midface prominence, severe telecanthus, sparse lateral eyebrows, protruding ears, fronto-nasal abnormalities, lacrimal-salivary apparatus agenesis, thin upper vermillion border, myopia, mental retardation, sensorineural hearing impairment, congenital heart anomalies with intraventricular conduction delay, hypochromic microcytic anaemia and skeletal abnormalities of the long bones with recurrent fractures. In this paper, we report a case of two brothers diagnosed with HS at the ages of 25 and 18 years, visited out clinic at different times due to dental reasons. In the radiological examinations, it was observed that both brothers have sphenoid sinuses agenesia, and their sella turcica were smaller than normal. HS may be observed very rarely, and it should be kept in mind that, in addition to various symptoms, it may also cause sphenoid sinus agenesis and sella turcica hypoplasia as shown for the first time in this case report.

Clinical significance of maxillary sinus hypoplasia in dentistry: A CBCT study.

BACKGROUND: The anatomy of the maxillary sinus is especially important for dentists due to the close proximity of the sinus to the maxillary posterior teeth. OBJECTIVES: The aim of the present study was to investigate the frequency of maxillary sinus pathology, anatomical variations, and the relationship between the tooth roots and the maxillary sinus by comparing a group with maxillary sinus hypoplasia (MSH) and a control group using cone-beam computed tomography (CBCT). MATERIAL AND METHODS: In the study, 69 CBCT images of 50 patients with MSH and 84 CBCT images of 49 patients without MSH were evaluated for pathology, and the presence of an accessory ostium, a septum and Haller cells in each maxillary sinus. RESULTS: The coincidence of pathology with MSH was 29%, and with non-hypoplastic maxillary sinuses it was 44% (p = 0.055). An accessory ostium was found in 14.5% of scans with MSH and in 39.3% of those without MSH (p = 0.001). Haller cells were found in 2.9% of the MSH cases, whereas their incidence in the control group was 23.8% (p = 0.000). The occurrence of a sinus septum was at the level of 4.3% in the group with MSH and 23.8% in the group without MSH (p = 0.001). CONCLUSIONS: The incidence of the relationship between the sinus wall and the posterior root apices was found smaller in the dentulous MSH patients. Also, the distance between the root apices and the sinus wall was longer in the dentulous MSH patients, and the vertical and horizontal alveolar bone was larger in the posteriorly edentulous MSH patients.

Examination of Nasolacrimal Duct Morphometry Using Cone Beam Computed Tomography in Patients With Unilateral Cleft Lip/Palate.

OBJECTIVE: The cleft lip/palate (CLP) deformity negatively affects the anatomy of the nasal cavity and maxilla. The effects of this deformity on the lacrimal system have been unidentified yet. This study aimed to evaluate the morphometric changes in the nasolacrimal duct using cone-beam computed tomography (CBCT) in patients with unilateral CLP. MATERIALS AND METHODS: Retrospective bilateral measurements of the narrowest transversal diameters and the lengths of the nasolacrimal ducts were made for the affected and unaffected sides of 28 patients with CLP and 28 control patients, using the CBCT images. The measurements were statistically compared. RESULTS: The mean narrowest transversal diameter of the nasolacrimal duct for the affected side of the patients with unilateral CLP was statistically significantly narrower than the unaffected side (P = 0.01). There were no statistically significant differences between the control group and the affected and unaffected sides of patient group with unilateral CLP regarding the nasolacrimal duct diameter. The differences were not statistically significant among all groups regarding the mean nasolacrimal duct length. CONCLUSION: The diameter of the nasolacrimal duct at the affected side of unilateral CLP was narrower than the unaffected side. According to this result, the CLP deformity can have an effect on the nasolacrimal duct diameter. However, CLP might not affect the nasolacrimal duct length.

Evaluation of Sella Turcica Shape and Dimensions in Cleft Subjects Using Cone-Beam Computed Tomography.

OBJECTIVE: The aim of this study was to assess the morphology of the sella turcica and measure its size in cleft and noncleft subjects. MATERIAL AND METHODS: Cone-beam computed tomography (CBCT) images of 54 individuals (29 males; 25 females) with cleft and 85 (22 males; 63 females) without cleft were used for this study. Syndromic patients with cleft(s) were not included because of possible additional endocrinological and/or morphological disorders. Linear measurements included length, depth, and diameter. The shape of the sella turcica was analyzed in the cleft and noncleft groups. An independent t test was conducted to evaluate differences between genders and groups. One-way ANOVA was used to compare age groups. RESULTS: The length (p < 0.001) of the sella turcica was smaller in noncleft subjects than in cleft subjects. Diameter (p = 0.014) and depth (p = 0.005) showed as constantly increasing from an age <15 to >25 years in the overall assessment. The distribution of the shape of the sella turcica differed significantly between groups (p < 0.001). CONCLUSIONS: In this study, CBCT was used to assess the morphology of the sella turcica. A majority of the subjects with cleft had a flattened sella turcica compared to that of the control group. A shorter length of the sella turcica was more evident in the cleft subjects than in the control group.

Investigation of the effects of storage time on the dimensional accuracy of impression materials using cone beam computed tomography.

PURPOSE: The storage conditions of impressions affect the dimensional accuracy of the impression materials. The aim of the study was to assess the effects of storage time on dimensional accuracy of five different impression materials by cone beam computed tomography (CBCT). MATERIALS AND METHODS: Polyether (Impregum), hydrocolloid (Hydrogum and Alginoplast), and silicone (Zetaflow and Honigum) impression materials were used for impressions taken from an acrylic master model. The impressions were poured and subjected to four different storage times: immediate use, and 1, 3, and 5 days of storage. Line 1 (between right and left first molar mesiobuccal cusp tips) and Line 2 (between right and left canine tips) were measured on a CBCT scanned model, and time dependent mean differences were analyzed by two-way univariate and Duncan's test (α=.05). RESULTS: For Line 1, the total mean difference of Impregum and Hydrogum were statistically different from Alginoplast (P<.05), while Zetaflow and Honigum had smaller discrepancies. Alginoplast resulted in more difference than the other impressions (P<.05). For Line 2, the total mean difference of Impregum was statistically different from the other impressions. Significant differences were observed in Line 1 and Line 2 for the different storage periods (P<.05). CONCLUSION: The dimensional accuracy of impression material is clinically acceptable if the impression material is stored in suitable conditions.

Detailed Anatomical Analysis of the Sphenoid Sinus and Sphenoid Sinus Ostium by Cone-Beam Computed Tomography.

The aim of this study is the evaluation of the anatomical structures of sphenoid sinus ostium used as a reference point for transsphenoidal surgery by cone beam computed tomography. The authors' study was performed using the cone-beam computed tomography images of 16 to 82-year old 200 (112 female, 88 male) patients (Newton 5G, Verona, Italy). Septum deviation of sphenoid sinus and the distance between 2 ostia were evaluated by coronal and axial sections, respectively. Pneumatization degree of sphenoid sinus, diameter of sphenoid sinus ostium, and distance lower edge of superior turbinate to sphenoid sinus ostium were measured by using sagittal sections. The sellar type was the most common pneumatization type of sphenoid sinus in authors' study. While the C-type septum deviation was observed as the most common, T-type deviation was the least type. Sphenoid sinus ostium was bilaterally in 71.5% of individuals, and it was not found in 10% of individuals included in the study. A significant decrease was determined in diameter of the left sphenoid sinus ostium with aging. The distances between 2 sphenoid sinus ostia were 7.30 ±â€Š2.77 mm for women and 6.09 ±â€Š2.58 mm for men, respectively. No statistical differences were found in women and men in terms of distances between the lower edge of the right and left superior turbinate and sphenoid sinus ostium on their sides. Consequently, making detailed preoperative radiological evaluation of anatomic variations of sphenoid sinus and sphenoid sinus ostium is important in terms of guiding the surgeon in the process of a successful transsphenoidal surgery.

Radiographic evaluation of third-molar development in relation to the chronological age of Turkish children in the southwest Eastern Anatolia region.

To study the chronological age of third-molar mineralisation of Turkish children from the southwest Eastern Anatolia region, the Demirjian staging method was used to determine the stage of the mineralisation of four third molars (18, 28, 38 and 48) and to compare third-molar development by sex and age with the results of previous studies. The study comprised 832 Turkish children from the southwest Eastern Anatolia region aged 6-16 years based on radiological evidence from digital orthopantomograms. The mean age of the 832 patients was 11.03±1.98 years, with 424 males (mean age, 10.97±1.97) and 408 females (mean age, 11.09±2.00). The orthopantomograms were scored by two observers. The Wilcoxon matched-pairs signed-rank test used to assess intra- and inter-observer assessment revealed strong agreement between both observers' measurements. Statistical analysis of the association between sex and age was performed with the Mann-Whitney U-test and the Wilcoxon test. Regression analysis was performed to obtain regression formulae for calculating the dental and the chronological age. The statistical analysis showed a strong correlation between age and third-molar development in males (R(2)=0.61) and females (R(2)=0.63). New equations (age=7.49+0.69, development stage (DS) 38+0.70, DS18) were derived for estimation of the chronological age. The results showed that there was no significant difference in mineralisation between 18 and 28 and 38 and 48 in males or females. For both sexes, the dental age was lower than the chronological age. Males reached the developmental stages earlier than females. In the whole population, the boys' and the girls' dental ages were 0.84 years and 0.16 years earlier, respectively, than their chronological ages. The use of third-molar teeth as a developmental marker is suitable, particularly when comparing the obtained standard deviation with other skeletal-age calculation techniques.