Aydan Kanli

Oral candidosis, denture cleanliness and hygiene habits in an elderly population

Background and aims: Poor denture hygiene and Candida infections are very common among elderly denture wearers. Candida species are usually innocuous, but they can cause disease when conditions are favorable. Oral hygiene habits have been found to be poor among the elderly. This may be due to decreasing manual abilities due to advanced age. Dentures act as a reservoir for yeasts, and this may be aggravated by poorly fitting and old dentures. The purpose of this study was to determine oral hygiene habits, denture cleanliness and presence of yeasts in elderly complete denture wearers. Methods: 42 subjects who had worn complete upper dentures for at least six months were surveyed. The mean age of the subjects was 74 years. Information about denture age, denture hygiene and hygiene habits of subjects was obtained through a structured interview. Clinical examination was conducted by one author. Denture cleanliness was assessed by using the Schubert and Schubert index. For cytological examination, palatal swabs were taken. A chi-square test was used to analyze the results. Results: A significant correlation was seen between oral candidosis and frequency of denture cleaning, and also between candidosis and denture cleanliness. There was no statistically significant correlation between denture cleaning methods and candidosis. The relationship between denture age and the presence of Candida was not significant. There was a significant correlation between denture cleanliness and denture age, cleaning method or frequency of cleaning. Conclusions: Only 16.7% of dentures worn by the elderly are properly cleaned. Older dentures tended to be dirtier than newer ones. There was a significant correlation between poor denture hygiene and prevalence of Candida.

The relationships between dental age, chronological age and bone age in Turkish adolescents with constitutional delay of growth.

The aim of this study was to investigate the relationships between dental age and bone age in Turkish adolescents with constitutional delay of growth and compare them with a group of normal, healthy adolescents. Left hand and wrist radiographs and dental panaromic radiographs of 33 adolescents (25 boys and 8 girls) aged between 10 and 16 years with constitutionally delayed growth were assessed. The control group comprised 41 healthy adolescents (24 boys, 17 girls) aged between 10 and 16 years. Bone age was determined according to Greulich and Pyle; dental age was assessed using the Demirjian method. In the control group, no statistical difference was found between chronological, bone and dental ages. In the group of adolescents with constitutional growth delay, there was no significant difference between chronological age and dental age, but the differences between dental age and bone age and between chronological age and bone age were found to be statistically significant. It was found that Demirjians dental age assessment is a valid method for scoring dental age in Turkish adolescents. Adolescents with constitutional delay of growth had dental maturation appropriate for chronological age, but not for bone age.

Validation of micro-computed tomography for occlusal caries detection: an in vitro study

Conventional methods of caries detection, including the gold standard of histological examination, have certain disadvantages that must be addressed prior to validating any other diagnostic technique-current or new. Here we evaluated the validity of micro-computed tomography (micro-CT) as an alternative gold-standard technique for caries detection. Sixty teeth with suspected occlusal caries were chosen from a pool of teeth extracted for orthodontic, periodontal, or surgical reasons. Identical reference points were marked on photographs taken for teeth and were used to evaluate each method. Dimensions of caries were assessed by two calibrated examiners using the ICDAS-II visual examination system, bitewing radiographs, and micro-CT. The teeth included in the study were selected randomly from solution before all measurements. For micro-CT, the device was set to 50 kV, 800 µA, pixel size 15 µm (at 1024 × 1024 resolution), and 1° rotation step. NRecon software (SkyScan) was used to obtain reconstructed images. For each diagnostic method, results were compared with histology results using the McNemar test. Receiver operator characteristic (ROC) analysis was also performed for each method (Z-test; p < 0.05). Besides showing a high correlation with histology results, micro-CT yielded the greatest values at the D3 threshold; moreover, accuracy and area under the ROC curve (AUC) values were greatest at the D1threshold. Our results indicate that micro-CT performs as well as or better than histological examination for the purpose of comparing methods for caries detection.

Sleep disorders in chronic orofacial pain patients

AbstractThe current study assessed the prevalence of sleep disturbance in a sample of 97 patients suffering from chronic orofacial pain. Patients were evaluated clinically and radiologically and they were asked about sleep disturbances after onset of pain: 75.3% of the patients reported reduced sleep hours, 71% of the patients reported interrupted sleep, 59.8% reported restless sleeping, and 55.7% of the patients reported difficulty in sleep onset.

Evaluation of Diagnostic Tests Using Information Theory for Multi-Class Diagnostic Problems and its Application for the Detection of Occlusal Caries Lesions

BACKGROUND Several methods are available to evaluate the performance of the tests when the purpose of the diagnostic test is to discriminate between two possible disease states. However multi-class diagnostic problems frequently appear in many areas of medical science. Hence, there is a need for methods which will enable us to characterize the accuracy of diagnostic tests when there are more than two possible disease states. AIMS To show that two information theory measures, information content (IC) and proportional reduction in diagnostic uncertainty (PRDU), can be used for the evaluation of the performance of diagnostic tests for multi-class diagnostic problems that may appear in different areas of medical science. STUDY DESIGN Diagnostic accuracy study. METHODS Sixty freshly extracted permanent human molar and pre-molar teeth suspected to have occlusal caries lesions were selected for the study and were assessed by two experienced examiners. Each examiner performed two evaluations. Histological examination was used as the gold standard. The scores of the histological examination were defined as sound (n=11), enamel caries (n=22) and dentin caries (n=27). Diagnostic performance of i) visual inspection, ii) radiography, iii) laser fluorescence (LF) and iv) micro-computed tomography (M-CT) caries detection methods was evaluated by calculating IC and PRDU. RESULTS Micro-computed tomography examination was the best method among the diagnostic techniques for the diagnosis of occlusal caries in terms of both IC and PRDU. M-CT examination supplied the maximum diagnostic information about the diagnosis of occlusal caries in the first (IC: 1.056; p<0.05), (PRDU: 70.5%) and second evaluation (IC: 1.105; p<0.05), (PRDU: 73.8%) for the first examiner. M-CT examination was the best method among the diagnostic techniques for the second examiner in both the first (IC:1.105; p<0.05), (PRDU:73.8%) and second evaluation (IC:1.061; p<0.05), (PRDU:70.8%). IC and PRDU were lowest for visual inspection. CONCLUSION The present study demonstrates that IC and PRDU can be used to evaluate diagnostic test performance when multiple disease states are being evaluated.

AĞIZ ORTAMINDA YAŞLANMA İLE BİRLİKTE GÖRÜLEN DEĞİŞİMLER-Changes in the Oral Cavity Due to Ageing

oz Yapilan bilimsel calismalara, hayat standartlarinin yukselmesine ve insanlarin hijyen kosullarina onem vererek yasamalarina bagli olarak son yuzyilda yasam suresinde onemli artis olmustur. Yasli bireylerde agiz ve dis sagliginin, genel saglik uzerindeki etkisi ihmal edilemeyecek kadar buyuktur. Yaslanmanin orofasiyal bolgedeki etkisinin yani sira, edinilen sistemik hastaliklar ve bunlarin tedavisinde kullanilan ilaclar agiz ortaminda istenmeyen degisikliklere yol acmaktadir. Dis kayiplari, asinmalar, Anahtar kelimeler: Yasli hasta, Orofasial degisimler periodontal hastaliklar, dis curukleri, oral mukozada meydana gelen lezyonlar vb. yasli hastalarin oral fonksiyonlari yeterince iyi yerine getirememelerine yol acar. Konusma bozukluklari, kaslarda atrofi, tat almada degisiklikler de gozlenebilir. Cigneme kabiliyeti protezlerle desteklenir ancak agiz kurulugu, protez kullanimina ve temizligine cesitli nedenlerden dolayi dikkat edilememesi mukozanin butunlugunu bozan rahatsizliklara yol acar. Boyle durumlarda ortaya cikan oral mukoza ve dislere ait komplikasyonlarin bazilari basit yollarla tedavi edilebilirken bazilari daha ciddi sorunlar dogurabilir. Yasli bireylerin, genel saglik durumunu takip eden tip hekimleri ile dis hekimlerinin birlikte hareket etmesi ve iyi bir dis tedavi planlamasi yaslinin agiz sagligini kazandirir, ancak duzenli kontrol goz ardi edilmemelidir. ABSTRACT Over the last century there has been a marked increase in life expectancy due to advances in science, improved living standards and people attaching more importance to hygiene conditions. The impact of oral and dental health on general health status of the elderly population is too big to be ignored. Besides impacts of ageing in the orofacial region, acquired systemic diseases and related medication produce unwanted changes in the oral cavity. Tooth loss, abrasions, periodontal disease, dental caries, oral mucosal lesions etc. impair satisfactory fulfillment of oral functions of elderly patients. Speech disorders, muscle atrophy, changes in taste may also occur. Dentures improve the chewing efficiency but dry mouth, denture use and cleaning deficiencies for various reasons might produce conditions disrupting integrity of oral mucosa. While some of the complications arising in the oral mucosa and teeth because of such situations might be treated with some simple measures, some might lead to serious problems. Cooperation between dentists and doctors following general health status of the elderly and a good dental treatment plan can help restore dental health of an elderly, but routine control should not be neglected. Keywords: Elderly patient, Orofacial changes