Evaluation of the thickness of masticatory muscles in patients with chronic periodontitis by ultrasonography.

OBJECTIVES: Periodontitis is one of the most common chronic inflammatory diseases. It causes changes in the biting abilities of individuals. However, periodontal treatment has positive effects on masticatory function. The aim of this study is to determine the effect of periodontitis and periodontal treatment on masticatory abilities by measuring masseter and temporal muscle thicknesses with ultrasonography before and after periodontal treatment in chronic periodontitis patients. METHODS: The patients included in the study were determined by clinical and radiological examination. The thickness of the masseter and temporal muscles of the patients were measured by ultrasonography. Periodontal measurements and treatments of the patients were completed by a single physician. IBM SPSS 20.0 (IBM Corp., Armonk, NY) statistical program was used for statistical analysis. RESULTS: A statistically significant difference was found between the values of periodontal measurements before and after treatment (p<0.05). In the ultrasonography measurements of the thickness of masseter and anterior temporal muscles, a statistically significant increase was observed in both rest and contraction values at all time intervals (p<0.05). Muscle thicknesses of male patients were higher than female patients. CONCLUSIONS: Periodontitis negatively affects the masticatory performance of individuals. Chronic periodontitis patients should be referred for periodontal treatment without wasting time.

The evaluation of superior semicircular canal in patients with unilateral cleft lip and palate using CBCT.

OBJECTIVES: The present study aims to evaluate the thickness and radiological patterns of the superior semicircular canal (SSC) in patients with unilateral cleft lip and palate (CL/P). METHODS: Cone beam computed tomography (CBCT) images of the patients were evaluated in axial and Pöschl planes. CBCT images of 84 patients with unilateral CL/P and 168 healthy individual controls were included in the study. Three study groups were established: the CS-CL/P group (cleft side temporal bones of the CL/P patients), NCS-CL/P (non-cleft side temporal bones of the CL/P patients) and the control group. The radiological patterns of SSCs were categorized as dehiscence, papyraceous, normal, pneumatised and thick. The minimum bone thickness of SSC was measured. RESULTS: It was found that the CS-CL/P group had a higher prevalence for SSCD compared to both the NCS-CL/P group and the control group. CS-CL/P group had a higher prevalence of dehiscence type and papyraceous type compared to the control group. The SSC thickness on the CS-CL/P patients was thinner than the NCS-CL/P patients and the control group sides (p = 0.033 and p < 0.001, respectively). CONCLUSIONS: The mean thickness of SSC was found significantly lower in the CS-CL/P group compared to both the NCS-CL/P group and the control group. The elevated prevalence of dehiscence and papyraceous types in the CS-C/LP group compared to the control group implies that the presence of a cleft may be a predisposing factor for these types.

Evaluation of the effect of antiepileptic drugs on mandibular bone quality by fractal analysis.

OBJECTIVES: Antiepileptic drugs (AEDs) are used to control seizures in epilepsy and their long-term use is common. AED use has been associated with decreased bone mineral density. The aim of this study is to determine the effect of AEDs on mandibular bone quality using fractal analysis and panoramic morphometric indices. METHODS: In this study, dental and medical records of 132 patients (66 AED users and 66 control group) were used. Fractal analysis (FA), the panoramic mandibular index (PMI), mandibular cortical width (MCW), and Klemetti index (KI) measurements were performed on panoramic radiographs. RESULTS: In all metrics, the mean values of the study group were significantly lower than the control group (p < 0.000). There is a statistically significant difference between the study and control groups in terms of KI distribution (p < 0.000). The mean fractal dimension (FD) values in each measured region of the female patients in the study group were found to be significantly lower than the female patients in the control group (p < 0.05). The mean FD values measured in ROI-2 and ROI-3 of male patients in the study group were found to be significantly lower than male patients in the control group (p < 0.05). CONCLUSION: The side effects of AEDs on bone metabolism were shown in this study. Dentists examining patients with epilepsy should be careful about osteoporotic changes in the jaws.

Three-dimensional assessment of pharyngeal airway in individuals with myotonic dystrophy type 1

Background/aim: The objectives of this study were to assess pharyngeal airway volume (PAV) in patients with myotonic dystrophy type 1 (DM1) by cone-beam computerized tomography (CBCT) and to evaluate the impact of diaphragm thickness and pulmonary function tests on PAV. Materials and methods: Thirty DM1 patients (10 female and 20 male; mean age 42.40 ± 12.07) were included in the study. Age and sex-matched thirty patients were participated as control group. In DM1 group pulmonary function tests (PFT) were performed. Independent t-test was used to compare PAV values of patients with DM1 and control group. The Mann­Whitney U test was used to compare the parameters according to sex ( p < 0.05). Pearson and Spearman correlation tests were used to evaluate the relationships between parameters of DM1 patients (p < 0.05). A multiple linear regression analysis was performed to explain the PAV with parameters that showed positive correlation with PAV. Results: Age of onset and disease duration were 22.37 ± 8.45 and 20.03 ± 12.08, respectively, in patients with DM1. PAV values of control group were significantly lower than DM1 group ( p < 0.001). Forced expiratory volume in 1 s and forced volume vital capacity values were higher in males than females in DM1 group according to sex ( p < 0.001). PAV values were greater in male patients than females of the DM1 group ( p = 0.022). Diaphragm thickness in DM1 group after inspiration and expiration were 2.60 ± 0.65 and 1.94 ± 0.40, respectively. According to the regression analysis, DTai and FVC were significantly explained the PAV. Conclusion: PAV was higher in DM1 group. There was a significant positive correlation between diaphragm thickness, pulmonary functions, and PAVs of DM1 patients. The amount of the PAV was mostly influenced by DTai and FVC. It is recommended to evaluate the PAV in patients with DM1 because of impaired respiratory functions and pharyngeal muscle involvement.

Proton pump inhibitors and mandibular bone quality: A preliminary study.

OBJECTIVES: Proton pump inhibitors (PPI) provide a long-lasting anti-acidic effect by inhibiting the proton pump, and they are one of the most commonly prescribed drugs worldwide. PPIs adversely affect the bone structure via deficiency of vitamins and minerals. The aim of this study was to investigate the possible PPI-induced bone changes in the mandible on panoramic radiographs with the methods of fractal analysis and panoramic morphometric indices. METHODS: Panoramic radiographs of 402 patients were used (201 PPI users, 201 control group). Fractal analysis was performed on 4 regions of interests (ROI): 1- upper part of the ramus, 2- angulus, 3- anterior of the mental foramen, 4- distal of the middle ramus. Also, the panoramic mandibular index (PMI), mandibular cortical width (MCW), and Klemetti index (KI) were performed on radiographs. RESULTS: There were significant differences in terms of ROI3, MCW, and KI between the control and study groups (p < 0.05) while there was no significant difference for ROI1, ROI2, ROI4, and PMI (p > 0.05). Males were severely affected than females. CONCLUSIONS: Osteoporotic changes were detected in the trabecular and cortical bone in the mental foramen region in PPI users with fractal analysis and morphometric indices, while there were no differences for mandibular ramus and angulus regions according to fractal analysis.

The evaluation of lateral pterygoid signal intensity changes related to temporomandibular joint anterior disc displacement.

OBJECTIVES: The aim of this study was to evaluate lateral pterygoid muscle (LPM) signal intensity changes related to different degrees of disc status groups using magnetic resonance imaging (MRI). METHODS: Four groups were established according to disc displacement of examined temporomandibular joint (TMJ) and opposing TMJ. MRI scans were obtained with a 1.5 T device. The signal intensity was measured from the sagittal slice where midportion of the muscle belly was observed. The regions of interest were placed over the superior and inferior heads of LPM. To normalize differences in signal intensity, signal intensity of the grey matter and white matter of the brain was also measured. Signal intensity ratio (SIR) was calculated. Measurements were performed in both T1- and T2-weighted images. RESULTS: In the intergroup comparisons, a statistically significant difference was found for SIR1 sup., SIR1 inf., SIR2 sup. and SIR2 inf. variables (p < 0.01). According to multiple comparison test (Tukey), no significant difference was found between group 0 and group 1 for SIR1 sup., SIR1 inf., SIR2 sup. and SIR2 inf. variables (p > 0.05). For SIR1 sup., SIR1 inf., SIR2 sup. and SIR2 inf. variables, significant differences were found between five binary comparison groups (1-2, 1-3, 2-3, 0-2, 0-3) (p < 0.05). CONCLUSION: In conclusion, SIR is correlated with the degree of disc displacement. The internal derangement of the opposite joint did not affect SIR of superior and inferior heads of examined LPM in both T1- and T2-weighted images. The inferior head of LPM was also found affected by disc displacement.

The effect of selective serotonin reuptake inhibitors on the human mandible.

OBJECTIVES: Selective serotonin reuptake inhibitors (SSRI) are a group of drugs that selectively and strongly block the serotonin transporter. Aim of this study was to evaluate the mandibular bone structure of patients who are using SSRIs with fractal analysis and panoramic morphometric indices [mandibular cortical width (MCW), panoramic mandibular index (PMI) and Klemetti index (KI)] and to compare with control group. METHODS: Patients who declared using SSRIs for more than six months had been included in the study group. In total, 212 dental panoramic radiographs (DPR) were assessed. For fractal analysis; three regions of interest (ROIs) were determined: ROI1 and ROI2 were chosen within trabecular bone, ROI3 was selected from cortical bone. MCW, PMI, and KI were obtained from DPRs. The study group was categorized into five subgroups of various SSRIs. The fractal dimension (FD) values and panoramic morphometric indices of these subgroups were also compared. RESULTS: There was no significant difference between the groups for age and gender (p = 0.57, p = 0.5). There were significant differences in the mean FD values between the study and control groups both for the ROI1 and ROI2 (p < 0.01, p < 0.01). There was no significant difference between the groups for the mean FD value of ROI3, MCW, PMI and KI (p = 0.93, p = 0.98, p = 0.74, p = 0.06). There were no significant differences for all the values between the SSRI subgroups (p = 0.52, p = 0.7, p = 0.76, p = 0.24, p = 0.31, p = 0.08) CONCLUSIONS: Trabecular rich sites of the mandible were found to be affected by SSRI usage.

Evaluation of styloid chain calcification related to temporomandibular joint disc displacement: a retrospective cohort study.

OBJECTIVES: The present study aimed to evaluate any relationship between elongated styloid process (ESP) and temporomandibular joint disc displacement (TMJD). STUDY DESIGN: A retrospective cohort study. SETTING: Dentomaxillofacial Radiology division of Erciyes University Dental Hospital. PARTICIPANTS: Ninety-four temporomandibular joints (TMJs) of 47 patients were allocated in this study. Intervention-disease: Two experienced dentomaxillofacial radiologists have interpreted all CBCT and MR images. Patients who referred with TMJ disorders were classified according to temporomandibular joint's disc status as normal disc position (ND), displacement with reduction (DWR) and displacement without reduction (DWoR). METHODS: Main outcome measures: Interpretation of styloid chain calcification pattern and styloid processes length measured linearly on reconstructed sagittal slices of CBCT. Randomization: Cone beam computed tomography (CBCT) and magnetic resonance (MR) images of 154 patients who were admitted between September 1, 2012 and September 1, 2019. Only 47 of them fulfilled the study requirements. Blinding: Single blind of the outcome measurements and interpretations of MR images. RESULTS: Total 94 TMJs of 47 patients disc status groups were analyzed and defined as DWoR (n = 25), DWR (n = 32), and ND (n = 37). On multivariate analysis, no statistical significant differences were found between groups in terms of styloid process lengths. Mean SP length and standard deviation of disc status groups (DWoR, DWR, and ND) are 35.5 (± 9.8) mm, 34.6 (± 9.2) mm, and 38.3 (± 8.9) mm, respectively. When patients were grouped individually according to their post-MRI diagnosis, the mean styloid process length in the non-temporomandibular joint disc displacement (non-TMJD) patients (47.9 ± 10.8) was significantly higher than the TMJD patients (36.1 ± 9.3). In this study, there is no intervention to cause any harm or side effects. CONCLUSION: Our results indicate that styloid-stylohyoid syndrome may be misdiagnosed with temporomandibular joint disorder (TMD). TRIAL REGISTRATION: Clinical Trials NCT04280107.

Effect of total edentulism on the internal bone structure of mandibular condyle: a preliminary study.

OBJECTIVE: The aim of this study was to assess the internal structure of the mandibular condyles in patients with total edentulism by applying fractal analysis on cone-beam computed tomography (CBCT) images and compare with dentate subjects. METHODS: A total of 136 mandibular condyles were assessed. All CBCT images were prepared with 0.25-mm slice thickness and maximum magnification. A 64 × 64 pixel region of interest (ROI) within the trabecular bone in the center of the condyle was selected. Fractal analysis was performed using White and Rudolph's box-counting method. RESULTS: Control and study groups were age and gender-matched. The mean fractal dimension (FD) value of the study group was significantly lower compared to the control group (p < 0.01). In the study group, the mean FD value of the females was significantly lower than males (p = 0.01). For the control group, there was no significant difference between the genders for FD (p = 0.11). There was no significant difference between the age subgroups of the female study group and the male control group for FD (p = 0.22, p = 0.33). The mean FD value of the younger age subgroup was significantly higher compared to the older age subgroup in the female control and male study group (p = 0.03, p = 0.01). CONCLUSION: The internal bone structure of mandibular condyles in edentulous patients was found to be affected by edentulism. Fractal analysis can be used as an effective method for assessing temporomandibular joint health.

The evaluation of the mandibular bone structure changes related to lactation with fractal analysis.

OBJECTIVES: Lactation-induced bone loss of lumbar spine, hip, femur and distal radius are well documented in the literature. The aim of this article is to investigate whether lactation affects the trabecular and cortical bone structure of human mandible. METHODS: 120 dental panoramic radiographs (DPR) of the lactating women who were breastfeeding for 3-6 months (study group) and 120 DPRs of the nulliparous women (control group) were evaluated. Regions of interest (ROI) were chosen from the geometric center of ramus, the geometric center of angulus and the cortical bone. ROIs were examined with fractal analysis method. Fractal dimension (FD) values of each ROI were compared with each other. In addition, the study group was divided into four subgroups according to age, and FD values were compared within the subgroups. RESULTS: The control and study groups were age-matched. FD values of mandibular ramus and angulus were significantly lower in the study group (p < 0.001, p < 0.001). There was no significant difference for FD values of cortical bone between the groups.(p = 1.49). There was no significant difference for FD values of ROIs between the age subgroups (p = 0.05, p = 0.94, p = 0.91). CONCLUSION: This is the first study to investigate the possible effect of lactation in human jaws. Trabecular rich sites of the mandible were found affected by lactation. Dentists who encounter with lactating patients must be careful during the dental processes such as tooth extraction, implant surgery, and orthodontic treatment.