Derya Yildirim

Early diagnosis of oral cancer.

Survival rates for oral cancer are very poor, at approximately 50% overall, and have not improved markedly in recent decades despite advances in therapeutic interventions. Detecting oral cancer at an early stage is believed to be the most effective means of reducing rates of death, morbidity and disfigurement from this disease. Tobacco and alcohol consumption and pre-malign lesions are the most common aetiological factors. The proportion of patients presenting with oral cancer at an advanced stage is troubling. Early diagnosis is the most effective way of reducing the individual burden of the disease, decreasing morbidity and mortality and improving quality of life. For early diagnosis, healthcare providers should perform oral cancer examinations as part of their patient care regime, and need to be knowledgeable about early signs of oral carcinoma. Oral cancer awareness among the public should also be improved.

Three-dimensional anatomic analysis of the lingula and mandibular foramen: a cone beam computed tomography study.

PurposeThe authors analyzed the anatomic location differences of the mandibular foramen (MF) and lingula in a cone beam computed tomography study, aiming to obtain information that could be used when performing mandibular osteotomies and the inferior alveolar nerve block (IANB). MethodsThree-dimensional mandibular computed tomography images were reconstructed from data for 139 patients (278 sides) aged between 9 and 18 years (growth group, 27 patients) and aged 19 to 71 years (adult group, 112 patients). ResultsIn the adult group, positive correlations were seen between right and left measurements. In the growth group, there are significant differences in lingula-anterior and MF-posterior ramus measurements. In the adult group, there are significant differences between man and woman MF-gonion distance measurements. Differences were seen in edentulous and asymmetry patients. ConclusionsThe MF is an important anatomic landmark for ramus surgery and IANB. When applied to ramus operations and IANB, the anatomic data provided by this study may help surgeons gain more understanding of nerve position during surgery.

Radiopacity evaluation of contemporary resin composites by digitization of images

Objective: The aim of this study was to evaluate the radiopacity of different composite resins and compare the values to those of human enamel and dentine. Materials and Methods: Five specimens of each material with thicknesses of 2 mm were prepared and radiographed alongside aluminum step wedge and human enamel and dentin. Three occlusal radiographs for each material were taken and digitized using a desktop scanner. Mean gray values of the test materials were measured using Image J software. Then a conversion was performed according to establish the radiopacity of the test materials, in millimeters of equivalent Al. Data were analyzed using one-way analysis of variance and Duncan multiple range tests (P < 0.05). Results: The radiopacity values varied among the restorative materials (P < 0.05). The radiopacity values of the materials tested were, in decreasing order: Enamel Plus HRI > Z250 > Filtek Ultimate ≥ Z550 > Nexcomp ≥ Nanoceram Bright > enamel ≥ Estelite Sigma Quick > Clearfil Majesty Esthetic ≥ Reflexions XLS ≥ Aelite LS Posterior ≥ dentin ≥ 2 mm Al. Conclusion: All resin composite materials investigated in this study presented different radiopacity values. However, all materials had radiopacity values greater than dentin and had sufficient radiopacity to meet International Organization for Standardization 4049 standard.

Evaluation of osteoporosis in jaw bones using cone beam CT and dual-energy X-ray absorptiometry

The aim of this study was to evaluate changes in jaw bones due to osteoporosis using cone beam computed tomography (CBCT) images. Subjects that had undergone CBCT for various oral conditions and demonstrating clinical findings of osteoporosis were invited to participate in the study. Dual X-ray absorptiometry (DXA) was performed on 90 patients aged over 30 years who underwent CBCT. The study groups were based on DXA results, and included 26 osteoporosis patients (mean age ± standard deviation; 58.52 ± 5.91), 33 osteopenia patients (52.67 ± 8.61) and 31 healthy controls (49.81 ± 10.47). CBCT images of jaw bones were evaluated using radiomorphometric indexes, CT values, histogram analysis (HA) and fractal dimension (FD) analysis. Right and left mandibular radiomorphometric indexes, CT values and HA measurements in osteoporosis patients were significantly lower than measurements in osteopenia patients and control subjects (P ≤ 0.05). Positive correlations were observed between measurements of spine bone mineral density (BMD) and right and left mandibular CT values (P ≤ 0.01) and HA (P ≤ 0.01) measurements. Left maxilla FD measurements in osteoporosis patients were significantly lower than in the control (P ≤ 0.05) and osteopenia (P ≤ 0.05) groups. Osteoporosis caused significant changes in radiomorphometric indexes, CT values, and HA and FD measurements in the jaw bones. (J Oral Sci 58, 185-194, 2016).

Subpontic osseous hyperplasia: Three case reports and literature review

Subpontic osseous hyperplasia (SOH) is an ectopic growth of bone occurring on the edentulous ridge beneath a fixed partial denture. The aim of this article is to present three patients with SOH with long-term follow-up and to make a current overview of the literature. Presented maxillary SOH is the second case in the dental literature. Intraorally the lesions were bone-hard and painless swellings in the subpontic space. Radiographically, the maxillary case was a nodular bone growth having similar radiodensity and trabeculation to the adjacent bone with a thin radiopaque border. Mandibular cases were bony growths, which were more radiopaque than the adjacent alveolar ridge. Follow-up radiographs revealed regression in two of the cases. Clinicians should take care not to cause the possible etiologies of SOH such as functional stresses and chronic irritation by the prosthetic treatments and be aware of SOH does not usually require treatment or a biopsy.

Endodontically related lesions on panoramic radiographs in a Turkish subpopulation

Objective: The purpose of this study was to evaluate the prevalence of detectable endodontically related lesions as determined from the reports of panoramic radiographs in a Turkish subpopulation. Materials and Methods: There were 19,625 reports of panoramic radiographs that were evaluated. Four investigators assessed the radiographs and reports that had been written. For each tooth of the subjects, the following items were surveyed: presence of periapical lesion, inadequate root canal treatment, external and internal root resorption. Results: The patients who had panoramic radiography reports were between the ages of 3 and 91 years (mean age 29,43 ± 18,83 years). 10,941 (56%) were female and 8684 (44%) were male patients. Inadequate root canal treatment was recorded in 588 (3%) radiography reports and it was more frequent in mandibular molar teeth. 2287 (11.7%) of the patients had periapical lesions and it was more frequent in maxillary incisor teeth and mandibular molar teeth. External resorption was observed in 61 (0.3%) patient records, while internal root resorption was reported in 14 (0.1%) reports. 81 inadequate root-filled teeth presented a periapical lesion. A positive strong linear correlation was found between the presence of inadequate root canal treatment and a periapical lesion among the patients (r = 0.098, P = 0.000). Conclusions: The results of this study suggest that external and internal root resorption were not frequent clinical conditions. The high frequency of periapical lesions and inadequate canal treatment in molar teeth indicate the need to improve the technical quality of root fillings, especially in molar teeth.

Long-term evaluation of single-puncture temporomandibular joint arthrocentesis in patients with unilateral temporomandibular disorders

The purpose of this study was to evaluate the long-term effects of the single-puncture arthrocentesis (SPA) technique. Forty-two patients with unilateral temporomandibular joint disorders (TMDs) were treated by SPA. Thirty-eight of these patients completed 1-24 months of follow-up (short-term group) and 21 completed 11 months or longer of follow-up (long-term group). The two groups were evaluated statistically for pain (visual analogue scale), maximum mouth opening, lateral excursion, and protrusion. Both follow-up duration groups showed significant improvements when compared to baseline levels for almost all of the outcome variables (P<0.05). Single puncture temporomandibular joint arthrocentesis is an effective treatment method over both the short and long term.

Evaluation of ultrasonography guidance for single-puncture temporomandibular joint arthrocentesis: A randomized clinical study

Abstract Objective To evaluate ultrasonography (US) guidance on the single-puncture temporomandibular joint (TMJ) arthrocentesis technique. Methods Twenty-four patients were randomly divided into two groups (n = 12 in each group), and single puncture arthrocentesis (SPA) was performed with and without US guidance in groups 1 and 2. During the one-year follow-up period, the groups were statistically evaluated by the visual analog scale for pain, maximum mouth opening, lateral excursion, and protrusion within each group and between the two groups. Results Both treatment groups showed significant improvement, compared to the baseline levels for almost all outcome variables. However, there were no statistically significant differences between groups 1 and 2 (p > 0.05). Conclusion US guidance can be used for cannula placement in SPA. However, the outcome results are the same with or without its use.

Comparison of radiopacities of different flowable resin composites

Objectives: Radiopacity can facilitate diagnostic observations adjacent to flowable resin composites. The aim of this study was to evaluate the radiopacity of the current low viscosity flowable resin composites and to compare them with human dental tissues. Materials and Methods: Five specimens of seven flowable light cured composite materials with a thickness of 2 mm were prepared and radiographed alongside an aluminum stepwedge, human enamel and dentin. Three standart occlusal radiographs for each material were taken with exposure time of 0.32 seconds and focus-film distance of 40 cm. Films were processed in an automatic device, and digitized using a desktop scanner. Mean gray values of the materials, stepwedge, enamel and dentine were measured using Image J software. The data were analyzed using the Duncan multiple range test. Results: The mean gray values of flowable resin composites ranged from 26.61 ± 1.45 to 38.38 ± 1.47. The radiopacity values of the materials evaluated were in decreasing order: G-aenial Flo, Filtek Ultimate Flowable, Flowline, Estelite Flow Quick, Leaddent Flow, Supraflow, Bright Light Flow. All flowable resin composites, except Bright Light Flow, demonstrated significantly greater radiopacity values than 2 mm of the aluminum scale and dentin (P < 0.05). The radiopacity of only one flowable composite, G-aenial Flo, was found to be significantly higher from enamel (P < 0.05). Conclusions: All investigated materials presented radiopacity values above the minimum recommended by the international organization for standardization.

Aneurysmal bone cyst of the mandible: Report of a case with a review of the literature

Aneurysmal bone cyst (ABC), is a rare benign osteolytic bone neoplasm of bone tissue characterized by several sponge-like blood or serum filled, generally non-endothelialized spaces of various diameters that can contain osteoid tissue and osteoclast-like giant cells. In this article, we describe a case of ABC in the mandibular corpus region with clinical, radiological and pathological findings and review the literature concerning the case. A 23-year-old male patient attended to our clinic with the complaint of a mild-pain on the left posterior lower jaw since two months. The superior margin of the lesion was extending between the apical third parts of the roots of the teeth 35-38. Cone beam computed tomography (CBCT) was performed. CBCT Slices revealed an expansile lesion with hydraulic-appearing outer margins above the mandibular canal. Excisional surgical treatment was performed after raising a mucoperiosteal flap and finalized with curette of lesion under local anesthesia. Diagnosis of aneurysmal bone cyst was confirmed by histopathological evaluation. The patient was pain free after six months follow-up, and panoramic radiography showed no evidence of recurrence. The ABC is most common in those regions of the skeleton where there is a relatively high venous pressure and high marrow content. Clinical presentation of the ABC varies from a small, indolent, asymptomatic lesion to rapidly growing, expansile, destructive lesion causing pain, swelling, deformity, neurologic symptoms, pathologic fracture, and perforation of the cortex. As the radiologic and clinical presentation of ABC is extremely variable, histopathologic examination is placed a great emphasis on for the diagnosis.