Direct-Acting Oral Anticoagulant/Vitamin K Antagonists: Do They Affect the Trabecular and Cortical Structure of the Mandible?

BACKGROUND: This study aimed to evaluate the mandibular bone structure of patients using oral anticoagulants (OACs) vitamin K antagonist drugs (warfarin) and other OACs including direct oral anticoagulants [(DOACs) apixaban, rivaroxaban, dabigatran, edoxaban]. Analyses were based upon the fractal dimension (FD), the panoramic mandibular index (PMI) and the Klemetti index (KI), which is also known as the mandibular cortical index (MCI). METHODOLOGY: Ninety participants were divided into three groups: group 1: 30 systemically healthy individuals who had not used any anticoagulants before, group 2: 30 individuals using warfarin, and group 3: 30 individuals using DOACs. FD was used to analyze trabecular bone architecture in the condyle, angle, and two sites in the alveolar bone. PMI was used to evaluate the quantity of cortical bone and KI was used to evaluate the cortical bone quality. RESULTS: There was no difference between the groups regarding FD analysis and KI; however, a difference was found between groups 1, 2, and 3 in the PMI (P≤ 0.001). The PMI in group 1 was higher than in groups 2 and 3. CONCLUSION: Mandibular radiomorphometric indices can be used on panoramic radiographs to evaluate the quantity of mandibular cortical bone in patients using oral anticoagulants.

The relationship of the position of mandibular third molar impaction with the development of dental and periodontal lesions in adjacent second molars.

OBJECTIVE: The aim of this study was to evaluate the effect of different positions of Mandibular third molar impaction teeth on dental and periodontal lesions of mandibular second molars and correlate the lesion severity with patient age. MATERIALS AND METHODS: This retrospective study assessed 212 CBCT images of patients who visited the department of Oral and Maxillofacial radiology of XX university between 2017 and 2021. Periodontal and dental lesion effects of impacted third molars on mandibular second molars were evaluated. While dental lesions were classified as mild, moderate, and severe, periodontal lesions were classified as mild in cases not exceeding 2/3 of the root, and severe in cases exceeding 2/3 of the root. Pearson's chi-square tests, Mann-Whitney U or Kruskal-Wallis test were used for data analsis. A multivariate logistic regression model was constructed for further analysis. RESULTS: Periodontal lesions were frequently observed in the second molar adjacent to the third molar (157 teeth, 74.1%), dental lesions were observed in 10%. Among the third molar positions, the mesioangular position was associated with a high (88%) prevalence of periodontal lesions (p<0.001), followed by the horizontal position (71%). The periodontal lesion was more severe in cases 30-39 years old and over 40 years old than in cases under 20 years old and 21-24 years old. Distoangular, horizontal and vertical/inverse positions are less likely to increase the severity of the periodontal lesion than the mesioangular position. (OR = 0.02; p <0.001, OR = 0.28; p =0.008, OR = 0.14; p <0.001,respectively). CONCLUSIONS: The third molars are often impacted in the mesioangular position, and this position most increases the risk of periodontal infection in the second molars. Accurate diagnosis and evaluation can minimize complications, and CBCT is a reliable imaging technique in which the position of the third molars and their relationship with the 2nd molars can be evaluated.

Is Online Video a Suitable Source to Obtain Sufficient and Useful Information About Peri-Implantitis?

PURPOSE: Recently, with the increase in cases of peri-implantitis, the amount of data patients can receive via social media about the condition has increased. The study presented here aims to examine what online videos (YouTubeTM, Google LLC, San Bruno, California) offer patients about peri-implantitis and to evaluate the quality of the information presented. MATERIALS AND METHODS: In this cross-sectional study, a systematic search was conducted into online videos containing information about peri-implantitis using the keyword "peri-implantitis" by an experienced periodontologist. The source of videos, video type, duration, number of days since upload, number of views, comments, likes, dislikes, and interaction index of each video were recorded. Videos were scored according to content; Score 0 (low content): videos with no description of clinical presentations, risk factors, or management options; Score 1 (moderate content): videos that described 1 clinical presentation and 1 etiologic factor and did not describe management options; Score 2 (high content): videos with the description of at least 2 clinical presentations, 2 etiologic factors, and 1 management option. The quality of each video was evaluated using the Global Quality Scale and DISCERN. Data were analyzed using the Kruskal-Wallis test, Spearman's test, and multinomial logistic regression analysis. Intraobserver agreement was calculated as the intraclass correlation coefficient. RESULTS: The first 200 videos were screened and, after exclusions, 103 videos were included for further analysis. United States-based videos were the majority (14 videos), 46.6% of the videos were uploaded by healthcare professionals, and 99% were in the educational videos category. Video content score 2 videos have higher mean values with 4,871.945 views, 6.002 comments, 50.729 likes, 7.751 viewing rate, and 0.023 interaction index than score 0 videos (P < .05). Statistically significant positive correlations were found between the video content score, Global Quality Scale, DISCERN, and the data showing the popularity and visibility of the videos (P < .01). CONCLUSIONS: Overall, half of the top-ranked online videos are valuable sources of information about peri-implantitis. Videos with high content are more popular and are of greater quality than videos with low content.

Does YouTube™ provide reliable information on oral candidiasis?

OBJECTIVE: To evaluate the quality, source, usefulness and/or reliability, visibility, and popularity of YouTube™ videos on oral candidiasis. MATERIALS AND METHODS: A YouTube™ search for "oral candidiasis" was performed, setting the English language. 133 of the 351 videos watched were included in the study. Two periodontologists scored the videos for visibility, popularity, quality, utility, and reliability. Videos' quality was evaluated using the DISCERN and the Global Quality Scale (GQS) tools, by categorizing them through quality assessment, source, duration, views, likes, and dislikes of each video were noted. RESULTS: 82.7% of the videos were moderately or very useful, and the GQS scores were mostly good (41.4%-Score 4) and excellent (42.1%-Score 5). Significant relationships were obtained between Source of Upload, Video Type, Total Discern, and GQS variables and Usefulness scores (p < 0.05). The 53.4% of the video sources were Healthcare professionals and their video usefulness scores were mostly "moderately useful" (47.9%) and "very useful" (%42.3). There was a significant positive correlation between the usefulness scores of the videos and the number of likes (p = 0.004), comments (p = 0.019), and the viewing rate (p = 0.006). CONCLUSIONS: The videos that rank high in searches for oral candidiasis on YouTube™ are mostly useful and comprehensive videos uploaded for educational purposes.

In vivo evaluation of mandibular trabecular and cortical bone quality in psoriasis vulgaris.

OBJECTIVE: The aim of this study was to evaluate the effects of psoriasis vulgaris on mandibular structure by calculating fractal dimension (FD) and radiomorphometric indices. STUDY DESIGN: Panoramic radiographs of 58 patients with psoriasis and 58 healthy participants were assessed. FD was used to analyze trabecular bone architecture in the condyle, angle, and 2 sites in the alveolar bone. Five radiomorphometric indices based on cortical thickness and the mandibular cortical index (MCI) for structure were used to assess cortical bone porosity. Comparisons were made between sites in trabecular and cortical bone. Quantitative and categorical data were statistically analyzed with the significance level at P < .05. RESULTS: FD was significantly lower in the patients with psoriasis than in the controls in the alveolar bone sites (P ≤ .035). Differences between measurement sites were insignificant in psoriasis (P ≥ .617), but the FD values of some measurement sides in the control group differed significantly (P ≤ .004). All quantitative radiomorphometric indices were significantly lower in patients with psoriasis (P ≤ .034) with significant differences between some sites in both groups. No significant difference was found in MCI frequency distribution between the groups (P = .782). CONCLUSIONS: Trabecular architecture and cortical thickness were negatively affected in patients with psoriasis, but no differences in cortical porosity were detected between groups.

Measurement of the trabecular bone structure of the TMJ region in patients with transverse maxillary deficiency: a CBCT fractal analysis study.

OBJECTIVE: This study aimed to evaluate the effect of transverse maxillary deficiency on condylar morphology via visual examination and fractal analysis of cone beam computed tomography (CBCT) scans. STUDY DESIGN: In total, 97 patients with posterior crossbite or maxillary narrowness and 36 control patients were included. The presence of degenerative changes in the bilateral condyles was evaluated with CBCT. Fractal dimension (FD) was calculated on the condylar images using ImageJ. RESULTS: Degenerative bone changes were discovered in 38 of the 133 scans (28.6%). There was no significant difference between the groups in terms of the incidence of degenerative changes for either the right or left sides (P ≥ .670). In coronal sections and in mean measurements, FD was significantly lower in the control group compared with the other groups in the right condyle (P ≤ .031). No significant differences were found between the mean FD values of the condyles with degenerative bone changes or the mean FD values of the normal condyles (P ≥ .256). CONCLUSIONS: In the presence of maxillary transverse deficiencies, degenerative bone changes in the mandibular condyle were not significantly different, but the FD of the right condyle was found to be higher compared with the control group.

Dental and temporomandibular joint alterations in rheumatoid arthritis patients and their association with salivary oxidative stress

Background/aim: Rheumatoid arthritis (RA) is the most extensive inflammatory arthritis causing permanent deformities in the joint. Increasing evidence suggests that oxidative stress is a substantial factor in the pathogenesis of RA. This study aimed to examine the salivary oxidant-antioxidant status of RA and control groups and to compare these biomarkers by correlating them with disease activity, acute phase reactants, and clinical findings. Materials and methods: Age and sex-matched 60 participants including 30 patients with RA and 30 control (50 females, 10 males; mean age: 42.62 ± 10.89 years) were evaluated. RA disease activity and severity were evaluated by the disease activity score 28-C reactive protein (DAS 28-CRP). Rheumatoid factor (RF) positivity, anticitrullinated protein antibodies (ACPA) positivity, erythrocyte sedimentation rate (ESR), CRP, tender and swollen joint counts, and medical treatment regimens of the patients (glucocorticoids, conventional or biologic disease-modifying antirheumatic drugs) were recorded. In the radiographic examination, dental findings, and bone alterations of the temporomandibular joint (TMJ) were recorded and compared for both groups. Saliva samples were obtained for analysis of total antioxidant status (TAS), total oxidant status (TOS), arylesterase (ARE), and oxidative stress index (OSI) levels. The data analysis was conducted by independent sample t-test and chi-square test. Results: Condylar erosion was the most common radiographic change in TMJ of RA patients. Osteophyte formation was a prominent finding in the control group. Lower TAS and higher OSI levels were found in RA patients compared with controls (p = 0.013; p = 0.029, respectively). The effect of DAS 28-CRP score on the levels of oxidative stress biomarkers in RA patients was not significant. Conclusion: Oxidative stress causes tissue damage in response to excessive mechanical loading, which in turn promotes TMD. However, disease activity has not a prominent impact on the salivary oxidative stress status of RA patients.

Determination of Root Canal Length Up to Perforation Area Using Different Electronic Apex Locators and CBCT Images Obtained at Different Voxel Sizes: A Comparative Ex Vivo Study.

OBJECTIVE: To compare the accuracy of electronic apex locators in the presence of blood and CBCT images obtained with two different voxel sizes (0.125 mm and 0.25 mm) in determining root canal length up to the perforation area. METHODS: Forty extracted, single-rooted human teeth were selected and an artificial root perforation (0.4 ± 0.1 or 1.0 ± 0.2 mm diameter) was created in the middle third of the root. The actual root canal length up to the perforation area was determined under a stereomicroscope. CBCT images were obtained with a voxel size of 0.125 mm and 0.25 mm. The root canal length up to the perforation area was measured on CBCT images and recorded as the radiographic length. The teeth were embedded in alginate and root canal length up to the perforation area was measured using two different EALs (DentaPort ZX [Morita, Tokyo, Japan] and Gold Reciproc motor [VDW, Munich, Germany]) and recorded as the electronic length. RESULTS: In teeth with an artificial root perforation 0.4 mm in diameter, the measurements obtained with DentaPort ZX were more accurate than with the Gold Reciproc motor (P ˂ 0.05), and on CBCT images, more accurate measurements were obtained with a voxel size of 0.125 mm compared to 0.25 mm (P ˂ 0.05). In teeth with an artificial root perforation 1.0 mm in diameter, the radiographic length was closer to actual length than the electronic length (P ˂ 0.05). CONCLUSION: In artificial root perforations with a diameter of 0.4 mm, CBCT gives more reliable results than EALs. Both EAL and CBCT measurements were closer to actual length in artificial perforations that were 1.0 mm in diameter.

Evaluation of periodontal health in breast cancer patients undergoing tamoxifen or aromatase inhibitors drugs therapy: A cross-sectional study.

AIM: To study the dental and periodontal status of women with breast cancer (BCa) having tamoxifen or aromatase inhibitors (AIs) treatment in comparison with control healthy women. METHODS: Fifty-one women on tamoxifen therapy, 52 women on AIs therapy and 52 systemically healthy controls were included in the study. The total number of teeth, the number of teeth indicated for extraction, the number of decayed teeth, and the duration of medication were recorded. Periodontal status was evaluated with gingival index (GI); plaque index (PI); bleeding on probing (BOP); probing depth (PD) and clinical attachment loss (CAL). RESULTS: The lowest number of teeth and decayed teeth was found in AIs users (P < .001 and P = .003 respectively). The highest CAL value was seen in AIs users (P = .042) whereas no significant difference was found between the groups in terms of PI, GI, and PD (P = .102, P = .233, and P = .306, respectively). Lower PI was observed in patients using AIs for less than 2 years (P = .048). CONCLUSIONS: While tamoxifen did not affect the dental and periodontal condition, AIs medication adversely affected the dental and periodontal condition by more tooth loss and higher CAL.

Ultrasonographic evaluation of jaw elevator muscles in young adults with bruxism and with and without attrition-type tooth wear: A pilot study.

OBJECTIVE: This pilot study was planned to analyze masticatory activation in bruxism patients with and without attrition by ultrasonographic evaluation of mandibular adductor muscles. METHODS: Sixty bruxism patients (group 1: 30 without attrition, group 2: 30 with attrition) and an age-sex matched control of 30 (group 3) were clinically examined. The thickness of bilateral temporalis and masseter muscles during clench and rest was measured by ultrasonography. RESULTS: The mean muscle thicknesses were higher in bruxing patients than in controls. In group 2, the clench/rest ratio (C/R) of the right and left masseter and temporal muscles were higher than the control group (p = 0.03, p = 0.01, p = 0.04, p = 0.03, respectively). CONCLUSION: The thickness of chewing muscles increases with bruxism. The occlusal forces in the teeth increase, and therefore, the tooth wear increases. Ultrasonographic muscle thickness can be used to determine muscle activity in bruxism patients.

Evaluation of osseous changes in dental panoramic radiography of thalassemia patients using mandibular indexes and fractal size analysis.

OBJECTIVE: This study aimed to evaluate the radiomorphometric indexes and fractal dimension (FD) on dental panoramic radiography (DPR) of Thalassemia Major (TM) patients. METHODS: In 59 TM patients and in 59 healthy control subjects, mandibular cortical index (MCI), mandibular cortical width (MCW), panoramic mandibular index (PMI), and FD of four different regions (FD1-4) were evaluated and compared using DPRs. RESULTS: The distribution of MCI in TM patients was similar to control subjects (p > 0.05). The mean MCW was significantly lower in TM patients (p = 0.001). There was no significant difference in PMI between TM patients and control subjects. The mean of FD measured in the supracortical area above the angle of mandible (FD2), in the anterior to the mental foramen (FD4) and mean FD of four different regions was significantly lower in TM patients (p = 0.003, p = 0.001, and p = 0.014, respectively). CONCLUSIONS: The radiomorphometric indices and fractal dimensions evaluated in the panoramic radiograph are capable of identifying thalassemia patients' jaw bone, and the results of DPR scanning can be used to refer these patients to appropriate medical investigation.

Relationship between condyle cortication, sphenooccipital synchondrosis, and chronological age.

OBJECTIVE: To assess the relationship between chronologic age, mandibular condyle cortication, and sphenooccipital synchondrosis (SOS) fusion. METHODS: Cone Beam Computed Tomography data of 253 patients were retrospectively evaluated. Mandibular condyle cortication was divided into three classes as Types I, II, and III. SOS fusion grade was categorized using a four-stage system (0-3). These variables were evaluated in relation to age and sex. RESULTS: There were significant positive relationships between age and condyle cortication, and between age and SOS fusion stage and between cortication type and SOS fusion stage. CONCLUSION: Due to the positive correlation between the degree of SOS fusion stage, the condyle cortication type, and the chronological age, these indicators can be used for age estimation.

The impact of different voxels and exposure parameters of CBCT for the assessment of external root resorptions: A phantom study.

This study aimed to compare the effectiveness of the different voxel sizes and imaging parameters of cone beam computed tomography (CBCT) on the determination of external root resorption (ERR). ERRs were created in coronal, middle and apical regions. Depths (0.62-0.73 mm) and diameters (0.68-0.81 mm) of ERRs were measured using a digital calliper. Images were obtained in 0.125, 0.2, 0.25, 0.3 and 0.4 mm3 voxel sizes and at different currents. Data were analysed using Friedman and Wilcoxon signed-rank tests at a level of P < 0.05. There was a difference between the parameters in determining the size of the ERR in coronal and middle regions (P < 0.05), but there was no difference in the apical region (P > 0.05). The change in current and exposure time did not make a difference in determining the dimensions of the ERRs (P > 0.05). Some voxel dimensions were more reliable in determining the depth and diameter of ERR in the coronal and middle region.

Evaluation of the effects of different forms of periodontal diseases on quality of life with OHIP-14 and SF-36 questionnaires: A cross-sectional study.

OBJECTIVES: To investigate the effect of generalized aggressive periodontitis (GAP), generalized chronic periodontitis (GCP) and gingivitis (G) on oral health-related quality of life (OHRQoL) with Oral Health Impact Profile-14 (OHIP-14) and Short Form-36 (SF-36) questionnaires. METHODS: One hundred GAP patients, 114 GCP and 109 G patients were included in the study. Age, gender, number of missing teeth, probing depth (PD), bleeding on probing (BOP), plaque index (PI) and clinical attachment level (CAL) of patients were recorded. The Turkish versions of OHIP-14 and SF-36 questionnaires were filled before any medication and dental treatment were approved. The one-way ANOVA test was used to compare three groups. RESULTS: Generalized aggressive periodontitis and GCP groups were similar to each other (P > 0.05) in most subscales except functional limitation and social disability of the OHIP-14 questionnaire (P = 0.034 and P = 0.018, respectively); conversely, there was no statistically difference between GAP and G groups in functional limitation and social disability subscales (P = 0.856 and P = 0.242, respectively). GAP group gave higher scores than GCP group in all subscales of SF-36 (P < 0.05). There was a negative correlation between OHIP-14 and SF-36 subscale scores in all groups. CONCLUSION: Study findings indicate that different forms of periodontal disease have different effects on quality of life of patients when measured by OHIP-14 and SF-36. Patients with GCP and GAP had poorer OHRQoL than G patients.

Effects of root-end filling on the fractal dimension of the periapical bone after periapical surgery: retrospective study.

OBJECTIVE: The aim of this study was to investigate the effects of root-end filling after periapical surgery on the fractal dimension (FD) of the periapical bone. METHODS: Thirty-eight patients who underwent periapical surgery were included in this study. The cases were divided into two subgroups: (1) In the gutta-percha group, root cavity and root-end fillings were not performed after root resection. In this group, there were 14 female patients and 6 male patients. (2) In the mineral trioxide aggregate (MTA) group, the root end was filled with MTA after root resection. In this group, there were 13 female patients and 5 male patients. Each patient underwent two periapical radiographs, one shortly after periapical surgery (10-15 days) and another one 1 year after periapical surgery. Regions of interest (ROIs) located close to the infected root apex were selected for each radiograph. Periapical radiographs were digitized and processed with an FD analysis using the box-counting method. RESULTS: FD was significantly increased in both groups over time (p < 0.05). The increases in FD between groups were not significant (p > 0.05). CONCLUSIONS: Mathematical morphology combined with the box-counting method showed that the FD change was independent of the root-end filling at the 1-year follow-up after periapical surgery. CLINICAL RELEVANCE: Because of the complex anatomy of the root canal, orthograde endodontic treatment may be inadequate and periapical surgery becomes an alternative in these cases. In this study, the effect of root-end filling on the increase in trabecular bone after periapical surgery was investigated using fractal analysis.

Relationship between the anatomic structures and mandibular posterior teeth for endodontic surgery in a Turkish population: a cone-beam computed tomographic analysis.

OBJECTIVE: The purpose of this study is to evaluate the relationship between anatomic structures and mandibular posterior region using cone-beam computed tomography (CBCT) in terms of endodontic surgery. METHODS: A total of 150 CBCT images were used to investigate the proximity of the anatomical structures and the mandibular posterior teeth. The buccal and lingual bone thickness overlying each root, buccolingual, and mesiodistal dimension of the roots were measured at the level of 3 mm apical resection, and the mental foramen (MF) distance to the premolar teeth and the distance of the mandibular canal (MC) to all the posterior teeth were measured. RESULTS: The thinnest part of the buccal cortical bone was measured in the first premolar teeth (1.70 mm) and in the mesial root of the first molar (2.25 mm) while the thickest region was measured in the distal root of the second molar tooth (6.95 mm). The maximum amount of substance to be removed was measured at the distal root of the second molar tooth (11.26 mm), and at least the first premolar tooth (5.52 mm) was measured for buccal resection. The distal root of the second molar tooth was found to be the closest tooth root to the MC with a mean of 2.75 mm, and the closest distance was measured as 0 mm. CONCLUSIONS: It is important to evaluate the parameters such as mandibular buccal and lingual bone thickness, location of the MC and the MF, and root size for atraumatic endodontic surgical approach. Evaluation of these data before endodontic surgery provides guidance to the clinician in the planning of endodontic surgery. CLINICAL RELEVANCE: The mandibular posterior region, which is difficult to reach with traditional surgical approach, is now easily reached using an operation microscope. For this reason, endodontic surgical procedures have become popular in mandibular posterior teeth. Therefore, the relationship between the mandibular posterior teeth and anatomical structures that are important in the planning of surgical access line is examined in this study.

Prevalence of anatomical variants in the clivus: fossa navicularis magna, canalis basilaris medianus, and craniopharyngeal canal.

PURPOSE: This study determined the prevalence of fossa navicularis magna (FNM), canalis basilaris medianus (CBM), and craniopharyngeal canal (CPC), the size of FNMs, and types of CBM using 3D computed tomography (CT) images. METHODS: A total of 1059 3D images [649 cone beam computed tomography (CBCT) and 410 CT] were evaluated in this study. The prevalence of FNM, CBM, and CPC, length, width, and depth of FNM, and type of CBM were assessed. RESULTS: Overall, FNM was identified in 7.6%, CPC in 0.3%, and CBM in 2.5% of the study group. Type 2 (0.1%) and Type 6 (0.1%) are the least common CBM types. There was no significant difference between genders for depth and width measurements (p > 0.05), however, the length of FNM was significantly higher in males than females in CBCT images (p = 0.02). CONCLUSION: FNM, CBM, and CPC are rare anatomical variants of clivus. However, they can facilitate spread of infection to the skull base or vice-versa. These types of anatomical variations should be known by radiologists to avoid unnecessary diagnosis and treatment procedures and to distinguish anatomic variations from pathological conditions.

Cone Beam Computed Tomographic Evaluation of Intracranial Physiologic Calcifications.

OBJECTIVE: The aim of the present study was to evaluate the incidence of physiologic intracranial calcifications detected in cone beam computed tomography (CBCT) images of a Turkish subpopulation. METHODS: The CBCT image of the full head of 573 patients taken between 2015 and 2018 was evaluated retrospectively. The prevalence of habenular calcification, petroclinoid ligament, coroid plexus, interclinoid ligament (ICL), and carotico-clinoid ligament (CCL) calcifications was investigated. The age and gender of the patients were recorded. RESULTS: Intracranial calcification was found in 190 (33.1%) of 573 cases. The frequency of physiological calcifications is respectively; 19.2% were found as habenular, 4.88% as ICL, 3.83% as CCL, 2.7% as petroclinoid ligament, and 2.4% as choroid plexus. 38.2% of the women and 29.3% of the men had intracranial calcification. In 4 patients, both ICL and CCL ossification were detected. No statistically significant relationship was found between age, gender, and calcifications. CONCLUSION: Cone beam computed tomography is a widely used imaging technique for dental diagnosis and treatment. Intracranial physiological calcifications may be a common incidental finding of CBCT scans.

Mandibular indexes and fractal properties on the panoramic radiographs of the patients using aromatase inhibitors.

OBJECTIVE:: This study was conducted to evaluate fractal dimension (FD), mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index (MCI) on panoramic radiographs to determine the mandibular cortical and trabecular bone changes in females with breast cancer undergoing aromatase inhibitors (AIs) treatment. METHODS:: In this retrospective study, FD analysis, PMI, MCI, and MCW were assessed over panoramic radiographs of 34 females under AI therapy as a patient group and 34 healthy age-gender matched individuals as a control group. RESULTS:: Mean FD values and MCW were slightly but not significantly lower in the patient group (1.47 ± 0.06 and 4.1 ± 1.2 respectively). FDs measured onthe supracortical area above the angulus mandibula (FD2) and anterior to the mental foramen (FD4) were significantly lower in patients (p = 0.037 and p = 0.046 respectively). Among the measured regions in patients, FD2 was significantly lower (p = 0.001). PMI was also significantly lower in patients (p = 0.001) and MCI were similar in both groups (p = 0.604). CONCLUSION:: AI use affects bone quality and evaluating FD, PMI, and MCW in panoramic radiography can be used to determine the effect of this drug on the jaw bones in the early period. ADVANCES IN KNOWLEDGE:: Aromatase inhibitors are the most commonly used drugs in breast cancer patients. This drug is thought to have osteoporotic effects on the jawbone. This study is the first study to evaluate osteoporotic changes with measurements made on panoramic radiographs and the results of the study are significant. We think this study will shed light on the studies that will investigate the effects of the drug on the jaw bones.

Available bone morphology and status of neural structures in the mandibular interforaminal region: three-dimensional analysis of anatomical structures.

PURPOSE: This study aimed to clarify the size and morphology of the mandible and to determine state of neural structures for the planning of the dental implantation using cone-beam computerized tomography (CBCT). METHODS: Of the 252 patients, CBCT images of 48 selected patients were evaluated. The bone height and width were measured and the type of the mental portion of the inferior alveolar canal, the anterior loop length (ALL), the location of the incisive canal and lingual foramen were identified with cross-sectional and multiplane reformatted CBCT images. According to buccal and lingual concavities, the shape of the mandible is classified as type A, B and C. RESULTS: Bone widths of males were significantly higher than female (p < 0.05). The thickest part of the alveolar bone was measured in the middle triple zone (d line) and the thinnest part was measured in the area near the alveolar crest (b line). The most seen type of mandible was type B (45.8%) that mandible was concave on the buccal side. Bone heights had a tendency to increase towards to the anterior mandible, and bone height in male patients was slightly but not significantly greater than that in female patients. ALL was 4.2 ± 1.2 mm and visible incisive canal length on CBCT was 9.7 ± 3.8 mm. CONCLUSION: CBCT assessment of morphological features of the alveolar bone and locations of nerve canals and foramina in the anterior-premolar region of mandible represent useful practical anatomical information about the interforaminal region. This information is the guide to the dentist before implant surgery.