Halil Sahman

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.

Diagnostic accuracy of cone-beam CT compared with panoramic images in predicting retromolar canal during extraction of impacted mandibular third molars.

Objectives: The clinical significance of the existence of a retromolar canal and of its neurovascular content is not yet clear.The aim of the present study was to assess the visibility, diameter and course of the mandibular retromolarcanal (MRC) using cone beam computed tomography (CBCT) scan -had been taken for pre-operative radiographic evaluation of impacted mandibular third molars- compared to panoramic radiographs. Study Design: Subjects eligible for study enrollment were those who underwent preoperative CBCT scan for the extraction of impactedmandibular third molars were determined to be extremely close to the mandibular canal on panoramic radiographs. Radiographs were screened for the presence and course of retromolar canals, and linear measurements. Results: 947hemimandibles in 632 patients were examined.A total of 253 MRCs (144 left, 109 right) were detected with CBCT images (26.7%). Only 29 of these canals were also seen on the corresponding panoramic radiographs. Most MRCs had a vertical course (type VI, 28.46%), followed by slightly curved (type I, 26.09%). The visibility of the MRC on the OPGs, according to the increase in the diameter, was not statistically significant for both sides (p>.05).Statistically difference were found for the width at the point of origin from the mandibular canal (p: .037), the mean distance from the MRC to the second molar (p: .042) and height of MRC when compared the gender. Conclusions: The findings suggest that the MRC isn’t a rare anatomical structure. This study therefore clearly establishes the incidence and importance of the MRC. The detection of the presence of the MRC using CBCT may be crucial for extraction of mandibular third molars. Key words:Accessory innervation, cone beam computed tomography, mandibular anatomy, panoramic radiographs, retromolar canal, retromolar foramen.

Cone Beam Computed Tomographic Analyses of the Position and Course of the Mandibular Canal: Relevance to the Sagittal Split Ramus Osteotomy

Purpose. The aim of this study was to document the position and course of the mandibular canal through the region of the mandibular angle and body in dental patients, using cone beam computed tomographic imaging. Methods. The position and course of the mandibular canal from the region of the third molar to the first molar were measured at five specific locations in the same plane: at three different positions just between the first and second molars; between the second and third molars; and just distal to the third molar. Results. The study sample was composed of 500 hemimandibles from 250 dental patients with a mean age of 26.32. Significant differences were found between genders, distances, and positions. B decreased significantly from the anterior positions to the posterior positions in both females and males. The mean values of S and CB increased significantly from the posterior positions to the anterior positions in both females and males. Conclusion. Because the sagittal split ramus osteotomy is a technically difficult procedure, we hope that the findings of the present study will help the surgeon in choosing the safest surgical technique for the treatment of mandibular deformities.

Detection of bifid mandibular condyle using computed tomography.

Objective: To determine the frequency and characteristics of bifid mandibular condyle (BMC) using computed tomography (CT) evaluation. Study Design: A retrospective study was carried out using the CT records of 550 patients referred to the Medical School of Erciyes University (Kayseri, Turkey) between 2007 and 2010. T-tests were used to compare frequency of BMC between the left and right sides and between female and male patients. Statistical analysis was performed using SPSS software and a chi-squared test. Results: Of the 550 Patients, 10 patients (1.82%) were found to have BMCs. Five patients were female (50%) and five were male (50%). Of these 10 patients, 7 (70%) had unilateral and 3 (30%) had bilateral BMCs. As a result, a total of 13 BMCs were found in 10 patients. No statistically significant differences were found between either the right- and left-sided BMCs or between female and male patients (p >.05). Conclusions: To our knowledge, this is the first retrospective study investigating the prevalence and characteristics of BMC using computed tomography. Although BMC is an uncommon anomaly, it may be a more frequent condition in the Turkish population. Further studies and research on the orientation of duplicated condylar heads should be carried out. Key words:Computed tomography, bifid condyle, double-headed condyle, orientation, frequency.

An unusual peripheral osteoma of the mandibular notch: a case report with computed tomography evaluation

An osteoma, a slow-growing benign osseous neoplasm of the bone, is characterized by a proliferation of osteoblasts that form bone trabeculae in the connective tissue stroma. It is an uncommon condition that generally occurs in the maxillofacial bones. This neoplasm may be clinically silent for years without any symptoms. It is usually diagnosed when it becomes enlarged and is incidentally observed during a radiological examination. The radiographic characteristic of the lesion is a well circumscribed round or oval radiopaque mass. In this paper, we present a case of an unusual localization of a peripheral osteoma incidentally detected during radiographic examination with subsequent three-dimensional computed tomography evaluation.

Incidental findings of carotid artery stenosis detected by calcifications on panoramic radiographs: report of three cases

Atherosclerosis, a progressive inflammatory disorder, may lead to coronary artery disease or stroke. The prevalence of atherosclerosis associated with mortality and morbidity is very high in developed countries, and is the underlying cause of approximately 50% of all deaths in Western societies. Panoramic radiographs (PRs) are an indispensable diagnostic tool used by dental practitioners. In the general dental population, the prevalence of positive incidental carotid artery calcifications (CACs) is reported to range from 2 to 5%. Therefore, incidental findings of CAC on PRs taken during routine dental evaluation may be useful for detecting asymptomatic patients at risk of stroke and could provide life-saving information. In this case report, we present radiological findings and follow-up of three patients with severe atherosclerosis that was incidentally detected on PRs, and discuss the role and importance of PRs in the detection of CACs.

Anterior Loop of the Inferior Alveolar Canal: A Cone-Beam Computerized Tomography Study of 494 Cases.

The aim of this study was to use cone-beam computerized tomography (CBCT) images of patients to assess the prevalence of different types, especially anterior loop, of the mental portion of the inferior alveolar canal and to evaluate the anterior loop lengths. CBCT images of 494 patients providing inclusion criteria were examined by 2 oral radiologists. Sagittal, axial, and multiplanar reformatted images were used to detect the type of mental portion of the inferior alveolar canal. The anterior loop length was measured in the respective sections of each CBCT image. Statistical analysis was performed using SPSS v. 15, and t tests were used for statistical analysis. Of the 494 patients, 217 anterior loops were detected in 141 (28.5%) patients. The mean anterior loop lengths for the right side and the left side were 2.19 ± 1 mm and 2.08 ± 0.89 mm, respectively. The difference between males and females in the mean anterior loop length was statistically significant for both sides (Right: P < .05; Left: P < .05). A presurgical CBCT image examination is necessary prior to implant insertion to reveal the presence of anterior loop and to detect actual anterior loop length.

Association of Toll-like receptors 2, 3, and 4 genes polymorphisms with periapical pathosis risk

Background The aim of this study was to investigate the role of gene variations of Toll-like receptors (TLR) 2, 3, and 4 on genetic susceptibility to periapical pathosis. Material and Methods One hundred patients were included in the study and divided into two groups as follows; Control Group (n=50) that have root canal treatment and no periapical lesion, Patient Group (n=50) that have root canal treatment and periapical lesion. TLR2 Arg753Gln, TLR3 (c.1377C/T) and TLR4 Asp299Gly and Thr399Ile polymorphisms were genotyped by using PCR-RFLP. Genotypical analysis of control and patient groups were investigated to disclose whether there is any association between periapical lesions and gene variations. Results There are no significant statistical differences between control and patient groups according to TLR 2 and 4 gene sequence. On the contrary, CC allele detected 74% for TLR 3 in patient group, and this difference was found to be statistically significant (p < 0.005). Conclusions According to these results, it can be suggested that patients with Toll-like receptor 3 gene polymorphisms could be susceptible to periapical pathosis. Key words:Toll-like receptors, periapical pathosis, endodontics.

Dentin dysplasia type I—report of a case treated with dental implants

Abstract Dentin dysplasia (DD) type I is a hereditary disturbance in dentin formation. In this anomaly, the teeth generally appear clinically unremarkable with normal crowns; and radiographically it is characterized by normal appearing crowns, absence or severe restriction of root formation, obliterated pulp chambers, and periapical radiolucencies without an obvious cause. Clinically, the teeth can be poorly aligned, drifting and mobile, and can prematurely exfoliate due to abnormal root formation. This condition is rarely encountered in dental practice. Little is known about the specific treatment of this disorder and management of patients with DD has presented with problems. This report documents a case of DD type I in a 19-year-old male and the clinical, radiographic, and histopathologic findings of this condition and treatment are described.