Ahmet Ercan Sekerci

Comparison of pharyngeal airway volume among different vertical skeletal patterns: a cone-beam computed tomography study.

OBJECTIVE To test the null hypothesis that there are no significant differences in pharyngeal airway volumes among adult patients with different vertical skeletal patterns and a clinically normal sagittal skeletal pattern using cone-beam computed tomography (CBCT). MATERIAL AND METHODS The study sample consisted of 100 adult patients (45 men and 55 women; mean age  =  24.0 ± 5.3 years) with a normal sagittal skeletal pattern divided into three groups according to the vertical skeletal patterns: high angle (32 patients: 15 women and 17 men), low angle (34 patients: 14 women and 20 men), and normal angle (34 patients: 16 women and 18 men) groups. Nasopharyngeal, oropharyngeal, and total airway volumes of patients in all vertical groups were calculated. Group differences were analyzed using one-way analysis of variance and post hoc Tukey tests. RESULTS Nasopharyngeal airway volume in the high-angle group (mean  =  6067.9 ± 1693.9 mm(3)) was significantly lower than that of the low- and normal-angle groups (P < .01). Oropharyngeal airway volume was highest in the low-angle group (mean  =  15,957.6 ± 6817.2 mm(3)) and significantly decreased in the control (mean  =  11,826.1 ± 4831.9 mm(3); P  =  .008) and high angle (mean  =  10,869.1 ± 4084.1 mm(3); P  =  .001) groups. Total airway volume was highest in the low-angle group (mean  =  24,261.6 ± 8470.1 mm(3)) and lowest in the high-angle group (mean  =  16,937.0 ± 5027.4 mm(3); P < .001). CONCLUSION The null hypothesis was rejected. Significant differences were found in pharyngeal airway volumes among different skeletal vertical patterns.

Condylar and ramal vertical asymmetry in adolescent patients with cleft lip and palate evaluated with cone-beam computed tomography.

INTRODUCTION The aims of this study were to evaluate condylar and ramal mandibular vertical asymmetry in a patient group affected by unilateral (UCLP) and bilateral (BCLP) cleft lip and palate, and to compare the findings with a well-matched control group with normal occlusion. METHODS The study groups included 20 UCLP patients (12 male, 8 female), 21 BCLP patients (12 male, 9 female), and a control group of 21 subjects with normal occlusion (10 male, 11 female). Measurements of condylar, ramal, and condylar plus ramal heights and asymmetry indexes were examined on cone-beam computed tomography images. One-way analysis of variance was used to determine potential statistical differences among the groups for condylar, ramal, and condylar plus ramal asymmetry index measurements. The post-hoc Tukey HSD test was used to determine individual differences. RESULTS No investigated group showed a statistically significant sex difference for any asymmetry index (P >0.05). There was a statistically significant difference between the normal and cleft sides in the ramal height and ramal plus condylar height measurements in the UCLP group (P = 0.004 and P = 0.006, respectively). The Tukey HSD test showed a statistically significant difference between the UCLP and BCLP groups in terms of ramal asymmetry index values (P = 0.018). CONCLUSIONS The ramal height and ramal plus condylar height measurements were significantly lower in the cleft side in the UCLP patients, and there was a statistically significant difference in ramal asymmetry index values between the patients affected by UCLP and BCLP.

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.

Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular first and second molars in Turkish individuals

Objective: The aim of this study was to investigate the root and canal morphology of mandibular first and second molars in a Turkish population by using cone beam computed tomography (CBCT). Study design: CBCT images of mandibular first (n = 823) and second molar (n = 925) teeth from 605 Turkish patients were analyzed. The root canal configurations were classified according to the method of Vertucci. Results: The majority of mandibular molars (95.8% of first molars, 85.4% of second molars) had two separate roots; however, three roots were identified in 2.06% of first molars and 3.45% of second molars. C-shaped canals occurred 0.85% of first molars and 4.1% of second molars. Three canals were found in 79.9% of first molars and 72.8% of second molars. Most distal roots had a simple type I configuration, whereas mesial roots had more complex canal systems, with more than one canal. The most common root morphology of first and second molars is the two rooted morphology with three canals. Both the mesial and distal roots showed wide variations in canal anatomy with type IV and type I canal configuration predominating in the mesial and distal roots, respectively. Conclusion: Vertucci type I and IV canal configurations were the most prevalent in the distal and mesial roots, respectively, of both the mandibular first and second permanent molar teeth. Key words:Cone-beam CT, Turkish, mandibular molars, root and canal morphology.

Detection and characterization of the mandibular accessory buccal foramen using CT

OBJECTIVE To investigate the frequency and characteristics of the mandibular accessory buccal foramen (ABF) with CT. METHODS A retrospective study was carried out using the CT records of 504 patients referred to the Erciyes University Medical School (Kayseri, Turkey) between 2007 and 2010. Presence, location, diameter, area and number of ABFs and their continuity with mandibular canal and distance to the mental foramen were evaluated using axial, sagittal and three-dimensional CT images. Statistical analysis was performed using SPSS® v. 15 (SPSS Inc., Chicago, IL), and t-tests were used for statistical analysis. RESULTS 14 ABFs were observed in 10 (2%) of 504 patients. The frequency of ABFs was found to be 2.6% in males and 1% in females. The mean distance between the ABF and the mental foramen was 5.0 mm [standard deviation (SD) ± 2.48]. The mean long axis of the ABFs was 1.4 mm (SD ± 0.4) and the mean area of them was 1.5 mm(2) (SD ± 0.8). The mean area of the mental foramen on the side with the ABF was 4.1 mm(2) (SD ± 2.71). CONCLUSIONS This study presents a relatively lower frequency of ABFs than that in the literature. These foramina could have more complex neurovascular structures than was previously thought. Thus, in special cases where a direct surgical exploration during the planned surgery is not indicated, CT or cone beam CT examination to determine the possible presence of ABFs may be indicated.

Assessment of pharyngeal airway volume in adolescent patients affected by bilateral cleft lip and palate using cone beam computed tomography

OBJECTIVE To test the null hypothesis that there were no significant differences for pharyngeal airway volumes between the adolescent patients affected by bilateral cleft lip and palate (BCLP) and well-matched controls using cone beam computed tomography. MATERIALS AND METHODS The study sample consisted of 16 patients (11 female and 5 male; mean [SD] age 14.1 [2.1] years) affected by BCLP and 16 patients (10 female and 6 male; mean [SD] age 13.4 [2.0] years) as age- and sex-matched control group. Craniofacial measurements and pharyngeal airway dimension, area, and volume measurements of patients in both groups were calculated and statistically examined using Students t-test and multiple linear regression analyses. RESULTS Statistically significant differences were found between the BCLP and control groups for SNB (P < .05), SN-GoGn (P < .05), Co-A (P < .05), PAS (P < .01), minAx (P < .01), and oropharyngeal airway volume (P < .05). The most predictive variables for oropharyngeal airway volume were found as PAS (r  =  .655 and P  =  .000) and minAx (r  =  .787 and P  =  .000). CONCLUSIONS The null hypothesis was rejected. Oropharyngeal (P < .05) and total (P > .05) airway volumes were found to be less in the BCLP group, and thus the treatment choice in these patients should have positive effects on the pharyngeal airway.

Odontogenic tumors: a collaborative study of 218 cases diagnosed over 12 years and comprehensive review of the literature

Objectives: The objective of this study was to analyze the frequency and distribution of odontogenic tumors (OTs) in the Cappadocia region of Turkey, and to compare the findings with those reported in the literature. Study Design: The records of the Oral and Maxillofacial Surgery and Pathology Departments at Erciyes University, with histologic diagnosis of odontogenic tumors (based on the World Health Organization classification, 2005), over a 12-year period, were analyzed. The relative frequency of different types of tumors was also analyzed and compared with the literature. Results: OTs in the present study constituted 2.74% of all the 7,942 registered biopsies. A total of 218 cases of OTs were collected and reviewed. Of these, (94.04%) were benign and (5.96%) were malignant. The mandible was the most commonly affected anatomic location, with 170 cases (77.9%). Ameloblastoma with a predilection for the posterior mandible was the most frequent odontogenic tumor (30.28%), followed by keratocystic odontogenic tumor (19.5%), odontoma (13.4%), and odontogenic myxoma (8.5%). Conclusions: OTs are rare neoplasms and appear to show geographic variations in the world. In Cappadocia, Turkey, they are more common in the mandible, with ameloblastoma followed by keratocystic odontogenic tumors with the incidences observed in the present study being similar to those of previous studies from Asia and Africa, and in contrast to those reported from American countries. Key words:Odontogenic tumors, WHO classification, prevalence, jaws.

Evaluation of root morphology and root canal configuration of premolars in the Turkish individuals using cone beam computed tomography

Objective: The aim of the present study is to assess the root and root canal morphology of maxillary and mandibular premolars in a Turkish population by using cone beam computed tomography (CBCT). Materials and Methods: In this study, CBCT images of 2134 premolars (987 maxillary, 1147 mandibular) were obtained from 404 patients. Details of gender, age, number of roots and canals, and canal configuration in each root were recorded. The canal configuration was classified and evaluated according to Vertuccis criteria. Results: The majority of maxillary premolars had two separate roots; although, three roots were identified in 1% of maxillary first premolars. However, most of the mandibular premolars had a single root. The two canals (69.9%) and type I (62.6%) and type II (34.1%) configuration for upper first premolar, one canal (82.1%) and type I (77.6%) canal configuration for second premolar was the most prevalent root canal frequency. The most prevalent root canal frequency was the one canal (96.2%) and type I (94.2%) and type V (3.2%) configuration for mandibular first premolar, one canal (98.9%) and type I (98.9%) canal configuration for second premolar. There was no difference in the root canal configurations and the numbers of canals between the left and the right side of both females and males (P > 0.05). Conclusions: Recognition of morphology and anatomy of the root canal system is one of the most important factors for successful endodontic treatment. Preoperative CBCT examination allows determination of root canal configuration of premolar teeth and helps clinicians in root canal treatment.

Assessment of the visibility and characteristics of the mandibular incisive canal: cone beam computed tomography versus panoramic radiography.

PURPOSE The aim of this study was to assess and compare the visibility, diameter, and course of the mandibular incisive canal (MIC) using cone beam computed tomography (CBCT) and panoramic radiography. MATERIALS AND METHODS CBCT images and panoramic radiographs from 243 patients were used in this study. Standard exposure and patient positioning protocols were used for all the patients. Both types of images were assessed by two dentomaxillofacial radiologists. The diameter and the endpoint level of the MIC were measured using the CBCT images. Statistical analysis was performed using t tests in statistical software. RESULTS Of the 486 hemimandibles examined, the MIC was visible in 249 (51.2%) radiographs and 459 (94.4%) CBCT images. The mean diameters of the MICs were 1.91±0.45 mm on the right side and 1.94±0.41 mm on the left side. The MICs on both the right and left sides of the mandible showed statistically significant differences in diameter in male versus female patients. The visibility of the MIC on the panoramic radiographs according to the increase in the diameter was not statistically significant for both sides. Twenty MICs reached to the midline of the mandible, and the majority of the MICs (n=114) terminated between the canine and the first premolar. CONCLUSION The visibility of the MIC in CBCT is much better than that observed in conventional panoramic radiography. Even some large MICs could not be observed in panoramic radiographs. Detection of the MIC using CBCT may be crucial for surgical procedures involving the interforaminal region.

The prevalence of pulp stones in a Turkish population. A radiographic survey

Objectives: The goal of this retrospective study was to determine the prevalence of pulp stones in a Turkish population. Any possible associations between pulp stones and gender, tooth type and dental arch were also evaluated. Study Design: Four hundred and sixty nine patients’ bitewing radiographs which were reached through the patient database of Erciyes University Dentistry School, Department of Oral Diagnosis and Radiology were examined. Of these 469 subjects whose mean age was 24( ± 10.7), 302 were females and 167 were males. A total of 6,926 teeth were examined during this study. Pulp stones were recorded as present or absent and any relations with gender, tooth type and dental arch were noted. Results: Pulp stones were identified in 270 (57.6 %) of the subjects and in 1,038 (15 %) of the teeth examined. Their presence were seldom found in the premolars (9.07%) but was much higher in the molars (90.92 %). Pulp stone occurrence was significantly more common in the first molars than in the second molars, and in the first premolars than in the second premolars in each dental arch. Their occurrence was higher in the maxilla than in the mandible for each tooth type. No difference between the two genders could be identified. Conclusion: Pulp stones are not only incidental radiographic findings of the pulp tissue but may also be an indicator of some serious underlying disease. On the other hand, they may provide useful information to predict about the susceptibility of patients for other dystrophic soft tissue calcifications such as urinary calculi and calcified atheromas. However, further study on this issue is needed. Key words: Prevalence, pulp stone, Turkish population.