Evaluation of the Change in Halitosis with the Improvement in Oral Health in Cleft Lip and Palate Patients.

AIM: This study aimed to assess the effects of hygiene education on periodontal health and mouth/nasal halitosis in patients with cleft. MATERIALS AND METHODS: 39 patients with cleft who were accepted for orthodontic treatment divided into two groups as with (Group1; n = 24) and without braces (Group2; n = 15). Plaque Index (PI), Gingival Index (GI), and Tongue coating Index (TCI) values were recorded. The BANA test microbiological kit, was used to determine the amount of anaerobic bacteria. Values of volatile sulfur components (VSC) for the measurement of oral and nasal halitosis were measured with a Halimeter device. After the initial measurements, oral hygiene instructions were given to eliminate the plaque production on teeth, periodontal structure, tongue and palate. All measurements were repeated 4 weeks after the hygiene instructions. Wilcoxon and Mann-Whitney U test were used for statistical analysis. RESULTS: In both groups, the PI, GI, values were significantly decreased (P < .05). Tongue coating area, thickness and TCI were significantly reduced (P < .05). Oral halitosis values decreased significantly (P < .05). The PI values decreased significantly more in the Group 1 (P < .05). Non significant difference was detected in nasal halitosis in both groups. In unilateral cleft lip and palate cases cases (n = 23), no significant difference was found in nasal halitosis values between the cleft and the healthy sides (P > 0.05). CONCLUSION: In patients with clet cases, periodontal health was improved and oral halitosis was reduced by the given hygiene education; brushing the teeth, especially the tongue and palate. However, hygiene education did not have a significant effect on nasal halitosis. Key Words: Cleft lip and palate, Halitosis, BANA test, Periodontal index.

Deep convolutional neural network-the evaluation of cervical vertebrae maturation.

OBJECTIVES: This study aimed to automatically determine the cervical vertebral maturation (CVM) processes on lateral cephalometric radiograph images using a proposed deep learning-based convolutional neural network (CNN) model and to test the success rate of this CNN model in detecting CVM stages using precision, recall, and F1-score. METHODS: A total of 588 digital lateral cephalometric radiographs of patients with a chronological age between 8 and 22 years were included in this study. CVM evaluation was carried out by two dentomaxillofacial radiologists. CVM stages in the images were divided into 6 subgroups according to the growth process. A convolutional neural network (CNN) model was developed in this study. Experimental studies for the developed model were carried out in the Jupyter Notebook environment using the Python programming language, the Keras, and TensorFlow libraries. RESULTS: As a result of the training that lasted 40 epochs, 58% training and 57% test accuracy were obtained. The model obtained results that were very close to the training on the test data. On the other hand, it was determined that the model showed the highest success in terms of precision and F1-score in the CVM Stage 1 and the highest success in the recall value in the CVM Stage 2. CONCLUSION: The experimental results have shown that the developed model achieved moderate success and it reached a classification accuracy of 58.66% in CVM stage classification.

Relationship between palatally impacted canines and dimensions and morphology of sella turcica: A cone-beam computed tomography study.

INTRODUCTION: This study aimed to analyze the association of unilateral and bilateral palatal canine impaction with the dimensions and morphology of sella turcica from 3-dimensional cone-beam computed tomography (CBCT) images. METHODS: CBCT images of patients with bilateral (BPI) (n = 12; 9 female 3 male; 20.75 ± 5.88 years) and unilateral (UPI) (n = 35; 22 female 13 male; 19.28 ± 5.57 years) palatally impacted canines were compared with a control group (n = 56; 34 female 22 male; 20.82 ± 4.88 years). Linear measurements regarding sella turcica were made, and its morphologic variations were categorized. Two group comparisons were made with the Student t test or Mann-Whitney U-test, whereas one-way analysis of variance or Kruskal-Wallis tests were used for multiple group comparisons. Categorical variables were compared using the chi-square or Fisher exact test as appropriate. The binary logistic regression analyses and correlations using Spearman or Pearson correlation analyses were used to determine associations between variables (P <0.05). RESULTS: Sella diameter was significantly smaller in the BPI group compared to UPI and control groups. There was a significant association between sella diameter and BPI when compared with the control group (χ2[1] = 9.150; P = 0.008). There were no significant differences between groups in the distribution of sella turcica morphology. CONCLUSIONS: Despite the similar genetic origin of the sella turcica region and teeth, the association of palatal canine impaction with dimensions and morphology of sella turcica was weak. Both local and genetic factors might contribute to the ectopic position of the canine.

Evaluation of the compatibility of C2, C3, and C4 fractal dimension values with hand-wrist and cervical vertebra maturation methods in determining skeletal maturation.

OBJECTIVES: To examine the correlation between the fractal dimension (FD) values of cervical vertebrae (C2, C3, and C4) and hand-wrist maturation (HWM) and cervical vertebra maturation (CVM) methods. In addition, the correlation between the pubertal growth spurt (PGS) and FD values was examined. METHODS: The lateral cephalometric and hand-wrist radiographs of 120 subjects (61 females and 59 males) aged 8-18 years with a mean age of 13 years, were evaluated retrospectively. The CVM stages were determined in accordance with Hassel-Farman's modification of Lamparski criteria. The HWM stages were determined in accordance with Björk and Grave-Brown criteria. Both HWM and CVM stages were divided into two according to PGS. Fractal analysis of cervical vertebrae was performed according to the White-Rudolph method. The relationships between HWM stages, CVM stages and other variables were evaluated by Spearman's rank-order correlation coefficient. The relationships between FD values, chronological age, and divided stages were evaluated by the Pearson correlation coefficient. The Mann-Whitney U test was used to compare the FD values of two divided stages. RESULTS: There were positive and statistically significant positive correlations between chronological age and both HWM and CVM stages. There was a positive and statistically significant correlation between CVM and HWM stages. In females and total, there were negative and statistically significant correlations between C4 FD values and divided HWM stages, and the differences between C4 FD values of divided HWM stages were also statistically significant. In total, there was a negative and statistically significant correlation between C4 FD values and divided CVM stages, and the difference between C4 FD values of divided CVM stages was also statistically significant. CONCLUSION: The negative correlations found between C4 FD values and divided HWM and CVM stages suggest the fractal analysis of cervical vertebrae, especially of C4, may be used as an objective tool for evaluating the PGS.

Nasal septal deviation in the unilateral cleft lip and palate deformities: a three-dimensional analysis.

OBJECTIVES: Lip and palate deformities are an important craniofacial congenital anomaly that negatively affects the anatomy of the nasal cavity and maxilla. This study aimed to evaluate the nasal septum deviation in individuals with a unilateral cleft lip and palate. METHODS: The sample consists of 22 unilateral cleft lip-palate patients and 20 controls with non-cleft skeletal Class III. Maximal septal deviation angle and linear dimension were measured on cone-beam computed tomography images. The localization of maximal septal deviation was determined. The data were analyzed and compared between unilateral cleft lip-palate patients and skeletal Class III individuals. RESULTS: For septal deviation, a significant discrepancy between unilateral cleft patients and skeletal Class III subjects was detected at the anterior nasal spine (ANS) level, the posterior nasal spine (PNS) level and the ANS-PNS midpoint level (p < 0.05). The maximum septal deviation angle of individuals with a unilateral cleft was significantly greater than individuals with skeletal Class III (p < 0.05). No statistically significant differences were found in the localization of maximum septal deviation between the unilateral cleft patients and the Class III individuals. CONCLUSION: Our results demonstrated that the maximum septal deviation angle and dimension had significant differences in individuals with a unilateral cleft, compared to a skeletal Class III control group. However, no statistically significant discrepancy was observed between three levels (ANS, PNS and ANS-PNS middle levels) in the unilateral cleft patients.

Correction to: Three­dimensional assessment of the sella turcica: comparison between cleft lip and palate patients and skeletal malocclusion classes.

In the original publication of the article, the given name and family name of the author were swapped. The correct author name is given in this erratum.

Examination of the possible relation of the superior semicircular canal morphology with the roof thickness of the glenoid fossa and bone changes of the temporomandibular joint.

PURPOSE: This study sought to assess the relationships between a morphological characteristic of the superior semicircular canal (SSC) and both the roof thickness of the glenoid fossa (GF) and bone changes of the temporomandibular joint (TMJ) on three-dimensional images. METHODS: Cone-beam computed tomography (CBCT) images of 200 individuals (105 females and 95 males; 400 temporal bone regions) were examined by two different observers. The correlations between the bone thickness overlying the SSC and the thickness of the roof of the GF with TMJ's bone pathologies were analyzed. RESULTS: The superior semicircular canal dehiscence (SSCD) was significantly associated with dehiscence of the roof of the GF. The relationship between the dehiscence of the SSC and the roof thickness of the GF was found to be strongly correlated (p < 0.05). There were no statistically significant differences between the bone changes of TMJ and the presence or absence of the SSCD. CONCLUSIONS: A correlation between the bone thickness overlying the SSC and the roof thickness of the GF was found. However, there was no relationship between the bone thickness overlying the SSC and bone changes of TMJ.

Three-dimensional assessment of the sella turcica: comparison between cleft lip and palate patients and skeletal malocclusion classes.

PURPOSE: The main aim of the present study was to investigate the dimensions and morphological appearance of the sella turcica in cleft lip and palate patients using cone-beam computed tomography (CBCT) images, compared to non-cleft individuals. METHODS: CBCT images of 40 (20 females and 20 males) cleft lip and palate patients and 60 (27 males and 33 females) non-cleft individuals were assessed, retrospectively. The linear dimensions (depth, diameter and length) of the sella turcica and inter-clinoid distance were measured. Sella turcica shapes were examined in the cleft lip and palate patients and non-cleft individuals. Non-cleft individuals were divided into skeletal malocclusion classes. All variables were analyzed using the Kruskal-Wallis test, Mann-Whitney U tests and Chi-square test. RESULTS: No significant difference was observed between individuals with and without cleft in the linear dimensions (depth, diameter and length) of the sella turcica (p > 0.05). However, a significant difference was found in the inter-clinoid distance between patients with cleft and non-cleft individuals (p < 0.05). Comparison of the sella turcica shape between skeletal malocclusion classes and patients with cleft showed significant differences (p < 0.05). CONCLUSIONS: No significant difference was determined in the depth, diameter, or length of the sella turcica in cleft patients when compared with non-cleft individuals. The inter-clinoid distance was lower in cleft patients than in non-cleft individuals, and this difference was statistically significant.

Evaluation of the Relationship of Dimensions of Maxillary Sinus Drainage System with Anatomical Variations and Sinusopathy: Cone-Beam Computed Tomography Findings.

OBJECTIVE: The aim of this study was to evaluate the correlation between the length of the infundibulum and ostium height with the anatomic variations of osteomeatal complex (OMC) and sinus pathology using cone-beam computed tomography (CBCT). METHODS: CBCT images of 204 patients (408 maxillary sinuses) were evaluated retrospectively. The height of the ostium and the length of the infundibulum were measured. The presence of maxillary sinus pathology, nasal septal deviation, Haller cells, concha bullosa, and sinus septa were analyzed. The correlation between the size of the maxillary sinus drainage system and anatomic variations was compared using the t test, Fisher's exact test, and χ2 test. The effect of tooth loss on the length of the infundibulum and ostium height was also analyzed using ANOVA. RESULTS: The height of the ostium and the maximal septal deviation angle were found to be significantly greater in males (p < 0.05). As ostium height increased, the presence of maxillary sinus septa increased (p < 0.05). No statistically significant association was detected between other variations and the length of infundibulum or ostium height. The relationship between tooth loss and both the length of the infundibulum and ostium height were found to be insignificant (p > 0.05). CONCLUSIONS: Radiographic examination, especially on CBCT images, is important for an evaluation of maxillary sinuses. here, we demonstrated a significant relationship between ostium height and the presence of maxillary sinus septa. However, it was found that nasal septal deviation, concha bullosa, Haller cells, and other sinusopathies did not have a major effect on the size of the maxillary sinus drainage system.

Does tooth loss in the mandibular posterior region have an effect on the mental index and panoramic mandibular index?

PURPOSE: Mental index (MI) and panoramic mandibular index (PMI) are important radiomorphometric indices used for assessing the quality of the mandibular bone. The aim of this study was to investigate the possible effect of mandibular posterior tooth/teeth loss in young adults on the MI and PMI (superior panoramic mandibular index: PMI-s, and inferior panoramic mandibular index: PMI-i). MATERIALS AND METHODS: Digital panoramic radiographs belonging to 253 patients aged between 18-35 years old were examined. According to the inclusion criteria of the study, a patient and control group was formed. The patient group (n=46) included individuals having at least one extracted tooth in the posterior region of the mandible, and the control group (n=45) included full dentate patients. The MI and PMI (PMI-i and PMI-s) were calculated bilaterally for all of the individuals. RESULTS: No significant difference was found between the MI, PMI-i and PMI-s indices of the patient group and the control group among both genders. CONCLUSION: The mandibular premolar and/or molar teeth loss in young adults did not lead to any change in the MI, PMI-i and PMI-s indices among both genders.

Dental management and orofacial manifestations of a patient with Robinow Syndrome.

Robinow syndrome (RS) is an extremely rare condition. Characteristic craniofacial findings of RS include a fetal facial appearance, ear abnormalities and oral findings. The aim of this case report was to evaluate the oral findings of a 26-year-old man with RS and to describe the dental treatments performed. The patient had short stature, vertebral anomalies, short and broad fingers, a fetal facial appearance, gingival hyperplasia, fissured tongue, caries and multiple impacted teeth. Periodontal and restorative dental treatments were performed under aseptic conditions with due precautions. No surgical treatment was performed to the impacted teeth because of the lack of symptoms.

Morphometric analysis of the foramen magnum using cone beam computed tomography

Background/aim: The aim of this study was to perform morphometric analysis of the foramen magnum (FM) using cone-beam computed tomography (CBCT). Materials and methods: This study included CBCT images of 190 individuals (88 males and 102 females). The sagittal and transverse diameters and circumference of the FM were measured. The shape of FM was classified as round, hexagonal, oval, egg-shaped, tetragonal, pentagonal, irregular A, and irregular B. The data were statistically analyzed with chi-square and t-tests to assess the level of significance for sex and age. Results: The means of its sagittal and transverse diameters and also circumference were higher in males than in females. Statistically significant differences were found between males and females for all variables (P < 0.05). No statistically significant difference (P > 0.05) was found between age groups for all variables. The round type was the most common, in 21.6% of the patients. Conclusion: CBCT images can provide valuable information regarding FM and the measurements of its sagittal and transvers diameters and also its circumference may be reliably used for sexual dimorphism in anthropometric analysis and forensic medicine.

Prevalence of Posterior Crossbite for Orthodontic Treatment Timing.

OBJECTIVE: To evaluate the prevalence and distribution of posterior crossbite in different dentition stages in a Turkish sample. STUDY DESIGN: 1554 subjects (843 girls, 711 boys) aged 4-25 years were evaluated to determine the prevalence of posterior crossbite in a Turkish sample. The subjects were classified according to four dentition stages (primary, early mixed, late mixed and permanent) and transversal occlusal status. The statistical evaluation was done by Chi-square, Fischer exact tests. RESULTS: Bilateral and unilateral crossbite on the right and left sides had the highest frequency in the permanent dentition (51.0%, 47.3%, and 53.6%; respectively). No significant differences were found between unilateral (right and left) and bilateral crossbite with regard to dentition stages. No significant differences were found between unilateral right or left side posterior crossbite with regard to dentition stages. CONCLUSION: An increasing trend in the prevalence of posterior crossbite was observed from the primary dentition towards permanent dentition in this study.

Effects of fixed and removable space maintainers on halitosis.

BACKGROUND: The current study evaluated the effects of fixed and removable space-maintainers on halitosis and oral health of children. METHODS: Forty-three patients randomly selected between the ages 4-10 whom fixed or removable space maintainers were indicated in Gazi University, Faculty of Dentistry, Department of Pedodontics. The inclusing criteria were: caries-free (with/without restorations), with absence of periodontal diseases, without systematic disease, no mouth breathing and no use of antibiotics the 2-months period before the study. The patients were subdivided into two groups: the group treated with fixed space maintainers (group 1, n = 27), the group treated with removable space maintainers (group 2, n = 16). The the plaque index (PI), gingival index (GI), periodontal screening index (PSI), tongue coating index (TCI) records and the halitosis measurements were obtained at three time periods (T1: immediately after application, T2: 1 week after application, T3: 5 weeks after application). The measurement values of T1 served as control. RESULTS: No statistically significant difference was found in the PI, GI, PSI, TCI and halitosis measurements between T1-T2, T2-T3 and T1-T3 in both appliance groups and between the groups (p > 0.05). CONCLUSIONS: The fixed and removable space maintainers did not affect oral health status and halitosis significantly.

Cephalometric assessment of soft tissue morphology of patients with acromegaly.

AIM: To assess the sagittal soft tissue morphology of patients with acromegaly in comparison with a healthy control group. METHODS: Twenty-seven patients with acromegaly (11 male, 16 female; mean age 47.3 ± 11.5 years) and 30 healthy subjects (15 male, 15 female; mean age 42.2 ± 17.4 years) were included in the study. Linear and angular measurements were made on lateral cephalograms to evaluate soft tissue and skeletal characteristics. The intergroup comparisons were analysed with the Student's t-test. RESULTS: Facial convexity (p < 0.01) and the nasolabial angle (p < 0.001) were reduced in patients with acromegaly, whereas nose prominence (p < 0.01), upper lip sulcus depth (p < 0.01), upper lip thickness (p < 0.01), basic upper lip thickness (p < 0.01), lower lip protrusion (p < 0.05), mentolabial sulcus depth (p < 0.05) and soft tissue chin thickness (p < 0.001) were increased. Anterior cranial base length (p < 0.05), the supraorbital ridge (p < 0.01), the length of the maxilla and mandible (p < 0.001, p < 0.01, respectively) were significantly increased, and mandibular prognathism was an acromegalic feature (p < 0.05). CONCLUSION: Acromegalic coarsening and thickening of the craniofacial soft tissues was identified from lateral cephalograms, which may therefore contribute to early diagnosis when evaluated together with other changes caused by the disease.

The prevalence of antral exostoses in the maxillary sinuses, evaluated by cone-beam computed tomography.

BACKGROUND/PURPOSE: Exostoses are outgrowths of normal compact and cancellous bone and may occur in different locations of the jaw. Exostoses are a rare anatomic variation in the maxillary sinuses. The purpose of this study was to investigate retrospectively the prevalence of location, size, shape, and symmetry of exostoses in the maxillary sinus, and to assess the relationship between demographic variables (i.e., age and sex) via cone-beam computed tomography images. MATERIALS AND METHODS: Cone-beam computed tomography images of 1000 patients [521 (52.1%) females and 479 (47.9%) males], aged 10-85 years (mean age, 44 years), were examined. Two investigators examined the exostoses for location (i.e., inferior wall, medial wall, lateral wall, or posterior wall of the maxillary sinuses), size, shape (i.e., broad-based or mushroom-like), and symmetry (i.e., unilateral or bilateral). The age of the patients was categorized into three groups: 10-30 years, 31-50 years, and 51+ years. The data were statistically analyzed by using chi-square test, Fisher's exact test, and the t test. RESULTS: In total, 52 exostoses from 48 patients (4.8%) were identified. Exostoses were more common in females (n = 28, 58.3%) than in males (n = 20, 41.7%); however, there was no statistically significant difference between the sexes (P > 0.05). The presence of exostoses was very similar for all age groups with no statistically significant differences (P > 0.05). CONCLUSION: Most exostoses were unilateral and on the inferior wall of the maxillary sinus. No statistically significant difference existed between the frequency and location of exostoses for sex or age groups (P > 0.05).

Variations of midline facial soft tissue thicknesses among three skeletal classes in Central Anatolian adults.

Facial reconstruction is a technique employed in a forensic investigation as a last resort to recreate an individual's facial appearance from his/her skull. Forensic anthropologists or artists use facial soft tissue thickness (FSTT) measurements as a guide in facial reconstructions. The aim of this study was to develop FSTT values for Central Anatolian adults, taking into consideration sex and skeletal classes; first, to achieve better results obtaining the likenesses of deceased individuals in two or three-dimensional forensic facial reconstructions and, second, to compare these values to existing databases. Lateral cephalograms were used to determine FSTT values at 10 midline facial landmarks of 167 adults. Descriptive statistics were calculated for these facial soft tissue thickness values, and these values were compared to those reported in two other comparable databases. The majority of the landmarks showed sex-based differences. Males were found to have significantly larger landmark values than female subjects. These results point not only to the necessity to present data in accordance with sexual dimorphism, but also the need to consider that individuals from different geographical areas have unique facial features and that, as a result, geographical population-specific FSTT values are required.

Evaluation of oxidative events and copper accumulation in oral tissues of patients with Wilson's disease: three case report.

Wilson's disease (WD), also known as hepatolenticular degeneration, was first described in 1912 by Kinnear Wilson. It is an autosomal recessive disorder caused by mutations in the ATP7B gene, a membrane-bound copper transporting ATPase. The disorder is caused by impairment of the copper transporting ATPase, ATP7B, in the liver, which disturbs copper transport, excretion into the bile, and incorporation into apoceruloplasmin. WD is an inherited copper metabolism disorder with pathological copper accumulation in many tissues, but especially in brain and liver. We conducted this study because copper accumulation in oral tissues in patients with WD have not been studied before. We think that copper accumulation and differences of oxidative events in oral tissues can cause tendency to periodontal diseases.

Prevalence and characteristics of non-syndromic distomolars: a retrospective study.

AIM: Distomolars are defined as the supernumerary teeth that erupt distal to the third molar. The aim of the present study was to evaluate the prevalence of distomolars in permanent dentition in a non-syndromic Turkish subpopulation. METHODS: A total of 10 111 panoramic radiographs of patients aged 18 years and over, who had no systemic diseases and syndromes, and who had not undergone any extractions in the third molar area, were examined to determine the presence, location, shape, and laterality of distomolars. The patients' age and sex were noted. RESULTS: The results showed that distomolars were observed in 0.26% of the investigated population. Distomolars were seen in 0.29% of male patients and in 0.23% of female patients. In total, 30 distomolars were observed in 26 patients. Maxillary distomolars were more frequently encountered than mandibular teeth. Bilateral distomolars were found in three male patients. Of the 30 distomolars, 25 were impacted and five were erupted. CONCLUSIONS: Although the frequency of distomolars is low, early diagnosis and treatment are important to minimize or prevent complications, such as delayed eruption, tooth displacement, crowding, root resorption of the adjacent tooth, and cystic formations.