Evaluation of radiographic visibility of root pulp in mandibular second molars using cone beam computed tomography images for age estimation.

The purpose of this study is to estimate chronological age and determine whether individuals were aged under or over 18 years using root pulp visibility (RPV) in cone-beam computed tomography (CBCT) images. The study included CBCT images of 699 individuals aged between 15 and 75 years. One thousand twenty-three mandibular second molar (2M) teeth were evaluated using Olze's RPV method in four stages. Descriptive statistics of the stages and the relationship between the stages and the chronological age were assessed. The distribution of the stages was analyzed according to the 18-year age threshold. There was a positive correlation between RPV stages and chronological ages in both sexes. For females and males, the mean ages of stage 0, stage 1, and stage 2, for females and males, were found as 27.21, 28.93, and 33.68 years, and 37.69, 40.9, and 44.88 years, respectively. Stage 0 and stage 1 were found both in individuals aged under and over 18 years, and stage 2 and stage 3 were not observed in individuals aged under 18 years. The presence of stage 2 and stage 3 may be an indication that an individual is aged over 18 years according to Olze's RPV age estimation method. For more reliable results, 2M teeth should be examined bilaterally in forensic science.

DETERMINATION OF MANDIBULAR BONE CHANGES IN PATIENTS WITH PRIMARY HYPOTHYROIDISM TREATED WITH LEVOTHYROXINE SODIUM.

Background: This study aimed to assess fractal dimension (FD) and the radiomorphometric indexes on the digital panoramic radiography (DPR) of patient with primary hypothyroidism receiving levothyroxine sodium replacement therapy. Methods: A total of 115 subjects were included in this cross sectional retrospective study. According to the results of the thyroid function tests, the subjects were divided into two groups as primary hypothyroidism (levothyroxine sodium replacement therapy given), (n = 57) and the healthy control group (n = 58). The fractal dimension (FD), panoramic mandibular index (PMI), mandibular cortical width (MCW), gonial index (GI) and mandibular cortical index (MCI) values of all patients were calculated on DPRs. The statistical analysis of all data was performed with SPSS version 22. Results: The distributions of age and gender in the primary hypothroidism group were similar to control group (p = 0.19 and p = 0.62, respectively). The two groups did not differ statistically significantly in terms of FD, PMI, MCW, GI, and MCI. Conclusion: We determined that mandibular cortical and trabecular bone structure did not significantly differ between healthy individuals and patients receiving drug replacement theraphy due to hypothyroidism, but our results should be further supported with the investigation of clinical parameters.

The effect of type 2 diabetes mellitus on changes in the fractal dimension of periapical lesion in teeth after root canal treatment: a fractal analysis study.

AIM: This single-centre retrospective case-control study evaluated fractal dimension (FD) changes in radiographs of periapical lesions using a fractal analysis in healthy individuals and type 2 diabetes mellitus (DM) patients following root canal treatment. METHODOLOGY: The study data consisted of two groups: the DM group which contained a total of 46 mandibular molar teeth in 37 patients with no systemic disease other than type 2 DM, and the control group which contained a total of 52 mandibular molar teeth in 41 patients without systemic disease. Periapical radiographs were obtained prior to root canal treatment and 1 year post-treatment. Fractal analysis was performed by selecting a region of interest on the periapical radiographs. For both groups, the FD changes in lesion area were calculated and compared. In addition, periapical status was evaluated using the periapical index (PAI) scores on periapical radiographs for both groups. Data were analysed using dependent-sample t-test, independent-sample t-test, Wilcoxon signed-rank test and Mann-Whitney U-test. RESULTS: In both groups, FD values were increased significantly 1 year post-treatment as compared with those prior to treatment (P < 0.05). The time-dependent increase in FD was significantly greater in the control group (P < 0.05). Time-dependent increases in FD did not differ between genders (P > 0.05). There was a significant decrease in PAI scores in both type 2 DM and control groups depending on time (P < 0.05). No significant difference was found between the groups in terms of time-related decreases in PAI scores (P > 0.05). CONCLUSION: An increase in the FD of the periapical lesion area was observed 1 year after root canal treatment. DM had a negative effect on FD increase.

Shear bond strength of zirconia ceramic to the primary tooth dentin.

BACKGROUND: There is no information about the shear bond strengths (SBS) of zirconia ceramic to primary tooth dentin. AIM: To investigate the effect of different surface treatments and cements on the shear bond strength (SBS) of zirconia ceramic to primary tooth dentin. MATERIALS AND METHODS: Prepared zirconia bars were distributed into four groups according to surface treatment procedure: control, sandblasting, CoJet and hot etching. The zirconia specimens in each group were further divided into subgroups according to cement (n = 13): self-adhesive resin (Rely-X Unicem), resin-modified glass ionomer (Ketac-Cem Plus), and universal bioactive (BioCem). Zirconia specimens were bonded to the primary tooth dentin surface by cement. SBS was measured, and the data were subjected to two-way ANOVA and Tukey's tests. RESULTS: Statistical differences were observed in the surface treatment procedures for Rely-X Unicem (P < 0.05), but no statistically significant differences were found in the sandblasting, CoJet and hot-etching groups for Ketac-Cem Plus (P > 0.05). For BioCem, the SBS value for the hot etching group was significantly lower than those for the CoJet and sandblasting groups (P < 0.05). The SBS values for the Rely-X Unicem subgroups (sandblasting, CoJet and hot etching) were significantly higher than those for the other cements (P < 0.05). CONCLUSION: The bond strength of zirconia ceramic to primary tooth dentin is affected by surface treatments and cements.

Alteration of Exon Definition Causes Amelogenesis Imperfecta.

Amelogenesis imperfecta (AI) is a collection of genetic disorders affecting the quality and/or quantity of tooth enamel. More than 20 genes are, so far, known to be responsible for this condition. In this study, we recruited 3 Turkish families with hypomaturation AI. Whole-exome sequence analyses identified disease-causing mutations in each proband, and these mutations cosegregated with the AI phenotype in all recruited members of each family. The AI-causing mutations in family 1 were a novel AMELX mutation [NM_182680.1:c.143T>C, p.(Leu48Ser)] in the proband and a novel homozygous MMP20 mutation [NM_004771.3:c.616G>A, p.(Asp206Asn)] in the mother of the proband. Previously reported compound heterozygous MMP20 mutations [NM_004771.3:c.103A>C, p.(Arg35=) and c.389C>T, p.(Thr130Ile)] caused the AI in family 2 and family 3. Minigene splicing analyses revealed that the AMELX missense mutation increased exonic definition of exon 4 and the MMP20 synonymous mutation decreased exonic definition of exon 1. These mutations would trigger an alteration of exon usage during RNA splicing, causing the enamel malformations. These results broaden our understanding of molecular genetic pathology of tooth enamel formation.

Assessment of paranasal sinus parameters according to ancient skulls' gender and age by using cone-beam computed tomography.

BACKGROUND: The aim of this study was to determine whether paranasal sinus dimensions and volume can be useful to identify gender and age estimation for ancient skulls using cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS: CBCT scans of 32 ancient skulls of approximately 1000 years of age were included in this retrospective study. The gender and age estimation of the skulls were made by an independent anthropologist, which was considered as the gold standard. Paranasal sinuses' dimensions (width and height) and volumes of each sinus were measured from the CBCT data set that was linked to the three-dimensional rendering software (Anatomage, Invivo 5.2). All measurements were performed by an independent observer. Intra-observer analysis was made. Mann-Whitney and Kruskal-Wallis tests were used to compare paranasal sinus parameters in terms of age estimation and gender (p < 0.05). RESULTS: The results demonstrated no statistically significant difference between measurements (p < 0.05). The measurements were found to be highly reprodu- cible. The mean volumes of frontal and sphenoid sinus were found to be higher in males. The distance from anterior-posterior wall of sphenoid sinus in axial sec- tions is larger in males (p > 0.05). The frontal sinus width and volume increased statistically with age above 60 years of age (p > 0.05). CONCLUSIONS: The paranasal volume and dimensions' measurements from CBCT data can be a promising technique to determine gender and age of ancient skulls because of its lower voxel sizes and higher resolution.

Anatomical characteristics of the lingual foramen in ancient skulls: a cone beam computed tomography study in an Anatolian population.

BACKGROUND: The purpose of this study is to evaluate the anatomical features of lingual foramina and their bony canals in Anatolian ancient mandibles (9-10th century) by using cone beam computed tomography (CBCT). MATERIALS AND METHODS: Fifty-eight ancient dry mandibles were scanned with CBCT. Lingual foramina were grouped into midline, paramedian, posterior foramina and combination of these groups. Midline group was also classified according to internal surface of the mandible (gonial tubercles [GTs]). The incidence, vertical distance and diameter of lingual foramina were measured according to age groups and gender. RESULTS: The incidence of the lingual foramen was 96.6%. Midline of the symphysis had the highest incidence (34.4%) of foramina (p < 0.05), followed by both midline and paramedian type (32.8%; p < 0.05). Classification in terms of GT represented class 3 as the most encountered group (28.6%). Number of foramina observed in the mandibles ranged from 0 to 6 with the incidence of 3.4% and 32.8%, respectively. The male and < 35 years groups presented larger measurement values in midline region (p < 0.05). CONCLUSIONS: Mandibular lingual foramina and bony canals are frequently present in ancient mandibles. When compared with modern subjects, similar findings are observed according to published literatures. CBCT is also proved to be an effective imaging modality in the detection of lingual foramina and canals in anthropological studies.

Correlation between the visibility of submandibular fossa and mandibular canal cortication on panoramic radiographs and submandibular fossa depth on CBCT.

BACKGROUND: To identify a correlation between the submandibular fossa (SF) visibility and mandibular canal (MC) cortication on panoramic image and the depth of SF measured on CBCT and also correlation between the depth of SF and vertical and horizontal location of MC on CBCT. MATERIAL AND METHODS: 500 CBCT scans and panoramic radiographs were evaluated. SF depth types were classified as type I (< 2mm); type II (2-3mm) and type III (> 3mm) on CBCT. Visibility of SF and the cortication of MC on panoramic radiographs were compared with the depth of SF on CBCT. Distances between MC and mandibular inferior, buccal and lingual cortices were measured. RESULTS: No statistically significant correlation was found between radiolucent appearances of SF, cortication of MC, and depth of SF. The deepest part of the fossa was in the second molar area followed by third and first molars. Negative weak correlations were found between B-MC, L-MC distances and depth of SF. CONCLUSION: Visibility of SF and cortication of MC on panoramic radiographs did not correlate with the depth of SF. A marked radiolucent submandibular fossa on panoramic image does not undoubtedly indicate a deep fossa, which emphasizes the importance of 3-D imaging in implant planning.

Comparative evaluation of ankaferd blood stopper, ferric sulfate, and formocresol as pulpotomy agent in primary teeth: A clinical study.

AIM: The aim of the study was to provide a comparative evaluation of the clinical and radiographic success of Ankaferd blood stopper (ABS), formocresol (FC), and ferric sulfate (FS) as pulpotomy agent in primary teeth. SETTINGS AND DESIGN: This is a clinical study. MATERIALS AND METHODS: A total of 45 primary mandibular molar teeth in 26 children aged 6-9 were selected for the study. Teeth were randomly divided into three groups according to the pulpotomy agents (ABS, FC, FS). Following treatment, for 24 months, teeth were clinically and radiographically evaluated once every 3 and 6 months respectively. STATISTICAL ANALYSIS USED: SPSS version 15 software was used in data analysis. Kaplan- Meier, Log Rank and Fisher's exact tests were used to analysis. RESULTS: After follow-up periods ranging from 6 to 24 months (average 20.8±0.56), the clinical success rates for ABS, FC, and FS were 87%, 87%, and 100% respectively. The overall radiographic success was 87%, 80%, and 87%. When success rates of the ABS were compared with other agents, there were no significant differences between groups (P > 0.05). CONCLUSION: Similar success was achieved in the pulpotomy treatment of primary teeth that using ABS, FC, and FS. ABS would be considered a suitable agent for pulpotomy treatment and can be used as an alternative to other agents.

The perinatal effects of maternal caffeine intake on fetal and neonatal brain levels of testosterone, estradiol, and dihydrotestosterone in rats.

Testosterone, estradiol, and dihydrotestosterone are the main sex steroid hormones responsible for the organization and sexual differentiation of brain structures during early development. The hypothalamo-pituitary-adrenocortical axis, adrenal cells, and gonads play a key role in the production of sex steroids and express adenosine receptors. Caffeine is a non-selective adenosine antagonist; therefore, it can modulate metabolic pathways in these tissues. Besides, the proportion of pregnant women that consume caffeine is ∼60%. That is why the relationship between maternal caffeine consumption and fetal development is important. Therefore, we aimed to investigate this modulatory effect of maternal caffeine consumption on sex steroids in the fetal and neonatal brain tissues. Pregnant rats were treated with a low (0.3 g/L) or high (0.8 g/L) dose of caffeine in their drinking water during pregnancy and lactation. The testosterone, estradiol, and dihydrotestosterone levels in the frontal cortex and hypothalamus were measured using radioimmunoassay at embryonic day 19 (E19), birth (PN0), and postnatal day 4 (PN4). The administration of low-dose caffeine increased the body weight in PN4 male and female rats and anogenital index in PN4 males. The administration of high-dose caffeine decreased the adrenal weight in E19 male rats and increased testosterone levels in the frontal cortex of E19 female rats and the hypothalamus of PN0 male rats. Maternal caffeine intake during pregnancy affects sex steroid levels in the frontal cortex and hypothalamus of the offspring. This concentration changes of the sex steroids in the brain may influence behavioral and neuroendocrine functions at some point in adult life.

Clinical performance of a glass ionomer sealant protected with two different resin-based agents over a 2-year follow-up period.

AIM: To evaluate the effects of two different resin coating materials on the clinical performance of a conventional glass ionomer sealant. MATERIALS AND METHODS: Permanent first mandibular molars of 60 children aged 6-9 years were sealed with Fuji VII. In each child, G-Coat Plus coating agent was applied to molars on one side and Heliobond coating agent to molars on the opposite side of the mouth. Clinical evaluations were carried out at 1, 6, 12, 18 and 24 months after sealant and coating application. RESULTS: At 1, 6, 12, 18 and 24 months after sealant and coating application, total sealant retention rates were 88%, 40%, 19%, 15% and 9% for molars coated with G-Coat Plus, and 93%, 47%, 17%, 15% and 7% for those coated with Heliobond. The differences between the two coating agents were not statistically significant (p>0.05). No incidence of caries was observed in either group during the two-year evaluation period. STATISTICS: Wilcoxon signed rank test was used to compare differences in retention rates and caries incidence by coating agent. CONCLUSION: Although retention rates of Fuji VII were relatively low and similar for both resin coating agents tested, dental caries were not observed in either group during the 24-month study period. In children with a high risk of caries and partially erupted molars, the use of a glass ionomer sealant with a resin-based coating agent should be encouraged.

Eruption cysts: A series of 66 cases with clinical features.

BACKGROUND: An eruption cyst (EC) is a benign, developmental cyst associated with a primary or permanent tooth. This paper presents 66 ECs in 53 patients who reported to 3 different centers in Turkey between 2014-2015. MATERIAL AND METHODS: 53 patients (31 male, 22 female) with 66 ECs were diagnosed and treated over a 1-year period. The mean age of patients was 5.4 years (minimum 5 months, maximum 11 years). Clinical examination and periapical radiographs were used to establish diagnosis. Age, gender, site, history of trauma and type of treatment were recorded. RESULTS: Of the 66 ECs diagnosed in 53 patients, more than half (56.6%) were located in the maxilla, with the maxillary first primary molars the teeth most commonly associated with ECs (30.3%). Multiple ECs were diagnosed in 13 of the 53 patients. ECs had previously diagnosed in the primary dentition of 2 patients, 3 patients reported a history of trauma to primary teeth. In the majority of patients (46 cases, 86.8%), no treatment was provided, whereas surgical treatment was provided in the remaining 7 cases (13.2%). CONCLUSIONS: Eruption cysts are usually asymptomatic and do not require treatment;. however, if the cyst is symptomatic, it should be treated with simple surgical excision.

Comparative evaluation of mineral trioxide aggregate and bioaggregate as apical barrier material in traumatized nonvital, immature teeth: A clinical pilot study.

BACKGROUND: Clinical research examining the use of mineral trioxide aggregate (MTA) as an apical barrier material are limited, and no studies have so far examined the clinical performance of BioAggregate as apical barrier material in nonvital immature teeth. AIM: This study was aimed to provide a comparative evaluation of the clinical and radiographic success of MTA and BioAggregate as an apical barrier material in children with traumatized nonvital, immature permanent maxillary incisors. SUBJECTS AND METHODS: A total of 26 maxillary incisor teeth in 20 children aged 7-11 were chosen for this study. Teeth were randomly divided into two groups according to the material to be applied, and the apical barrier was performed. Following treatment, for 24-month, teeth were clinically and radiographically evaluated once every 3- and 6-month, respectively. RESULTS: All teeth treated with MTA and BioAggregate were clinically and radiographically successful throughout the 24-month follow-up period. CONCLUSIONS: Similar success was achieved in the apical barrier that using BioAggregate and MTA. BioAggregate would be considered suitable materials for apical barrier technique and can be used as an alternative to MTA.

Erratum:Preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as new prognostic factors for patients with colorectal cancer.

In this article published in Volume 21, issue 5, the authors' names appeared in the Pubmed abstract as: "Mahsuni Sevinc M, Riza Gunduz U, Kinaci E, Armagan Aydin A, Bayrak S, Umar Gursu R, Gunduz S". The correct authors' names are: "Sevinc MM, Gunduz UR, Kinaci E, Aydin AA, Bayrak S, Gursu RU, Gunduz S" This error appeared only in the PubMed database and not in the print form of the Journal.

Carcinoid tumor of the cecum presenting with acute appendicitis: a case report.

BACKGROUND: Acute appendicitis is the most common cause of acute abdomen. Carcinoid tumor of the appendix is a rare incidental finding that can present with the clinical picture of acute appendicitis. CASE REPORT: During open surgery for acute appendicitis, a 3 cm solid mass, not noticed externally, was palpated at the base of the appendix. The mass and the appendix were excised by en-bloc wedge resection. The histopathological examination of the lesion revealed carcinoid tumor. CONCLUSION: The aim of this presentation is to remind that neoplasms of the appendix may, although rarely, present the clinical picture of acute appendicitis, and to highlight that they, particularly those located at the base of the appendix and in cecum, may be overlooked during laparoscopy. The importance of preoperative computerized tomography ins uch cases has to be underlined.

Clinical and radiological evaluation of calcium sulfate as direct pulp capping material in primary teeth.

AIM: To evaluate the clinical and radiological response of primary molars to direct pulp capping with calcium sulfate hemihydrate. MATERIALS AND METHODS: Forty primary molar teeth in 40 healthy children aged 5-9 years were treated by direct pulp capping. Teeth were randomly assigned to two groups (n=20) according to material used for capping, as follows: Group 1: calcium hydroxide cement (Dycal); Group 2: calcium sulfate hemihydrate (Dentogen). All teeth were restored with a conventional glass ionomer base (Fuji IX) and amalgam. RESULTS: After 12 months, the overall success rate of direct pulp capping was approximately 75% (24/32 teeth, excluding exfoliations). The success rate did not differ significantly between calcium hydroxide and calcium sulfate hemihydrate treatment. CONCLUSION: Calcium sulfate hemihydrate was found to be as successful as calcium hydroxide for direct pulp capping of primary molars with Class I cavities. Further histological studies are needed to support these findings.

The effects of surface pretreatment on the microleakage of resin-modified glass-ionomer cement restorations.

OBJECTIVE: To evaluate the effect of different surface pretreatments on the marginal microleakage of Vitremer restorations. STUDY DESIGN: Class V cavities were prepared on the labial and lingual surfaces of extracted human third molar teeth. Cavities were randomly distributed into six groups according to surface treatment, as follows: Group NC (negative control): no surface treatment; Group VP (positive control): Vitremer Primer; Group PA: 32% phosphoric acid; Group PAA: 20% polyacrylic acid; Group PLP: self-etch adhesive (Prompt L Pop); Group PB: etch & rinse adhesive (Prime & Bond NT). All cavities were restored with Vitremer. Teeth were thermocycled, stained with 0.5% basic fuchsin dye and sectioned. Microleakage values were quantitatively assessed by linear measurement of dye penetration using image-analyzing software. Differences between occlusal and gingival microleakage values within groups were evaluated using paired t-tests, and differences among groups were analysed using one-way analysis of variance (ANOVA) and Tukey tests. RESULTS: There were statistically significant differences between the occlusal and gingival microleakage values for all groups (p < 0.05). Microleakage differed significantly among surface pretreatment groups (p < 0.001). The negative control and PLP groups showed similar microleakage values, but were significantly higher than other groups for both margins. Although there were no statistically significant differences between positive control and PA, PAA, PB groups, microleakage values of positive control group were smaller than all other experimental groups except for PB group. CONCLUSIONS: Vitremer restorations require surface pretreatment to prevent excessive microleakage. Pretreatment with etch & rinse adhesives and Vitremer Primer may reduce microleakage of Vitremer restorations.

Evaluation of microtensile bond strength of different fissure sealants to bovine enamel.

BACKGROUND: The aim of this study was to evaluate the microtensile bond strength (µTBS) of a new fissure sealant and compare it with conventional sealants which are applied to enamel alone, and also with self-etch and etch-and-rinse adhesives. METHODS: Enamel specimens were prepared and randomly distributed into three groups according to fissure sealant (Aegis, Helioseal F, Helioseal Clear). Each group was then subdivided according to adhesive system (Clearfil S3, Single Bond, no adhesive). A universal testing machine was used to measure µTBS, and data were analysed using one-way ANOVA and Tukey's tests. RESULTS: µTBS values for all Aegis subgroups were significantly lower than for comparable Helioseal F and Helioseal Clear subgroups (p < 0.05). No differences were observed in µTBS of Helioseal F and Helioseal Clear (p > 0.05). In the Helioseal Clear group, µTBS values for Single Bond were significantly higher than for Clearfil S3 (p < 0.05). However, no significant differences were found between the µTBS values of the adhesive subgroups in the Aegis or Helioseal F groups (p > 0.05). CONCLUSIONS: Sealant µTBS values may be affected by material content. The addition of an adhesive may improve µTBS values of sealant to enamel.

Evaluation of certain risk factors for early childhood caries in Samsun, Turkey.

AIM: Early childhood caries (ECC) is a relatively new term used to describe any stage of caries lesion in any primary tooth surface in a child under 6 years of age. The purpose of this study was to identify certain factors that influence the development of ECC among children in Samsun, Turkey. MATERIALS AND METHODS: Data were collected for 226 children (108 girls, 118 boys) aged 3-6 years. Questionnaires were administered to the mothers of participating children to obtain information on infant feeding habits and the mother's level of education and oral health knowledge. Clinical diagnoses of ECC were based on intraoral examinations conducted using a flashlight, disposable mirror and wooden tongue depressor. RESULTS: ECC was diagnosed in 46.9% of children. The mean dmf-t was 2.87. Significant associations were found between ECC prevalence and bottle feeding while sleeping and between ECC and the mother's level of education (p<0.05). The caries rate increased with the addition of sugar-containing substances to bottles; however, the increase was not statistically significant (p>0.05). There were no correlations observed between ECC and the mother's oral health knowledge or attitude (p>0.05). CONCLUSION: Within the limitation of this study, among the various factors investigated, infant feeding habits and the mother's level of education were found to have significant effects on the development of ECC.

Usage of white mineral trioxide aggregate in a non-vital primary molar with no permanent successor.

The aim of this study was to present the treatment and long-term follow-up of a case in which white mineral trioxide aggregate (WMTA) was used in the pulpectomy of a non-vital primary molar with no permanent successor. The physiological, aesthetic and functional consequences of treating primary teeth without permanent successors makes this a unique challenge. In the present case, WMTA was used in the pulpectomy of a primary molar with no permanent successor in an 8-year-old child. The treatment was considered successful. Follow-up examinations showed that root resorption in the mesial root surface, with no infra-occlusion or ankylosis 36 months after treatment. WMTA may be considered as an alternative pulpectomy material for non-vital primary teeth with no permanent successors, although long-term clinical studies are still needed.