Evaluation of two different rapid maxillary expansion surgical techniques and their effects on the malar complex based on 3d cone-beam computed tomography.

We compared and evaluated the effects of two techniques used for surgically assisted rapid maxillary expansion (SARME) using three-dimensional (3D) cone-beam computed tomography, focusing on changes in soft and hard tissue in the malar region. A conventional Le Fort I osteotomy group (10 patients, mean age: 19.3 years) and a high Le Fort I group (12 patients, mean age: 20.4 years) underwent 3D analyses. Changes in hard and soft tissue of the malar region were compared. The average increases in the bone malar width and soft malar width in the high Le Fort I group between the pre- and postoperative periods were 1.43 ± 1.23 and 1.39 ± 1.19 mm, respectively. The average increases in the bone malar depth on the right and left sides in the high Le Fort I group were 1.34 ± 0.81 and 1.60 ± 0.54 mm, respectively. Progress in hard tissues did not reflect significant changes in soft tissue. CONTEXT: Effects of high Le Fort I SARME on the malar complex. AIMS: To compare and evaluate the effects of two techniques used for SARME, using 3D cone-beam computed tomography, focusing on changes in hard and soft tissues in the malar region. SETTINGS AND DESIGN: A conventional Le Fort I osteotomy group (10 patients, mean age: 19.3 years) and a high Le Fort I group (12 patients, mean age: 20.4 years). METHODS AND MATERIAL: Each group underwent 3D analyses, and changes in hard and soft tissues of the malar region were compared. STATISTICAL ANALYSIS USED: The SPSS software (ver. 15.0 for Windows) was used. The Kolmogorov-Smirnov test, Student's t test, and paired-samples test were conducted. RESULTS: The average increases in the bone malar width and soft malar width in the high Le Fort I group between the pre- and postoperative periods were 1.43 ± 1.23 and 1.39 ± 1.19 mm, respectively. The average increases in the bone malar depth on the right and left sides in the high Le Fort I group were 1.34 ± 0.81 and 1.60 ± 0.54 mm, respectively. CONCLUSIONS: Progress in hard tissues did not reflect significant changes in soft tissue.

Conservative surgical treatment of the jaw cysts in children: Case study of five patients.

AIMS: Conservative treatment of jaw cysts establishes low surgical complication risk and protects vital anatomical structures such as inferior alveolar nerve, maxillary sinus and permanent tooth germs. Marsupialization and decompression have been widely used in children. The aim of this study was to evaluate the results of the conservative treatment of jaw cysts in five children. MATERIALS AND METHODS: This article presents case series of marsupialization in jaw cysts associated with impacted teeth in five children. A total of nine impacted teeth within the cystic lesions were observed. RESULTS: Complete resolution of all cystic lesions and simultaneous eruption of six impacted teeth within the cyst were managed. The other two teeth were erupted orthodontically and one had to be extracted. CONCLUSIONS: Marsupialization is effective for the treatment of cystic lesions in growing patients as it preserves vital anatomical structures and enables eruption of the impacted teeth within the cyst.

Is 2 mm a safe distance from the inferior alveolar canal to avoid neurosensory complications in implant surgery?

AIM: The aim of the present study was to compare the neurosensory complications related to implants inserted closer than 2 mm to the inferior alveolar canal (IAC) with those inserted further than 2 mm. MATERIALS AND METHODS: A total of 474 implants in 314 patients placed posterior to mental foramen area were evaluated retrospectively on panoramic radiographs. Patients were divided into two groups regarding implant proximity to the IAC (Group 1, distance ≤2 mm, Group 2, distance >2 mm). Postoperative neurosensory complications (pain and paresthesia) were recorded. Chi-square test was used for statistical comparison and P ≤ 0.05 was considered significant. RESULTS: One hundred and fifty-three implants (32.2%) were inserted closer than 2 mm to the IAC whereas 321 implants (67.8%) were inserted further than 2 mm. Three implants which had a distance of 0 mm to the IAC (0.63%) caused paresthesia after surgery. Implant distance to IAC did not show a significant difference regarding pain and paresthesia (P = 0.06 and P = 0.08, respectively). CONCLUSION: When 2 mm is considered as a safety distance, the distance of the implants to the IAC did not yield any statistical difference regarding postoperative neurosensory complications.

Evaluation of articular eminence pneumatization using cone beam computed tomography.

AIM: Knowledge about the anatomy of the temporomandibular joint (TMJ) and its surrounding structures is mandatory for success in surgical interventions and for understanding the pathway of spread of infections in this region. This study aims to investigate the anatomy and morphology of pneumatized articular eminence (PAT) using cone beam computed tomography (CBCT) imaging in a group of patients. METHODS: A retrospective study on 825 patients (377 males, 448 females) aged between 18 and 91 years was performed using sagittal and coronal CBCT images. PAT was defined as non-expansile, nondestructive cyst-like radiolucency in the zygomatic process of the temporal bone, which appears similar to the mastoid air cells. It was classified in two groups as unilocular and multilocular. Statistical comparison of gender, age and localization was performed using chi-square test and correspondence analysis. P<0.05 was considered as significant. RESULTS: Twenty-eight pneumatized articular eminence were found in 21 patients, representing a prevalence of 2.54%. Patients with PAT had a mean age of 28.9 years with a range of 21-78 years. Ten cases (47.6%) occurred in females and 11 cases (52.4%) occurred in males. The results of statistical tests showed no significant differences among the groups with respect to gender, age, and localization (P>0.05). CONCLUSION: Pneumatization of the articular eminence is a challenging entity for TMJ surgery and spread of infections in this region. Practitioners who are dealing with TMJ surgery and pathology should have detailed information about this anatomical variation since it may cause serious complications.

Do antibacterial mouthrinses affect bacteraemia in third molar surgery? A pilot study.

BACKGROUND: The aim of this pilot study was to evaluate the effects of mouthrinses containing 7.5% povidone iodine and 0.2% chlorhexidine on bacteraemia following impacted third molar surgery. METHODS: Thirty-four patients were enrolled in this study. Patients in the first group were asked to rinse their mouth with the mouthrinse containing 7.5% povidone iodine, patients in the second group were asked to rinse with the mouthrinse containing 0.2% chlorhexidine and patients in the third group were asked to rinse with 0.9% NaCl (sterile saline) solution. All rinses were used for one minute preoperatively. Peripheral venous blood samples were collected at baseline (preoperatively), 1 and 15 minutes after the completion of surgical tooth removal. Each blood sample was divided in two, placed in aerobic and anaerobic culture bottles and processed for microbiological examination. RESULTS: Bactaeremia was detected in 33% of the povidone iodine group, 33% of the chlorhexidine group and 50% of the control group. Isolated bacteria were 58% anaerobes and predominantly 92%Streptococcus species. Incidence of bacteraemia was reduced with chlorhexidine and povidone iodine mouthrinses in third molar surgery, although the difference was not statistically significant (p > 0.05). CONCLUSIONS: Bacteraemia was reduced with antibacterial mouthrinses in third molar surgery. The results of this study should be confirmed with further studies conducted on a larger patient population and with different antibacterial mouthrinses.

Investigation of pneumatized articular eminence in orthodontic malocclusions.

OBJECTIVES: To investigate the prevalence and characteristics of pneumatized articular tubercule (PAT) or eminence in an orthodontic patient population and to examine the possible correlations between different orthodontic malocclusions and pneumatized articular eminence types. SETTING AND SAMPLE POPULATION: Department of Orthodontics, Faculty of Dentistry, Ankara University, Turkey. MATERIAL AND METHODS: Pre-treatment panoramic radiographs were evaluated retrospectively from files of 1405 children and adolescents (459 boys and 946 girls) having various types of malocclusions. Diagnosis of PAT on the radiographs was recorded only if unequivocal pneumatization of the articular eminence could be seen or if the defect was located in the articular eminence posterior to the zygomaticotemporal suture, as a well-defined unilocular- or multilocular radiolucency. PAT was classified as unilocular or multilocular and unilateral or bilateral. Chi-square test was performed to evaluate age, gender, localization, type of malocclusion and prevalence differences. RESULTS: Sixty-six pneumatized articular eminences were found in 48 patients, representing a prevalence of 3.42%. The results of chi-square test showed no statistically significant differences considering age (p = 0.516), gender (p = 0.719), type of malocclusion (p = 0.155) and localization (p = 0.738). CONCLUSIONS: A relatively high rate of pneumatized articular eminence was observed among patients with orthodontic malocclusions (3.42%) when compared to the general population studies. Knowledge about these structures is helpful for the interpretation of cephalometric and panoramic radiographs and provides valuable information especially prior to temporomandibular joint surgery to avoid intra-operative reconstruction and complications.

Magnetic resonance imaging evaluation of mandibular condyle bone marrow and temporomandibular joint disc signal intensity in anaemia patients.

OBJECTIVES: To compare the signal intensity (SI) of mandibular condyle bone marrow (MCBM) and the temporomandibular joint (TMJ) disc in patients with chronic anaemia and healthy subjects, and to investigate the relationships between bone marrow changes, age, types of anaemia and severity of anaemia. METHODS: MRIs of 18 patients with chronic anaemia were compared with those of 12 healthy subjects. The SI of MCBM and the TMJ disc were quantitatively evaluated. The SI of the grey matter (GM), white matter (WM) and the lateral pterygoid muscle were also investigated. Relationships between age, MCBM and TMJ disc signal-intensities and anaemia severity, and correlations between the groups, were analysed. RESULTS: The mean MCBM SI was lower in anaemia patients (including both subgroups and also separately) than in healthy subjects (P < 0.05). No statistical significance was found for GM, WM and the muscle SI between the anaemia patients and healthy patient group (P > 0.05). No statistical significance was found between the groups with respect to the anterior band, whereas the mean SI value of the posterior band in the study group was significantly lower than in healthy subjects (P < 0.05). There were no correlations between age and MCBM SI, or between anaemia severity and MCBM SI. CONCLUSIONS: Anaemia may cause bone marrow alterations without any internal derangement. Patients with chronic anaemia exhibit lower mandibular condyle bone marrow and posterior band SI than healthy subjects.

Radiographic evaluation of pneumatized articular eminence in a group of Turkish children.

OBJECTIVES: The purpose of this study was to determine the prevalence and characteristics of patients with pneumatized articular eminence (PAT) in a group of Turkish children in order to make a contribution to pneumatization phenomenon in childhood. METHODS: 1049 panoramic radiographs were retrospectively evaluated. PAT was defined as non-expansile, non-destructive cyst-like radiolucency in the zygomatic process of the temporal bone, which appears similar to the mastoid air cells. It was classified as unilocular or multilocular on the radiograph. Statistical comparison of gender, age and localization was performed using a chi-square test (P<0.05). RESULTS: Twenty-four pneumatized articular eminences were found in 17 patients, representing a prevalence of 1.62%. Patients with pneumatized articular eminence had a mean age of 11.2 (SD 3.13) years with a range of 7-16 years. Eight cases (47.1%) occurred in girls and nine cases (52.9%) occurred in boys. The results of statistical tests showed no statistically significant differences among the groups with respect to gender, age and localization (P<0.05). CONCLUSIONS: Pneumatization of accessory air cells begins before puberty, contrary to the general opinion and statements. Knowledge about these structures is helpful for the interpretation of imaging such as panoramic radiographs and provides valuable information to understand the spread and differential diagnosis of pathological entities in this region.

Evaluation of gustatory function in postmenopausal women.

OBJECTIVE: The aim of this study is to evaluate the gustatory function in postmenopausal women. SUBJECTS AND METHODS: Whole mouth taste test and spatial taste test were administered to 20 postmenopausal women (Group 1) and 20 age-matched male subjects (Group 2). Further investigations were carried out for subjective assessment of taste alteration and nutritional differences between premenopausal and postmenopausal periods. RESULTS: There was a significant reduction in sucrose perception and in palatal sensitivity in postmenopausal women (p<0.05). Only 7(35%) of the female patients noticed alteration in taste perception during the postmenopausal period. Alteration in dietary habits after menopause was reported by 9 (45%) patients. CONCLUSION: This study demonstrates that taste perception of the tongue does not change, but that there is a disorder in palatal perception in postmenopausal women. Furthermore, there is tendency to preference of sweeter foods during menopause.