Correlation of upper airway radiographic measurements with risk status for obstructive sleep apnea syndrome in young dental patients.

OBJECTIVE: The aim of the present study is to compare radiographic measurements of the upper airway (UA) in young adult patients with different levels of risk status for obstructive sleep apnea syndrome. STUDY DESIGN: The study included 50 patients between 18 and 30 years of age who were referred for dental examination and evaluation of impacted third molars. Case record forms, including habit history, along with the Berlin Questionnaire and the Epworth Sleepiness Scale, were completed by the patients and their relatives. According to the answers, 25 low-risk patients and 25 high-risk patients were selected. Cephalometric radiographs and cone beam computed radiography images were obtained for radiographic analysis when the patients were admitted into the study. RESULTS: There were significant differences in body mass index, neck circumference measurements, Epworth score, and smoking status between risk groups. There were significant differences for UA measurements on radiographic evaluation. Body mass index (BMI) was found to be correlated positively with neck circumference and Epworth scores and negatively with UA measurements for all patients. Velopharyngeal measurements showed the highest correlation with Epworth scores, BMI, and neck circumference. CONCLUSIONS: The radiographic findings correlated with the survey results. Our data suggest that radiographic measurements of UA may be used as a predictor of risk for obstructive sleep apnea syndrome in a young population.

A possible association of idiopathic osteosclerosis with excessive occlusal forces.

OBJECTIVES: The aim of the study was to determine the relationship between idiopathic osteosclerotic lesions and occlusal forces using the T-Scan II computerized occlusal analysis device, and to test the sensitivity of the system in occlusal analysis. METHOD AND MATERIALS: The study was conducted with 21 volunteers with idiopathic osteosclerosis (IO; 14 women, 7 men) aged between 17 and 62 years (mean 29.95). For every patient, seven or eight recordings were made with the T-Scan II occlusal analysis device in maximum intercuspation, and the last two (excluding any with technical problems) were chosen for evaluation. For each lesion-related area, the distribution of high occlusal forces from two different movies was analyzed. RESULTS: In 18 patients (85.71%), lesions were observed in an area of high occlusal force, and in 13 patients (61.9%), the lesions were located at the first area subjected to high occlusal forces. The percentage distribution of high forces at a lesion related area ranged from 0% to 88%. On average, the high forces at an osteosclerotic lesion area accounted for 20% of the maximum total force. No statistical differences were observed between the measurements of the two selected recordings (P > .05). CONCLUSION: The findings of this study suggest a possible relationship between IO and occlusal forces and primary contacts. T-Scan II was found to be a successful diagnostic device for detecting primary contacts and excessive occlusal forces.

Bilateral and pseudobilateral tonsilloliths: Three dimensional imaging with cone-beam computed tomography.

PURPOSE: Tonsilloliths are calcifications found in the crypts of the palatal tonsils and can be detected on routine panoramic examinations. This study was performed to highlight the benefits of cone-beam computed tomography (CBCT) in the diagnosis of tonsilloliths appearing bilaterally on panoramic radiographs. MATERIALS AND METHODS: The sample group consisted of 7 patients who had bilateral radiopaque lesions at the area of the ascending ramus on panoramic radiographs. CBCT images for every patient were obtained from both sides of the jaw to determine the exact locations of the lesions and to rule out other calcifications. The calcifications were evaluated on the CBCT images using Ez3D2009 software. Additionally, the obtained images in DICOM format were transferred to ITK SNAP 2.4.0 pc software for semiautomatic segmentation. Segmentation was performed using contrast differences between the soft tissues and calcifications on grayscale images, and the volume in mm(3) of the segmented three dimensional models were obtained. RESULTS: CBCT scans revealed that what appeared on panoramic radiographs as bilateral images were in fact unilateral lesions in 2 cases. The total volume of the calcifications ranged from 7.92 to 302.5mm(3). The patients with bilaterally multiple and large calcifications were found to be symptomatic. CONCLUSION: The cases provided the evidence that tonsilloliths should be considered in the differential diagnosis of radiopaque masses involving the mandibular ramus, and they highlight the need for a CBCT scan to differentiate pseudo- or ghost images from true bilateral pathologies.

Self-reported problems before and after prosthodontic treatments according to newly created Turkish version of oral health impact profile.

The aim of the study was to assess patients' socio-demographic factors with their removable prosthesis in general, as well as to assess their problems with the functional limitation, physical pain, psychological discomfort, physical disability, social disability, and handicap investigate impaired oral health-related quality of life (OHRQoL) in patient treated with removable dentures before treatment and at 1 and 12 months after treatment. The first part of the questionnaire was comprised of 20 questions. It was designed in four different sections as: (i) general socio-demographic factors, (ii) general health, (iii) experience and use of dental and denture care, and (iv) anamnestic sign and symptoms of temporomandibular disorders (TMD). A statistical analysis system (SAS) was used for data management and analysis. Patient-reported problems were studied using the item list contained in the Turkish version of the oral health impact profile (OHIP) in a convenience sample of 136 prosthodontic patients before (m(0)), 1 month after (m(1)), and 12 months (m(2)) after treatment were then examined by using two-way ANOVA with repeated measurement. Differences in OHRQoL were present when item-specific prevalence was stratified by time of total scores; gender, residential area, working status, self-reported general health, smoking status, denture type, importance of the convenient dental care, trauma story, self-reported TMD/pain, and self-reported TMD/difficulty opening mouth wide. At baseline, the most prevalent frequently reported problems "difficulties chewing" (49.3%), "digestion worse" (40.4%), "take longer to complete a meal" (36%), "food catching" (30.9%), and "dentures not fitting" (29.4%), and m(2) the most prevalent frequently reported problems were "avoid going out" (25%), "difficulties chewing" (17.6), "sore jaw" (15.5%), and "take longer to complete a meal" (14%). The study confirmed that denture status is by far the strongest predictor of impaired OHRQoL compared to socio-demographic factors. Subjects with strong or moderate values had significantly fewer oral health-related problems (OHIP-extent) of time of total scores. The number of problems decreased substantially after prosthodontic treatment. The profile of pretreatment and post-treatment problems differed substantially, but in general, only a few problems remained after adaptation to new dentures.

Self-reported denture hygiene habits and oral tissue conditions of complete denture wearers.

The aim of the study was to examine the influence of denture hygiene on the development and intensity of denture stomatitis and traumatic ulcers and their relationship to age, gender, educational level, smoking status, age of the denture, denture hygiene habits and denture-wearing behavior. The study population comprised 310 complete denture (CD) wearers (159 males and 151 females) aged 60-85 living in Kirikkale, Turkey. Denture hygiene habits were assessed and recorded, and any relationships between denture hygiene habits and the condition of oral tissue were assessed. The majority (48.4%) of participants reported cleaning their dentures with a toothbrush and toothpaste and 45.2% with a toothbrush only. Less than half (44.8%) removed their dentures overnight. Stomatitis was observed in 35.8% and traumatic ulcers in 29% of patients. A positive relationship was observed between poor denture hygiene habits and the presence of denture-related stomatitis and traumatic ulcers. The degree of denture hygiene was significantly associated with age, sex, education, general health status, smoking status, self-perception of halitosis, overnight denture removal and denture immersion habits.

Assessment of blood mercury levels in practicing Turkish clinicians, dental students, and dental nurses.

OBJECTIVES: Potential sources of exposure of the dental health team and their patients to mercury vapor in the dental clinic include accidental spillage of elemental mercury, use of mechanical amalgamators, and dry cutting of old amalgam restorations using high-speed instrumentation. The purpose of this study was to evaluate the extent of mercury exposure in Turkish dental staff by cold-vapor atomic absorption spectrometry. METHOD AND MATERIALS: A total of 211 clinicians, dental students, and dental nurses answered a questionnaire concerning sex, age, occupation, number of amalgam restorations performed per week, number of amalgam restorations removed per week, methods of trituration, number of amalgam restorations present in their own mouths, frequency of fish consumption, smoking, vitamin intake, and bruxism. For each subject, a 5-mL sample of whole blood was drawn and frozen until the time of analysis. Blood mercury levels were measured by means of cold-vapor atomic absorption spectrometry. Blood mercury levels were also analyzed in a control group of 58 non-dental-staff blood donors. RESULTS: Normal blood mercury values are considered to be in the range of 0 to 5 ng Hg/mL. Of the dental staff evaluated, 51.7% had a blood concentration of mercury less than 5 ng Hg/mL, and 33.6% had a blood concentration above 5 ng Hg/mL. The difference between the test and control groups was statistically significant (P < .01). CONCLUSION: Mercury is being absorbed as a result of dental practice but that although there is, in general, a low level of mercury contamination in the dental operatory because of amalgam work, sufficient care is being taken to prevent higher levels of contamination with an increased use of mercury.

Evaluation of oral malodor in children.

OBJECTIVE: The aim of this study was to assess oral malodor in highly caries-active children aged 7-15 years, analyze its association with oral malodor parameters, and investigate whether oral hygiene practices and orodental treatments can decrease the effect of oral malodor. STUDY DESIGN: The study included a total of 30 subjects with high caries activity (11 boys and 19 girls), mean age 10.5 +/- 2.4 years, who were living in Kirikkale, Middle Anatolia, Turkey. Oral malodor assessment was carried out by portable sulfide monitor and organoleptic method. A self-administered structured questionnaire was given to the participants. The baseline and final measurements were taken for both malodor-related parameters (volatile sulfur compounds [VSCs] and organoleptic ratings) and dental parameters (tongue coating scores [TCS], plaque index [PI], dental index [DFS+DMFS], community periodontal index of treatment needs [CPITN]). Analysis included frequency, cross-tabulations, analysis of variance, independent-samples t test,and paired t test. Odds ratios of VSC-related factors were also calculated. Significance was set at the 5% level. RESULTS: Gender, DFS+DMFS, and frequency of toothbrushing were not found to be significantly correlated with either VSC levels in mouth air or organoleptic ratings (P > .05). However, tongue coating (P = .003), CPITN (P = .014), PI (P = .017), and age (P = .053) were significantly correlated with VSC levels in mouth air. Regarding the final recordings, significant correlation (P < .001) was found between VSC levels and TCS. Also, significant differences were found between baseline and final measurements in both oral malodor parameters and dental parameters (TCS, CPITN, and PI; P < .001). CONCLUSIONS: These results revealed that oral malodor in children is related to periodontal parameters and especially tongue coating. Moreover, malodor parameters were improved by increased awareness of the importance of oral hygiene.

Oral malodor and removable complete dentures in the elderly.

OBJECTIVE: The objectives of this study were to assess oral malodor in patients with removable complete dentures and analyze its association with age, sex, subjective oral dryness, burning mouth, tongue coating, and overnight denture wear in elderly subjects. STUDY DESIGN: The study comprised 105 complete denture wearers (56 male, 49 female) between the ages of 50 and 78 from the province of Kirikkale in the Central Anatolia Region of Turkey. Oral malodor was assessed using a portable sulfide monitor. Participants were given a self-administered, structured questionnaire. Baseline and final volatile sulfur compound (VSC) levels and tongue-coating scores (TCS) were measured. Analysis included frequency, cross-tabulations, ANOVA, and independent sample and paired t tests. Odds ratios of VSC-related factors were also calculated. A P value less than .05 was considered statistically significant. RESULTS: There was no significant correlation found between age, gender, smoking, existence of a medical condition, or regular use of medication and VSC levels in mouth air (P > .05). However, educational level (P < .05), oral dryness (P < .05), burning mouth (P < .05), overnight denture wear (P < .01), and TCS (P < .001) were found to be significantly correlated with VSC levels. Significant differences were also found between baseline and final measurements of both VSC levels and TCS (P < .01). CONCLUSION: This study found the accumulation of bacterial plaque on the tongue, oral dryness, burning mouth, overnight denture wear, and lower educational levels to be significantly related to oral malodor. Following tongue care maintenance and overnight removal of dentures, patients' oral malodor levels decreased significantly.

Factors associated with self-reported halitosis (SRH) and perceived taste disturbance (PTD) in elderly.

The aim of this study was to estimate the prevalence of self-reported halitosis (SRH) and perceived taste disturbance (PTD) and analyze their association with age, gender, subjective oral dryness, burning mouth, tongue coating, number of teeth remaining, and type of dentures and wear duration in healthy elderly. Subjects who neither reported systemic disorders nor medication use were included in the study. The participants of this study were 254 healthy subjects, 116 males (mean age: 63.2+/-7.2 years) and 138 females (mean age: 61.9+/-6.8 years), all aged 55 years and above. A self-administered structured questionnaire on SRH and PTD was given to the participants. Each subject underwent a comprehensive dental examination by one of the examiners. The number of carious teeth, number of restorations, type of dentures (fixed-partial, removable-partial or complete dentures) and wear duration, and tongue coating status were recorded. Associations of the categorical background variables (age, gender, smoking status, tooth brushing frequency) with SRH and PTD were examined using the chi(2)-test. Spearman's rho correlation coefficient was used to analyze the relationship between taste disturbance and SRH with relevant variables (p<0.05). The prevalence of SRH was 28.3% and the prevalence of PTD was 8.3%. Use of the toothbrush less than once daily was the factor most strongly associated with SRH. Of the individuals with SRH, 73.6% reported subjective oral dryness (p<0.001) and 9.7% had burning mouth (p=0.008). Of the individuals with PTD, 71.4% reported subjective oral dryness (p=0.003) and 14.3% had burning mouth (p=0.019). Age (p<0.05), denture type (p<0.001), tongue coating (p<0.001), frequency of tooth brushing (p<0.000 for SRH and p<0.05 for PTD) were significantly associated with SRH and PTD. Educational level of the participants was significantly different for SRH (p<0.05). Gender was not found to be associated with either SRH or PTD (p>0.05). We concluded that the factors most strongly associated with SRH and PTD were subjective oral dryness, tongue coating, inadequate oral hygiene practice and partial and/or complete denture wear. Other factors with significant associations included older age and lower education levels. Smoking was found to be associated with SRH.

Evaluation of systemic markers related to anemia of chronic disease in the peripheral blood of smokers and non-smokers with chronic periodontitis.

OBJECTIVES: The aim of this study was to investigate the effect of cigarette smoking on clinical parameters and signs anemia of chronic disease in chronic periodontitis patients. METHODS: The study base consisted of 88 patients with chronic periodontitis including 45 volunteer current smokers with age range of 30-69 (45.5+/-8.5) and 43 volunteer non-smokers with age range of 32-61 years (45.8+/-7.9). The clinical parameters including plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL) were recorded and several red blood cell parameters were determined from peripheral blood samples. RESULTS: In smokers, PI, PD and CAL were significantly higher than non-smokers (P<.05). The number of erythrocytes and the levels of hemoglobin, hematocrit and iron were lower in smokers compared to non-smokers (P<.05). CONCLUSIONS: In the present study, it is concluded that cigarette smoking may be effective on the signs of anemia of chronic disease in patients with chronic periodontitis.

Evaluation of the oral health status of the people aged 65 years and over living in near rural district of Middle Anatolia, Turkey.

The aim of this study was to assess the oral health status of aged 65 years and over, and evaluate the level of edentulousness and study the factors that could have an influence on edentulism. The participants of this study were 215 patients; 94 males (47.3%) and 121 females (56.3%), aged 65 years and over. Each subject underwent a comprehensive dental and radiographic examination by one examiner. Periodontal attachment loss observed in the panoramic radiographs was divided into three diagnostic categories: infrabony defects, horizontal bone loss, and furcation lesions. The number of teeth with apical periodontitis lesions, the number of carious teeth, and restorations, type of dentures and wear duration, intrabony root remains, impacted teeth, smoking status, educational level and self-reported medical history of the participants were recorded. Extent of tooth loss was significantly higher in females than males and increased with increasing age (p<0.05). Tooth loss was significantly associated with educational levels; lower literacy level was found to be associated with a higher number of missing teeth (p<0.01). Also, as the educational levels of the participants increased, the number of infrabony defects, furcation lesions and number of carious teeth decreased (p<0.05). Low literacy level and female gender are found to be high-risk groups for tooth loss. Community-based oral disease prevention programs should be implemented to reduce the risk for tooth loss in this population.