Fatma Caglayan

Incidental findings in the maxillofacial region detected by cone beam CT.

PURPOSE The purpose of this study was to determine the location, nature, and occurrence of incidental maxillofacial findings on cone beam computed tomography (CBCT) scans performed for maxillofacial diagnostic purposes. MATERIALS AND METHODS CBCT images of 207 consecutive patients (129 females and 78 males) were examined. The sample consisted of 85 temporomandibular joint (TMJ) disorder patients, 45 paranasal sinusitis patients, 30 obstructive sleep apnea syndrome patients, 15 implant patients, and 32 others. RESULTS The overall rate of incidental findings was 92.8%. The highest rate of incidental findings was in the airway area (51.8%), followed by impacted teeth (21.7%), TMJ findings (11.1%), endodontic lesions (4.3%), condensing osteitis (1%), and others (2.9%). The airway incidental findings included mucosal thickening (21.3%), deviation of the nasal septum (12.6%), conchal hypertrophy (11.1%), bullous concha (3.9%), and retention cysts (2.9%). The impacted teeth consisted of third molars (18.8%) and canines (2.9%). The incidental findings for the TMJ patients were erosion of the condyle (4.8%), osteophytes (3.4%), and bifid condyle (2.9%). CONCLUSION Oral radiologists should be aware of possible incidental findings and should be vigilant about comprehensively evaluating possible underlying diseases.

Differential diagnosis of denture-induced stomatitis, Candida, and their variations in patients using complete denture : a clinical and mycological study

Denture‐induced stomatitis usually occurs in persons who wear a complete or a partial denture. Among the many aetiological and predisposing factors, Candida spp. are believed to play an important role in the initiation and progression of the infection. Seventy cases who attended the clinics of the Dental Faculty, University of Atatürk, Turkey were investigated from the viewpoint of denture‐induced stomatitis. After questioning the patients for their personal information, they were examined clinically and smears were obtained from lesions of the palatal mucosa and the contiguous denture surface by calcium aliginate swabs, and inoculated onto Sabouraud dextrose agar supplemented with 1% chloramphenicol, and CHROMagar Candida. Individual yeast species were identified by a germ tube test, development of blastospores, chlamydospores and pseudohyphae and assimilation tests employing the commercial kit API 20C AUX system. According to the results obtained, 70% of the cases had denture‐induced stomatitis, and in 68% of them mycological culture results were positive. Candida albicans was the most frequently isolated fungus (68.75%). On the other hand, fungal growth was much more pronounced in the cultures made from the inner surface of the dentures. In conclusion, this study showed that candidal infections are not the predisposing factor in the occurrence of denture‐induced stomatitis, but they play a major role, as also some other factors, especially those related with dentures.

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.

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.

Dental Panoramic Radiography in the Diagnosis of Osteoporosis

Osteoporosis is common in the elderly and the dentist is often the only healthcare professional that they visit regularly. Since dental panoramic radiographs (DPRs) are widely used for routine examinations when planning treatment, this study evaluated whether the presence of osteoporosis might be apparent in a population of patients who underwent DPR. The mandibular cortical index (MCI) and a new method of measuring the mandibular radiographic density (m-RD), which used DPR that incorporated an aluminium step-wedge, were compared with the total vertebral bone mineral density (v-BMD) of the lumbar vertebrae measured using dual energy X-ray absorptiometry (DXA) in 25 osteoporotic women. Although there was only a weak correlation between m-RD and v-BMD, significant correlation was found between MCI and v-BMD. Since both m-RD and MCI were related to v-BMD, dental radiographic density and MCI may be useful in clinical dental practice to identify osteoporotic women with previously undetected low BMD.

Foramen tympanicum or foramen of Huschke: anatomical cone beam CT study

OBJECTIVE The foramen of Huschke (foramen tympanicum) represents a developmental defect in the antero-inferior aspect of the bony external auditory meatus. The foramen is located at the antero-inferior aspect of the external auditory canal, posteromedial to the temporomandibular joint. The aim of this study is to define the prevalence and location of the foramen of Huschke. METHODS We retrospectively examined 207 cone beam CT (CBCT) studies (414 ears). We used flat panel detector (FPD)-based CBCT (New Tom FP; Quantitative Radiology, Verona, Italy) for imaging in our department. We noted the location of the foramen tympanicum and calculated its prevalence as a percentage. RESULTS We found a foramen tympanicum in 37 (17.9%) of 207 patients. This was unilateral in 24 patients (11.6%) and bilateral in 13 patients (6.3%). Mean axial diameter was 5 mm and mean sagittal diameter was 2 mm. CONCLUSION The foramen tympanicum is an uncommon disorder and is well demonstrated on CBCT. This is the first study to detect the foramen tympanicum using FPD-based CBCT.

Evaluation of enamel pearls by cone-beam computed tomography (CBCT).

Objective: The aim of this study was to evaluate the frequency of enamel pearls according to population, sex and tooth groups on Cone-Beam Computed Tomography (CBCT) or Dental Volumetric Tomography (DVT) scans of patients, retrospectively. Study Design: In this study, 15185 teeth belonging to 768 patients, 430 female and 338 male, was performed cross-sectional examination by CBCT. The volumetric Computed Tomography used in the study is Newton FP based on flat-panel. The data were analyzed with Pearson chi-squared test. Results: Enamel pearls were detected in 36 subjects (4.69%). Of these enamel pearls, 19 were detected in male and 17 were in male. There was no statistically a significant association between prevalence of enamel pearls and sex. All of enamel pearls were detected in molar teeth, for prevalence 0.83%. Conclusion: All of enamel pearls are found upper and lower molar teeth, especially the most commonly in maxillary second and third molars. Key words: Enamel pearls, ectopic mineralization, radiography, CBCT, DVT.

Associations between the articular eminence inclination and condylar bone changes, condylar movements, and condyle and fossa shapes

ObjectivesThe purpose of the present study was to determine the inclination and height of the articular eminence with respect to the condylar bone changes, condyle shape, fossa shape and condylar movements in patients with and without temporomandibular joint (TMJ) dysfunction using cone-beam computed tomography (CBCT).MethodsThe associations between the eminence inclination and the condylar bone changes, condylar movements, condylar shape and fossa shape were evaluated in patients with TMJ disorders and control patients without TMJ disorders. The measurements of the articular eminence inclination were established on central sagittal slices of the TMJ. The central coronal slices were used to determine the condyle and fossa shapes. The types of movements of the condyles were determined on open-mouth images, and mandibular hypermobility or hypomobility was noted for each joint.ResultsThere were no significant differences in the eminence inclination and height with respect to the condylar bone changes and condylar movements in the TMJ disorder group. However, there was a significant association between the eminence inclination and the fossa shape in the TMJ disorder group and significant associations between the eminence inclination and both the condyle and fossa shapes in the control group. The articular eminence inclination was steeper in the control group than in the TMJ disorder group.ConclusionsThe eminence inclination was steeper in the control patients than in the patients with TMJ disorders, and was not correlated with the condylar bone changes or condylar movements.

Are All Soft Tissue Calcifications Detected by Cone-Beam Computed Tomography in the Submandibular Region Sialoliths?

Heterotrophic soft tissue calcification occurs with the deposit of calcium salts in soft tissue rather than bone. The aim of this report is to describe cone-beam computed tomographic (CBCT) and ultrasonographic (US) findings of 2 cases of soft tissue calcifications that were initially diagnosed as submandibular or parotid sialolithiasis. Multiple soft tissue calcifications were evaluated by panoramic radiography, CBCT imaging, and US imaging in a 50-year-old male patient and a 30-year-old male patient. Calcifications were detected in the soft tissue of the submandibular area at axial, coronal, and multiplanar reformatted examinations and were prediagnosed as sialolithiasis. US examination was conducted to determine the complete relation between the soft tissues and the calcifications. In conclusion, high-resolution dental volumetric tomography with a low radiation dose is the optimal diagnostic tool to analyze the skeletal structure of the maxillofacial region in 3 dimensions. However, it is not sufficient to examine the soft tissues. US imaging is a useful diagnostic tool to evaluate the relation between the soft tissues and the calcifications in the submandibular area.

Morphometric and morphologic evaluation of the mental foramen in relation to age and sex: an anatomic cone beam computed tomography study.

Objective The aim of this study was to assess the vertical and horizontal position, angle, and diameter of the mental foramen (MF) according to sex and age by cone beam computed tomography in a Turkish patient population. Methods Cone beam computed tomography records of 192 consecutive patients consisting of 106 women and 86 men were examined, retrospectively. The vertical and horizontal positions of MF, angle and diameter of MF, and distance from MF to the alveolar crest and the base of the mandible were evaluated with respect to sex and age groups. Results There were statistically significant differences in the distance of MF to the alveolar crest according to age groups. When we compared the right and left sides, we have only found out statistically significant differences in the angles of MF and that it was higher in the left side. Conclusions From our results, the detection of the position of MF can provide detailed information for preoperative treatment planning (for surgery and dental implant surgery procedures), especially in the mandibular premolar region.