Perspective on Temporomandibular Joint Disorder: Foramen Tympanicum Defect.

BACKGROUND: Foramen tympanicum (FT) is a defect located anterior-inferior to the external acoustic meatus. We evaluated its prevalence, location, size, and relationship with temporomandibular joint (TMJ) disorders. METHODS: Cone beam computed tomography was performed for 200 patients who presented to the Karamanoglu Mehmetbey University Ahmet Kelesoglu Faculty of Dentistry Hospital. The location and size of the FT in the axial and sagittal planes were evaluated. Descriptive statistics were used to compare the study parameters among age and sex groups. Patients with FT were reevaluated by two maxillofacial surgeons at the study centre. RESULTS: In total, 200 images from 400 joints were examined. Unilateral and bilateral FT (19 [9.5%] and 8 [4%], respectively) was detected in 35 (17.5%) images from 27 (13.5%) patients. Examinations were performed for TMJ disorders in 24 patients. Participants with bilateral defects had the highest rates of presence of sounds and ear pain on the left and right sides (p < .05). CONCLUSION: Foramen tympanicum can lead to TMJ disorders and spread of tumours or infections from the external auditory canal to the infratemporal fossa. The increased prevalence of such disorders in patients with bilateral FT suggests an association between them.

A potential novel technique for measurement of pulp volume on periapical radiography: A pilot study.

Pulp volume can be assessed during dental treatment. Three-dimensional imaging techniques are not routinely used for this purpose because of high radiation doses. This study aimed to develop a novel method to measure pulp volume using periapical radiography. In this study, cone-beam computed tomography (CBCT) was used as a reference method. Periapical radiography and CBCTs obtained from the same patients (n = 32) were recorded. Pulp volume was determined by observing the density differences between the pulp and peripheral structures using ImageJ. A method of graph and volume calculation was developed for each tooth. The Shapiro-Wilk test and Mann-Whitney U test were used to show normality and non-normal distributions. The Bland-Altman plot was used to show the scattering of the mean versus difference values of the measurements of the two methods used to calculate the pulp volume. Normality was evaluated using the Shapiro-Wilk test. CBCT measurements are normally distributed (p = 0.307), while ImageJ is not normally distributed (p = 0.027). Therefore, the mean difference between the two groups was analyzed using the nonparametric Mann-Whitney U test. There was a statistically significant difference between the CBCT and ImageJ measurements (p = 0.01). According to Spearman's correlation analysis, the results obtained from the novel method were moderately correlated with those obtained from the reference method (r = 0.444). The results of this study indicated that a novel method-based Java software can be used to calculate pulp volume using low-dose radiation containing periapical radiography.

Effect of tobacco use on cadmium accumulation in the oral keratinized mucosa.

BACKGROUND: This cross-sectional study aimed to evaluate the effect of tobacco use on the accumulation of cadmium (Cd), a carcinogenic element, in the oral keratinized mucosa (OKM). METHODS: OKM samples were obtained by standard punch biopsy from nonsmokers (n = 19) and smokers (n = 21). Cd analysis was performed using inductively coupled plasma optical emission spectroscopy (ICP-OES). The calibration curve R2 values for three wavelengths (214,439, 226,502, and 228,802 nm) were at the level of 0.9999. The frequency of consumption of foods that are Cd sources, such as seafood, rice, and vegetables, was assessed in all patients. The age, sex, and nutritional habits of all patients and the frequency of tobacco consumption by smokers were recorded. The independent t-test, Mann-Whitney U test, Fisher's exact test, and Spearman correlation test were used for the statistical analyses, and p < 0.05 was considered significant. RESULTS: Although the Cd levels in nonsmokers were higher than those in smokers, no statistically significant difference was found (p > 0.05). In smokers, a positive correlation was found between age and Cd level (r = 0.574, p = 0.006). No significant relationship was found between the groups in terms of nutrition or between the frequency of tobacco consumption and Cd accumulation. CONCLUSION: The OKM may not have the characteristic cumulative accumulation in terms of toxic elements. Changes in the turnover rate, keratinization, and apoptotic mechanisms in the OKM with the thermal/chemical effects of tobacco may be responsible for the difference in Cd accumulation. TRIAL REGISTRATION NUMBER: TCTR20230206001/06 Feb 2023 (TCTR: Thai Clinical Trials Registry).

A novel approach to radiographic detection of growth development period with hand-wrist radiographs: A preliminary study with ImageJ imaging software.

OBJECTIVE: The purpose of this study is to determine whether or not the ImageJ program can be used to automatically determine the growth period of the hand and wrist which have different growth-development periods according to the density values in the phalanges in radiographs. SETTING AND SAMPLE POPULATION: Our study included hands-wrist radiographs of 270 individuals aged 8-17 years. MATERIAL AND METHODS: The study's participants were classified into 7 groups according to their skeletal maturation stage (PP2=, MP3=, MP3cap, DP3u, PP3u, MP3u, and Ru) which included pre-peak, peak, and post-peak periods. The total density values (TDV) and pure density values (PDV) in the distal, medial, and proximal phalanges were calculated using each radiograph in the ImageJ program. Analysis of variance (ANOVA) was used to evaluate the density values and chronological age, and pairwise comparisons were made using the post-hoc LSD test. RESULTS: The total density value was graphically zigzagged in the mesial, distal, and proximal phalanges. However, the pure density value increased continuously until the post-peak period and decreased after the DP3u period until the Ru period. While no significant difference in total density values was observed between the growth periods for all three phalanges, a significant difference in pure density values was observed. CONCLUSION: It has been demonstrated in the ImageJ program that the peak growth period can be distinguished using the pure density values obtained from all phalanges of the third finger and that this method can be used as an alternative to the growth period detection through artificial intelligence.

The diagnostic performance of the Java-based software colorization tool in the diagnosis of dental caries: an in vitro study.

OBJECTIVE: This in vitro study aimed to compare the diagnostic outcomes of caries detection in premolar and molar teeth on digital periapical radiographs viewed as grayscale images and in the Java-based software (JBS) pseudocolor spectrum. METHOD AND MATERIALS: The study comprised 92 premolar or molar human teeth (n = 46 with caries and n = 46 without clinical caries). For each tooth, digital periapical radiographic images (DPRIs), JBS pseudocolor images, and stereomicroscope images were collected, and caries presence and depth were recorded. In JBS pseudocolor images, regions of interest (ROIs) were detected, and ROI values for caries area (ROI1), non-caries area (ROI2), mesial area (ROI3), and distal area (ROI4) were obtained. The degree of inter-observer agreement was determined using the kappa coefficient, and the sensitivity and specificity of the methods were assessed using ROC analysis. RESULTS: While neither method was consistent with stereomicroscopy in determining caries depth (P < .005), for both observers the kappa value of JBS pseudocolor images were slightly higher than those for DPRIs. ROI1 was found to be significantly lower than ROI2 (P < .001), whereas no difference was found between ROI3 and ROI4 (P = .877). For both observers, the sensitivity and specificity obtained from JBS pseudocolor were above 89%. CONCLUSION: JBS pseudocolor images can be used for caries detection and offer high sensitivity and specificity.

Microleakage beneath orthodontic brackets in high field magnetic resonance imaging (MRI) AT 1.5 & 3 Tesla.

OBJECTIVES: The aim of the present study was to evaluate the effects of 1.5 T and 3 T MRI on the adhesion between the orthodontic brackets and the teeth by evaluating the microleakage between the enamel, adhesive and brackets interfaces. METHODS: 58 extracted human premolars which were received a standard bracket bonding procedure were randomly divided into three groups; control group (n = 20; no MRI), 1.5 T MRI group (n = 19; 20 min MRI exposure of 1.5 T) and 3 T MRI group (n = 19; 20 min MRI exposure of 3 T). The teeth were kept in distiled water for 2 weeks, and thereafter subjected to 500 thermal cycles. Then, specimens were sealed with nail varnish, stained with 0.5% basic fuchsin for 24 h, sectioned and photographed under a stereomicroscope. Microleakage was scored with regard to the adhesive-enamel and bracket-adhesive interfaces at the occlusal and gingival levels. Statistical analysis was accomplished by Kruskal-Wallis and Bonferroni-Dunn tests. RESULTS: All of the groups exhibited statistically similar microleakage scores in the adhesive-enamel interface along occlusal margins (p>0.05, p = 0.331). The mean microleakage scores along gingival margins in the 3 T MRI group was significantly higher compared to the control group both in the adhesive-enamel and bracket-adhesive interfaces (p<0.05, p = 0.019 and p = 0.020 respectively). The microleakage scores along the gingival margins were also significantly higher than the occlusal margins in the 3 T MRI group (p<0.05, p = 0.029). CONCLUSIONS: 3 T MRI may weaken the adhesion between the enamel and the stainless steel orthodontic brackets.

The relationship between oral cancer and cadmium: a review.

Cadmium (Cd) has been classified as a type I carcinogen. Since it is ingested orally through food and tobacco use, Cd is likely to be closely related to oral cancers. The relationship between cadmium and oral cancer was investigated using papers on Pubmed and Web of Science. Thus a total of 11 studies from these databases were included in the review. Cd concentrations were significantly higher in both the blood and hair of oral cancer patients than in controls. Additionally, it has been reported that Cd increases the activity of reactive oxygen species. Tobacco plants contain varying levels of Cd. The presence of high Cd concentrations in patients who use tobacco products and develop oral cancer is strong evidence that Cd is directly related to oral cancer. While planning a study to determine the Cd concentrations in biological samples, it is advisable to examine the methodologies of previous studies and to avoid technical deficiencies. New cell line studies are required to explain the relationship between Cd and autophagy-apoptosis.

A novel approach to radiographic detection of bucco-palatal/lingual dilacerations: A preliminary study with ImageJ.

The purpose of our study is to determine whether bucco-palatal/lingual (BPL) root dilacerations (RD), especially in single root teeth, can be determined using the ImageJ program through only one periapical radiography. Extracted teeth without any RD (n = 8) were determined as the control group (Group 1) and with RD in apical 1/3 part at least 20° with the longitudinal axis in the BPL direction (n = 8) as the study group (Group 2). With the help of a simple holder system prepared, digital periapical radiographs of all teeth were taken in an anteroposterior position. Histogram analysis of all periapical radiographs was performed using the spectrum feature of ImageJ software. It was aimed to make a dilaceration analysis by comparing the groups using mean, standard deviation, minimum, maximum, and bin width values. As a result of the Mann-Whitney U test, all mean and maximum values showed a statistically significant difference between the study and control groups (p < 0.05). This pilot study revealed that the ImageJ software can be used to diagnose BPL dilaceration in the apical 1/3 part of the root. It is important for dentists and patients that it can contribute to limiting the radiation dose to which patients will be exposed.

Recurrent Aphthous Stomatitis as a Result of Zinc Deficiency.

PURPOSE: The purpose of this study is to evaluate the results of patients, with a chief complaint of recurrent aphthous stomatitis (RAS), who were found to have zinc deficiency as the predisposing factor and received appropriate replacement therapy. MATERIALS AND METHODS: A retrospective study was conducted using data from the medical records of patients with a chief complaint of RAS. Patients with potential ulcer-causing conditions were excluded. All patients were intraorally examined to rule out trauma-associated aetiologies. Blood tests were ordered to measure total blood count, serum transferrin, ferritin, zinc, folic acid and vitamin B12 levels. RESULTS: A total of 48 patients, 34 with zinc deficiency and 14 with both zinc and iron deficiencies, were included in this study. Patients received an initial three-monthly replacement treatment and blood tests for the certain deficiencies were repeated at the end of this time interval. Two patients with zinc deficiency reported no relief due to incorrect intake of tablets with milk. Following correct instructions, all patients reached normal serum mineral levels and reported no recurrences. All patients remained asymptomatic and their mineral levels were monitored in every 3 months to detect any abnormalities. Overall mean follow-up for this study was 12.06 months (range: 8-28 months, SD: ± 5.7). CONCLUSION: Zinc deficiency should be considered and investigated as part of the diagnostic process of RAS. A simple blood test may aid in correct diagnosis and complete resolution of this recurring condition rather than constant prescription of certain medicines to suppress the symptoms.

Determination of mandibular morphology in a TURKISH population with Down syndrome using panoramic radiography.

BACKGROUND: Down syndrome (DS) is by far the most common known chromosomal disorder. Some characteristic features of DS are generalised growth deficiency, craniofacial abnormalities such as mandibular prognathism and underdevelopment of the midfacial region, dental abnormalities such as taurodontism and hypodontia. Individuals with DS have an increased prevalence of periodontal disease compared with age-matched control patients. The aim of the present study is to determine the morphologic features of the mandible among individuals with DS. METHODS: Thirty-four DS patients and thirty four age- and gender-matched control subjects underwent panoramic radiography, which included measurement of the mandibular canal (MC), the mandibular foramen (MF), the mandibular ramus (MR), the distance from the MC to the mandibular lower border (C-MLB), and the distance between the MC and the alveolar crest upper limit (C-AUL). Patients were separated into two groups based on age: < 15 (n = 15) and ≥ 15 (n = 19). In order to determine whether the MF, MR, MC, C-AUL, and C-MLB scores differed according to the groups (DS and control), one-way multivariate analysis of covariance (MANCOVA) was applied in which gender and age were taken as covariates. RESULTS: When the main effect according to the group was examined separately according to each measurement, the MF in the DS group was high with a moderate effect (F = 9207; p = 0.003). MR (F = 40,518; p < 0.001), MC (F = 23,747; p < 0.001), and C-AUL (F = 58,571; p < 0.001) in the DS group were lower with a larger effect. C-MLB did not significantly differ between the groups, and the effect size was quite low (p > 0.05). CONCLUSIONS: Mandibular canal morphology may exhibit anatomical variations in DS. The alveolar bone level may differ from non-DS due to growth development retardation and/or periodontal diseases.

Comparison of the Angulation of the Unerupted Mandibular Second Premolar in Turkish Population with Tooth Agenesis.

OBJECTIVE: This study aimed to evaluate the unerupted mandibular second premolar (MnP2) angulation in individuals with different tooth agenesis in Turkish population. METHODS: We retrospectively reviewed panoramic radiographs of patients treated at Akdeniz University. According to the agenesis, the subjects were categorized into three groups: 22 patients with unilateral MnP2 agenesis (Group 1), 22 patients with bilateral mandibular incisor agenesis (MnI, Group 2), and 22 patients with no agenesis excluding third molars (Group 3). The angle between the first mandibular molar and unerupted MnP2 (ɣ angle) and the angle between the mandibular basis and unerupted MnP2 (Ɵ angle) were measured on both the right and left sides in Groups 2 and 3 using the method determined by Shalish et al. RESULTS: Groups 1 and 2 were compared with the control group with respect to (ɣ) and (Ɵ). No significant difference was found between Groups 2 and 3 on both the right and left sides (p>0.05). The comparison between Groups 1 and 3 revealed significant differences in the ɣ and Ɵ angle only on the left side (p>0.05). CONCLUSION: Posterior rotation of the mandibular condyle during the growth-development period may be one of the factors responsible for the difference in the Ɵ angle between the MnI agenesis and control groups. A difference in the total number of teeth on the dental arch may be a reason for the differences in the ɣ angle between the MnI agenesis and control groups.