Hakan Kurt

Occlusal Caries Depth Measurements Obtained by Five Different Imaging Modalities

The study aimed to assess the accuracy and reproducibility of occlusal caries depth measurements obtained from different imaging modalities. The study comprised 21 human mandibular molar teeth with occlusal caries. Teeth were imaged using film, CCD, two different cone-beam computerized tomography (CBCT) units and a microcomputer tomography (micro-CT). Thereafter, each tooth was serially sectioned, and the section with the deepest carious lesion was scanned using a high-resolution scanner. Each image set was separately viewed by three oral radiologists. Images were viewed randomly, and each set was viewed twice. Lesion depth was measured on film images using a digital caliper, on CCD and CBCT images using built-in measurement tools, on micro-CT images using the Mimics software program, and on histological images using AxioVision Rel. 4.7. Intra- and inter-rater reliabilities were assessed according to the Bland/Altman method by calculating Intraclass Correlation Coefficients (ICCs). Mean/median values obtained with intraoral systems were lower than those obtained with 3-D and histological images for all observers and both readings. Intra-observer ICC values for all observers were highest for histology and micro-CT. In addition, intra-observer ICC values were higher for histology and CBCT than for histology and intra-oral methods. Inter-observer ICC values for first and second readings were high for all observers. No differences in repeatability were found between Accuitomo and Iluma CBCT images or between intra-oral film and CCD images. Micro-CT was found to be the best imaging method for the ex vivo measurement of occlusal caries depth. In addition, both CBCT units performed similarly and better than intra-oral modalities.

Evaluation of the superior semicircular canal morphology using cone beam computed tomography: a possible correlation for temporomandibular joint symptoms

OBJECTIVE This study aimed to assess the superior semicircular canal (SSCC) morphology and to determine whether superior semicircular canal dehiscence (SSCD) correlates with temporomandibular joint (TMJ) symptoms. STUDY DESIGN Clinical data and cone beam computed tomography (CBCT) scans of 175 patients were retrospectively examined by 2 observers. Distribution and thickness measurements of the different types of bone cover of the SSCC were performed. RESULTS Five radiologic SSCC patterns were identified from CBCT data: 147 cases (42%) were defined as normal (0.6-1.7 mm thickness); 62 cases (17.71%) had a papyraceous pattern (<0.5 mm); 77 cases (22%) showed a thick pattern (>1.8 mm); and 42 cases (12%) had a pneumatized pattern. Observer 1 and 2 diagnosed SSCD in 22 of 350 (6.28%) temporal bones individually and had no discordances between the 2 reviews. All patients with SSCD were identified as having TMJ signs and symptoms (P < .05). CONCLUSIONS Maxillofacial radiologists should be informed about these structures, which can be helpful for the interpretation of CBCT scans.

The prevalence, anatomic locations and characteristics of the odontomas using panoramic radiographs

Objectives: Odontomas are the most common variety of odontogenic tumors and derived from differentiated epithelial and mesenchymal cells. The purpose of this study is to evaluate the prevalence, types and localization of the odontomas in Turkish patients. Materials and Methods: This was a retrospective study of panoramic images that were taken between April 2011 and January 2014 in the Department of Dentomaxillofacial Radiology, Gulhane Military Medical Academy (GATA), Turkey. A total of 14,250 panoramic images were evaluated by an experienced dentomaxillofacial radiology specialist. The clinicopathologic features of odontomas such as, anatomic location, distribution in gender, age of the patients and the incidence of the odontomas were assessed. Results: A total of 22 odontomas in 20 patients (11 females; 9 males) (0.14%) were found of the 14,250 patients` panoramic view. About 36.4% of the lesions were complex odontomas and 63.6% were diagnosed as compound odontomas. About 18.2% of all cases were in the maxilla and 81.8% in the mandible. The anterior portion of mandible was found the most common location (40.9%) in this study. Conclusions: According to the result of this study, the compound types of the odontomas are more common than complex odontomas and the anterior mandible is the most affected site. It was noted that even though odontomas are the most common variety of odontogenic tumors, they rarely occur.

Effects of various cone-beam computed tomography settings on the detection of recurrent caries under restorations in extracted primary teeth

Purpose The aim of this study was to assess the ex vivo diagnostic ability of 9 different cone-beam computed tomography (CBCT) settings in the detection of recurrent caries under amalgam restorations in primary teeth. Materials and Methods Fifty-two primary teeth were used. Twenty-six teeth had dentine caries and 26 teeth did not have dentine caries. Black class II cavities were prepared and restored with amalgam. In the 26 carious teeth, recurrent caries were left under restorations. The other 26 intact teeth that did not have caries served as controls. Teeth were imaged using a 100×90-mm field of view and a 0.2-mm voxel size with 9 different CBCT settings. Four observers assessed the images using a 5-point scale. Kappa values were calculated to assess observer agreement. CBCT settings were compared with the gold standard using a receiver operating characteristic analysis. The area under the curve (AUC) values for each setting were compared using the chi-square test, with a significance level of α=.05. Results Intraobserver kappa values ranged from 0.366 to 0.664 for observer 1, from 0.311 to 0.447 for observer 2, from 0.597 to 1.000 for observer 3, and from 0.869 to 1 for observer 4. Furthermore, interobserver kappa values among the observers ranged from 0.133 to 0.814 for the first reading and from 0.197 to 0.805 for the second reading. The highest AUC values were found for setting 5 (0.5916) and setting 3 (0.5886), and were not found to be statistically significant (P>.05). Conclusion Variations in tube voltage and tube current did not affect the detection of recurrent caries under amalgam restorations in primary teeth.

Evaluation of foramen tympanicum using cone-beam computed tomography in orthodontic malocclusions.

AbstractThe foramen tympanicum is a persistent anatomic formation of the temporal bone due to a defect in ossification normal bone physiology in neonatal or postnatal period. This study determined the occurrence and location of the foramen tympanicum in a Turkish sample using cone-beam computed tomography. Scans of 370 sites in 185 patients were retrospectively analyzed to determine foramen tympanicum occurrence, sizes, and locations according to their orthodontic malocclusions. Measurements were done on axial and sagittal sections to identify the dimensions. Differences in foramen tympanicum incidence by measurements, sex, side, malocclusions, and location were statistically evaluated. Foramen tympanicum was determined in 42 (22.7%) of 185 patients. No statistical difference was found considering location and sex (P > 0.05), but it was found more bilaterally in female patients within significance level at P = 0.024. Mean sizes did not differ significantly by sex but were found to be greater in females. In axial diameter, the average measurement was found wider on the right side of all patients (P = 0.017). The findings showed a greater foramen tympanicum dimension among class II than among class I and III subjects (P < 0.05). Knowledge about these structures is helpful for the interpretation of imaging (especially cone-beam computed tomography) and provides valuable information especially before orthognathic surgery to avoid intraoperative reconstruction and complications.