Jaffe Lichtenstein Type of Polyostotic Skeletal Fibrous Dysplasia With the Involvement of Cranial Bones.

ABSTRACT: Fibrous dysplasia (FD), a benign fibro-osseous bone tumor commonly involving the craniofacial region, presents a wide spectrum of radiographic patterns. When FD lesions are suspected, various imaging modalities and histopathologic analyses may be required to reach a firm diagnosis. Here, the authors report the case of a 10-year-old male patient presenting with polyostotic type of FD with follow-up data for the next 9 years. The patient showed involvement of cranial bones and bilateral femurs, with skin pigmentation and no endocrine disease, consistent with the diagnosis of Jaffe Lichtenstein disease. The craniofacial radiographic features obtained with computed tomography and cone-beam computerized tomography are documented in this article.

A 5 years follow-up for ischemic cardiac outcomes in patients with carotid artery calcification on panoramic radiographs confirmed by doppler ultrasonography in Turkish population.

OBJECTIVE: To evaluate the diagnostic accuracy of digital panoramic radiograph (DPR) for detection of carotid artery calcification (CAC) confirmed by Doppler Ultrasonography (DUSG) and to clarify the relationship between between CAC identified by DPR and cardiovascular events through a 5 year follow-up period. METHODS: Of 3600 consecutive patients examined, 158 patients presented with CAC as detected by DPR. The final study group was composed of 96 patients who had CAC confirmed by DUSG or CT angiogram. The control group was composed of 62 patients who has normal DUSG. The end point of the study was the occurrence of any cardiovascular event. RESULTS: 72 (75%) of the 96 patients with CAC confirmed by DUSG (16 patients had significant stenosis) had bilateral and 24 (25%) had unilateral CAS as detected by DUSG. There was a low agreement between the examination results with a κ value of 0.488 (p < 0.005) for calcification. Study data revealed that smoking, chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM) and diastolic hypertension were significantly more common in patients with CAC than the control group (p < 0.05). During the follow-up period, 13 subjects had myocardial infarction and 1 subject died; in the control group, 1 patient died after MI and 1 patient died of a non-cardiac event. CONCLUSION: Patients with CAC detectable by DPR concomitant with COPD, DM, smoking or diastolic hypertension are more likely to suffer from vascular events. Therefore, patients with detectable carotid plaque in DPR require referral to a cardiovascular surgery clinic for further investigations.

Kaposi's sarcoma concurrent with granulomatosis polyangiitis.

Kaposi's sarcoma (KS), a malignant vascular tumor, can develop in patients who receive corticosteroids or immunosuppressive therapy. We report a patient with KS and granulomatosis polyangiitis (GPA). To the best of our knowledge, this is the first report regarding the co-occurrence of these two diseases. The physician must be aware of the risk of cancer in patients with rheumatism.

Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs.

OBJECTIVES: There is no consensus on the relationship between fractal dimension and trabecular bone complexity. Our aims were to examine the changes in fractal dimension (FD) from peri-implant alveolar bone on digital panoramic radiographs 6 and 12 months after prosthodontic loading and to compare these with baseline values calculated just after loading. MATERIAL AND METHODS: Three panoramic radiographs taken from 76 implant patients taken (1) after prosthodontic loading (3 months ± 2 weeks after insertion = baseline), (2) 6 months ± 2 weeks after loading, and (3) 12 months ±2 weeks after loading were considered for the study. Panoramic images were obtained using storage phosphor plates of the Digora PCT system and saved into a computer. Three regions of interest from mesial, distal, and apical areas were selected for each implant on three consecutive panoramic images. Statistical analysis of the data was performed using two-way repeated measures ANOVA, independent t test and paired t test, and pairwise comparisons (P < 0.05). RESULTS: Mean FD values at baseline were 1.202, 1.224, and 1.199 for apical, mesial, and distal areas. The FD values were calculated as 1.121, 1.113, and 1.128 at the 6th month. The differences between values calculated at baseline and the 6th month were statistically significant for all aspects, indicating a significant decrease in FD 6 months after prosthodontic loading (P < 0.05). FD values calculated at the 12th month were 1.121, 1.110, and 1.121 for apical, mesial, and distal aspects, respectively, with no significant differences from corresponding values obtained at the 6th month (P > 0.05). CONCLUSIONS: FD values of trabecular bone around implants 6 months after prosthodontic loading are significantly lower than the baseline values. However, no significant decrease or increase was observed at 12 months, which revealed comparable results with peri-implant alveolar bone at 6 months. CLINICAL RELEVANCE: Trabecular bone around successful dental implants exhibits lower fractal dimension values 6 months after prosthodontic loading and displays stable bony microstructure at 12 months of follow-up.

Oral health-related quality of life among institutionalized patients after dental rehabilitation.

AIM: The aim of the present study was to determine the changes in oral health-related quality of life before and 3 months after dental rehabilitation among geriatric patients residing in a state-owned nursing home, using the General Oral Health Assessment Index (GOHAI). METHODS: Data from 40 patients were collected through the administration of a structured questionnaire, as well as from medical records and intraoral examinations. Sociodemographic and behavioral variables, and denture use/length of use were recorded. The GOHAI questionnaire was completed before and 3 months after dental rehabilitation by the same examiner. Normality of the GOHAI scores was examined with the Kolmogorov-Smirnov test. Data were analyzed using descriptive statistics, t-tests, one-way ancova and ancova (P < 0.05). RESULTS: The study sample included 32 men (80%) and eight women (20%) with a mean age of 72.75 years. Mean GOHAI scores increased from 41.275 (low) to 53.100 (moderate) 3 months after dental rehabilitation (t = 1.42, P < 0.001, r = 0.86). Patients with poor oral hygiene (P = 0.000), those who had been using dentures (P = 0.000) and patients younger than 70 years-of-age (P = 0.03) provided higher GOHAI scores after dental rehabilitation. GOHAI scores before and after dental rehabilitation were not influenced by sociodemographic and behavioral variables (P > 0.05). The after treatment GOHAI scores, which were corrected according to gender and age, showed no significant differences regarding the education level, income, behavioral variables, use of dentures, oral hygiene status and presence of systemic diseases (F = 0.62, P = 0.69). CONCLUSIONS: Dental rehabilitation of institutionalized geriatric patients resulted in a significant improvement in GOHAI scores, indicating an improvement in oral health-related quality of life after receiving proper dental care.

Construction of a copper stepwedge with aluminum equivalent mean gray values.

OBJECTIVES: To produce a copper (Cu) stepwedge with aluminum (Al) equivalent mean gray values (MGV). MATERIAL AND METHODS: The thicknesses of Cu steps that were equivalent to those of the Al were formulated using the X-ray attenuation properties of the materials. The Al and fabricated Cu stepwedges were radiographed, but the MGVs of the Cu stepwedge were mismatching to those of the Al. Using a mathematical function to adjust the pixel MGV of Cu stepwedge to those of the Al, new Cu stepwedges were created. In vitro iterations were performed until best approximation to Al was reached. RESULTS: The MGV of the Cu stepwedges fabricated by formularization were different than those of Al (p=0.001). Iteration method led to MGV similar to those of the Al stepwedge (p=0.207). CONCLUSIONS: Construction of a Cu stepwedge according to the basic rules of radiophysic failed to result in a stepwedge with similar radiodensity values to those of Al stepwedge. Further studies may use the formularization method only for prototype Cu wedge production, but consecutive iterations shall be compassed to obtain the best approximation to Al MGV.

Construction of a copper stepwedge with aluminum equivalent mean gray values

OBJECTIVES: To produce a copper (Cu) stepwedge with aluminum (Al) equivalent mean gray values (MGV). MATERIAL AND METHODS: The thicknesses of Cu steps that were equivalent to those of the Al were formulated using the X-ray attenuation properties of the materials. The Al and fabricated Cu stepwedges were radiographed, but the MGVs of the Cu stepwedge were mismatching to those of the Al. Using a mathematical function to adjust the pixel MGV of Cu stepwedge to those of the Al, new Cu stepwedges were created. In vitro iterations were performed until best approximation to Al was reached. RESULTS: The MGV of the Cu stepwedges fabricated by formularization were different than those of Al (p=0.001). Iteration method led to MGV similar to those of the Al stepwedge (p=0.207). CONCLUSIONS: Construction of a Cu stepwedge according to the basic rules of radiophysic failed to result in a stepwedge with similar radiodensity values to those of Al stepwedge. Further studies may use the formularization method only for prototype Cu wedge production, but consecutive iterations shall be compassed to obtain the best approximation to Al MGV.

Effect of various digital processing algorithms on the measurement accuracy of endodontic file length.

OBJECTIVE: The aim of this study was to compare the accuracy of endodontic file lengths after application of various image enhancement modalities. STUDY DESIGN: Endodontic files of three different ISO sizes were inserted in 20 single-rooted extracted permanent mandibular premolar teeth and standardized images were obtained. Original digital images were then enhanced using five processing algorithms. Six evaluators measured the length of each file on each image. The measurements from each processing algorithm and each file size were compared using repeated measures ANOVA and Bonferroni tests (P = 0.05). Paired t test was performed to compare the measurements with the true lengths of the files (P = 0.05). RESULTS: All of the processing algorithms provided significantly shorter measurements than the true length of each file size (P < 0.05). The threshold enhancement modality produced significantly higher mean error values (P < 0.05), while there was no significant difference among the other enhancement modalities (P > 0.05). Decrease in mean error value was observed with increasing file size (P < 0.05). CONCLUSIONS: Invert, contrast/brightness and edge enhancement algorithms may be recommended for accurate file length measurements when utilizing storage phosphor plates.

Oral mucosal conditions and risk factors among elderly in a Turkish school of dentistry.

BACKGROUND: Prevalence studies are important to determine the oral health status and treatment needs of elderly people. Our aim was to obtain data for the prevalence of oral mucosal conditions (OMC) in a Turkish elderly sample and to compare our results with different geographic regions. OBJECTIVE: The purpose of this clinical-based study was to determine the prevalence of OMC and associated risk factors in a clinical-based Turkish elderly sample. METHODS: The study sample consisted of 700 patients >60 years old. The clinical examination of patients was performed by both authors. All participants were questioned about their general health status, medication use, oral hygiene habits, tobacco or alcohol use, use of dentures, and the length of denture use. Chi2 Pearson's test with Fisher's exact probability test was used to analyze the data. Logistic regression models were used to assess the influence of independent variables; odds ratios were calculated with 95% confidence intervals. Statistical significance was defined as p <0.05. RESULTS: OMC were recorded in 40.7% of the study sample. The logistic regression model revealed that male gender, length of denture use, smoking habit, and being a former smoker increased the probability of having an OMC. Smoking habit also increased the risk of having leukoplakia. The denture-related lesions accounted for 36.4% with the length of denture use and diabetes mellitus being significant risk factors for denture stomatitis and denture hyperplasia. The model for traumatic ulcer included medication use as a significant risk factor. CONCLUSIONS: Our results regarding an elderly Turkish sample support the studies of other populations where the prevalence of OMC was related to length of denture use, smoking, and gender. We also observed some important associations between denture-related lesions, systemic diseases, and medication use which require further investigation.

Demineralized freeze-dried bone allograft and platelet-rich plasma vs platelet-rich plasma alone in infrabony defects: a clinical and radiographic evaluation.

The objective of this work is to compare the clinical and radiographic outcomes of demineralized freeze-dried bone allograft (DFDBA)/platelet-rich plasma (PRP) combination with PRP alone for the treatment of infrabony defects 18 months after surgery and to examine the influence of radiographic defect angle on the clinical and radiographic outcomes. Twenty-eight infrabony defects were treated with DFDBA/PRP combination or PRP alone. Clinical parameters and radiographic measurements were compared at baseline and 18 months. Interquartile range was performed to classify the defect angles. Mann-Whitney, Wilcoxon test, and Pearson correlation were used to analyze the data. The DFDBA/PRP combination exhibited more favorable gains in both clinical and radiographic parameters than PRP alone group (p < 0.05). A correlation existed between defect angle, defect depth, and clinical/radiographic outcomes for the defects treated with DFDBA/PRP. The narrow defects presented more favorable clinical attachment level values (CAL) gain, probing pocket depth (PPD) reduction and defect resolution than wide defects in the combination group (p < 0.05). The influence of baseline defect angle was not significant in the PRP-alone group (p > 0.05). The results indicate that DFDBA/PRP combination is more effective than PRP alone for the treatment of infrabony defects, and the amount of CAL gain, PPD reduction, and bone fill increases when the infrabony defect is narrow and deep before DFDBA/PRP combination treatment.