Ahmet Berhan Yilmaz

Reliability of mandibular cortical index and mandibular bone mineral density in the detection of osteoporotic women

OBJECTIVES Measuring the bone mineral density (BMD) of the femur and lumbar vertebrae has been the traditional method for determining osteoporosis in women. In this study, we tried to determine the relationships between mandibular dual-energy X-ray absorptiometry (m-DXA) values obtained with a new methodology, mandibular cortical index (MCI), total BMD values of the femur and lumbar vertebrae in 80 women with osteoporosis determined by DXA in conformity with T-score thresholds, as defined by the World Health Organization (WHO). METHODS m-DXA and panoramic radiography were performed on 80 women with osteoporosis. m-DXA was calculated by manual analysis of DXA scans. MCI was determined by the appearance of the mandibles on panoramic radiographs. DXA measurements of the skeletal BMD (femur and lumbar vertebras) and MCI values were also calculated. Correlations between these variables were assessed. RESULTS Although there were no correlations between skeletal BMD (total BMD values of the femur and lumbar vertebras) and mandibular measurements (mDXA and MCI), we found that there was a significant correlation between the skeletal BMDs (r = 0.355, P = 0.001). CONCLUSIONS It is concluded that no significant correlations were found between the mandibular and non-mandibular measures in women with osteoporosis.

Changes in the mandibular angle in the dentulous and edentulous states

STATEMENT OF PROBLEM Reliable measurement of individual gonial angles is difficult because of the superimposed images appearing on the lateral cephalograms. However, this disadvantage is not encountered in orthopantomography. PURPOSE This study determined whether the mean measurements of the mandibular angles of a group of totally edentulous patients were greater than those of unilaterally and posteriorly partially edentulous patients. Changes in the gonial angle between denture wearers and nondenture wearers in each group were also compared. MATERIAL AND METHODS A total of 134 panelipse radiographs were used for measurements of mandibular angles. All radiographs used in this study were taken with the same panelipse machine by the same person. Of the 134 radiographs, 49 were of unilaterally and posteriorly partially edentulous adults and 85 were of totally edentulous adults. RESULTS No significant differences were found between the mandibular angles when comparing partially edentulous and totally edentulous subjects. CONCLUSION Within the limits of this study, there was no significant difference between the dentulous and edentulous states.

The frequency of bifid mandibular condyle in a Turkish patient population.

OBJECTIVE The objective of this study was to investigate the frequency and pattern of bifid mandibular condyles (BMCs). METHODS A retrospective study was performed using panoramic radiographs from 10 200 patients undergoing dental treatment in the Department of Oral and Maxillofacial Radiology (Erzurum, Turkey) between 1996 and 2008. RESULTS Of the 10 200 patients, 32 (0.3%) had BMCs, of whom 17 were female (53.1%) and 15 were male (46.9%). The age range of the patients with BMCs was 5 to 71 years (mean age 30.0+/-0.40). Of these 32 patients, 24 (75.0%) had unilateral and 8 (25.0%) had bilateral BMCs, none of the patients had a history of trauma. No symptoms associated with bifid condyles were observed in any of the patients with BMCs. CONCLUSIONS It is possible that BMC is a more frequent condition than is commonly perceived. However, because of the minimal symptoms associated with this condition, the authors believe that it will remain an incidental finding upon routine radiographic examination, rather than a clinical observation. Nevertheless, in symptomatic cases or in cases where surgical treatment is planned, panoramic radiographs should be supplemented with CT.

Oxidative stress and myeloperoxidase levels in saliva of patients with recurrent aphthous stomatitis

OBJECTIVE Recurrent aphthous stomatitis (RAS) is the most common oral ulcerative condition affecting 5-25% of the general population. The aim of this study was to evaluate the oxidative stress parameters in saliva of patients with RAS and to investigate the relationship among these parameters in either group. MATERIALS AND METHODS The study involved 50 patients with RAS of whom 24 were male and 26 were female, and 25 healthy controls of whom 13 were male and 12 were female. RESULTS There was no statistically significant difference in the salivary total antioxidant capacity, total oxidant status, oxidative stress index levels, and myeloperoxidase activity between patients with RAS and those in the control group. CONCLUSIONS The results show that reactive oxygen species may not play a role in the etiology of RAS.

Pneumatization of the articular eminence on cone beam computed tomography: prevalence, characteristics and a review of the literature

OBJECTIVES The aim of this study was to determine the prevalence and characteristics of pneumatized articular eminence (PAT) by cone beam CT (CBCT) and to present a review of the PAT literature. METHODS A retrospective study was performed using sagittal and coronal CBCT images of 514 patients in the Department of Oral and Maxillofacial Radiology, Ataturk University, Turkey. Age and gender were recorded for all patients and, for the cases of PAT, laterality and types were also recorded. The χ(2) test was used. RESULTS Of the 514 patients, 41 (8.0%) had PAT, of whom 25 were female (61.0%) and 16 were male (39.0%). This difference was not statistically significant (P > 0.05). The age range of the patients with PAT was 15-62 years (mean 30.6 ± 11.4). Of the 41 patients, 31 (75.6%) had unilateral and 10 (24.4%) had bilateral PAT. 17 (41.5%) PATs were unilocular and 24 (58.5%) were multilocular. CONCLUSIONS It is possible that PAT is a more frequent condition than is commonly perceived. In differential diagnosis of suspected cases or in cases for which surgical treatment is planned, panoramic radiographs should be supplemented with CBCT.

Radiographic evaluation on prevalence of Stafne bone defect: a study from two centres in Turkey

OBJECTIVES The aim of this study was to investigate the frequency of Stafne bone defect (SBD) and to describe the clinical and radiological characteristics of detected cases. METHODS A retrospective study was performed using panoramic radiographs from 34 221 patients undergoing dental treatment in the Department of Oral and Maxillofacial Radiology at Erciyes University and Ataturk University, Turkey. After finding an image compatible with SBD in the radiographs, multislice CT (MSCT) on seven patients and cone beam CT (CBCT) on six patients were performed to confirm the diagnosis. RESULTS Of the 34 221 patients, 29 (0.08 %) had SBDs, of whom 4 were female (13.8%) and 25 were male (86.2 %). The age range of patients with SBD was 18-77 years (mean age 49.6 years). SBD was found in the lingual molar region in 28 patients and in the lingual canine-premolar region of the mandible in 1 patient. The contour of the concavities on CT images (MSCT and CBCT) was detected. The MSCT revealed glandular tissue within the defects. CONCLUSIONS According to our results, SBD is an uncommon anomaly. Examination of MSCT images supports the presence of aberrant submandibular glands within these mandibular defects, suggesting that pressure from submandibular gland tissue had caused the SBD, as generally thought. Both CBCT and MSCT can provide adequate support for the detection of SBDs. The CBCT could be suggested as the most suitable non-invasive diagnostic modality for this bony configuration of the mandible since it provides a lower radiation exposure dose than MSCT.

Radiological examination of the articular eminence morphology using cone beam CT

OBJECTIVE The purpose of the present study was to investigate the articular eminence inclination and height according to age and gender in patients with temporomandibular joint (TMJ) dysfunction and healthy controls using cone beam CT (CBCT). METHODS The measurements were performed on CBCT records of 52 TMJ dysfunction patients (11 males and 41 females) and 41 control patients (17 males and 24 females). The eminence inclination and height were measured on the CBCT images. RESULTS The eminence inclination and height values were higher in males than in females in both TMJ dysfunction patient and control groups; however, these differences were not statistically significant (p>0.05). While no statistically significant differences were found in the eminence inclination and height values between the age groups (p>0.05) in the TMJ dysfunction patient group, there were statistically significant differences in the control group. The eminence inclination was highest between the ages of 21 and 30 years and showed a decrease after the age of 30 years. Additionally, the eminence inclinations of the control patients were statistically higher than those of the TMJ dysfunction patients. CONCLUSION There were no statistically significant differences in eminence inclination and height according to gender. The eminence inclination reaches its highest value between the ages of 21 and 30 years and shows a decrease after the age of 31 years in healthy patients. The eminence inclination was steeper in healthy control patients than in patients with TMJ dysfunction.

Is the assessment of dental age by the Nolla method valid for eastern Turkish children

Abstract:  The aim of this study was to investigate whether or not the Nolla method is appropriate for Turkish children for the determination of the dental age (DA). A group of 719 children between the ages of 6 and 18 years were included in the study. DAs from orthopantograms by the Nolla method were estimated. The results obtained were compared with chronologic age (CA). Paired t and the Wilcoxon tests were performed. Both genders were underestimated in dental maturity when compared with the reference samples in total (−0.3 years) (p < 0.01). The differences in girls were statistically significant in total and in all groups except for 7–7.9. The differences in boys between the CAs and DAs were not statistically significant in total and in all groups except for 7–7.9 and 8–8.9. Although the accuracy of this method was suitable for boys, according to our findings, it was not suitable for girls.

Cone beam computed tomography imaging of ponticulus posticus: prevalence, characteristics, and a review of the literature

OBJECTIVE The aim of this study was to investigate the frequency of ponticulus posticus (PP) using cone beam computed tomography (CBCT) and to describe the radiologic characteristics of the detected cases. STUDY DESIGN The presence and types of PP were investigated on 730 CBCT images. RESULTS PP was found in 17.4% (127) of the 730 CBCT scans. Of these 127 patients, 79 (10.8%) had bilateral PP and 48 (6.6%) had unilateral PP. Male predominance was found with a prevalence of 19.5% (54 of 277) and female prevalence was 16.1% (73 of 453). The prevalence of PP increased with age; the highest prevalence of PP was seen in those who were 49 to 81 years of age. CONCLUSIONS This study shows that PP is not an uncommon anatomic variation and is a natural incidental finding on CBCT.

A retrospective analysis of sphenoid sinus hypoplasia and agenesis using dental volumetric CT in Turkish individuals.

PURPOSE In adults, sphenoid sinus agenesis is an extremely rare anomaly. The objective of this study was to investigate the prevalence of sphenoid sinus hypoplasia and agenesis using dental volumetric computed tomography (DVCT) in a population of Turkish individuals. MATERIALS AND METHODS DVCT scans in the axial, coronal and sagittal planes of the sphenoid sinus of 384 patients were examined for evidence of sphenoid sinus agenesis and hypoplasia. RESULTS In the DVCT scans, bilateral agenesis of sphenoid sinus was not seen. Unilateral agenesis of sphenoid sinus was seen in 0.26% of the sample, and sphenoid sinus hypoplasia was seen in 0.52%. Unilateral hypoplasia of the sphenoid sinus was observed in 0.26% of the sample, and bilateral hypoplasia of sphenoid sinus was observed in 0.26%. CONCLUSION In this study, we found a low frequency of sphenoid sinus agenesis. Compared with sphenoid sinus agenesis, the frequency of sphenoid sinus hypoplasia was higher. DVCT may be used as a diagnostic tool to investigate the paranasal sinus.