Kahraman Güngör

Patterns of third molar impaction in a group of volunteers in Turkey.

Abstract.The aim of this study was to investigate the different variables in mesio-vertically positioned impacted or erupted third molars in a group of volunteers in Turkey to determine the angular changes and levels of eruption radiographically using standardised panoramic radiographs. There were 213 volunteers with impacted and erupted third molars included in this study, most of whom were dental students. Standardised panoramic radiographs were taken from all the volunteers. The radiographic parameters included angulation of tooth, level of eruption, development of root, mesiodistal crown width, retromolar space, and gonial angle. Statistical analysis was done using the t-test for independent groups. It was found that the mesiodistal angulation of third molars was significantly greater while the retromolar space of third molars was significantly smaller in the impacted group (P<0.05). There was also a significant difference in retromolar space/third molar crown width ratio (P<0.05).

Craniofacial and pharyngeal airway morphology in patients with acromegaly.

Abstract Objective. The aim of this study was to assess differences in craniofacial characteristics, upper spine and pharyngeal airway morphology in patients with acromegaly compared with healthy individuals. Materials and methods. Twenty-one patients with acromegaly were compared with 22 controls by linear and angular measurements on cephalograms. The differences between the mean values of cephalometric parameters were analyzed with Mann-Whitney U-test. Results. With respect to controls, anterior (p < 0.05), middle (p < 0.01) and posterior (p < 0.05) cranial base lengths were increased, sella turcica was enlarged (p < 0.001) and upper spine morphology demonstrated differences in the height of atlas (p < 0.01) and axis (p < 0.05) in patients with acromegaly. Craniofacial changes were predominantly found in the frontal bone (p < 0.01) and the mandible (p < 0.05). As for the airway, patients with acromegaly exhibited diminished dimensions at nasal (p < 0.001), uvular (p < 0.01), mandibular (p < 0.01) pharyngeal levels and at the narrowest point of the pharyngeal airway space (p < 0.001) compared to healthy controls. Soft palate width was significantly higher (p < 0.001) and the hyoid bone was more vertically positioned (p < 0.01) in patients with acromegaly. Conclusions. Current results point to the importance of the reduced airway dimensions and that dentists and/or orthodontists should be aware of the cranial or dental abnormalities in patients with acromegaly.

Assessment of endodontically treated teeth by using different radiographic methods: an ex vivo comparison between CBCT and other radiographic techniques

Purpose To compare different radiographic methods for assessing endodontically treated teeth. Materials and Methods Root canal treatments were applied in 120 extracted mandibular teeth, which were divided into four groups: (1) ideal root canal treatment (60 teeth), (2) insufficient lateral condensation (20 teeth), (3) root canals filled short of the apex (20 teeth), (4) overfilled root canal treatment (20 teeth). The teeth were imaged using intraoral film, panoramic film, digital intraoral systems (CCD and PSP), CCD obtained with portable X-ray source, digital panoramic, and CBCT images obtained at 0.3 mm3 and 0.2 mm3 voxel size. Images were evaluated separately by three observers, twice. Kappa coefficients were calculated. The percentage of correct readings obtained from each modality was calculated and compared using a t-test (p<0.05). Results The intra-observer kappa for each observer ranged between 0.327 and 0.849. The inter-observer kappa for each observer for both readings ranged between 0.312 and 0.749. For the ideal root canal treatment group, CBCT with 0.2 mm3 voxel images revealed the best results. For insufficient lateral condensation, the best readings were found with periapical film followed by CCD and PSP. The assessment of teeth with root canals filled short of the apex showed the highest percentage of correct readings by CBCT and CCD. For the overfilled canal treatment group, PSP images and conventional periapical film radiographs had the best scores. Conclusion CBCT was found to be successful in the assessment of teeth with ideal root canal treatment and teeth with canals filled short of the apex.

Distribution of sagittal occlusal relationships in different stages of dentition

The aim of this study was to assess the distribution of sagittal occlusal relationships in different dentition periods in a Turkish sample group. In total, 1,110 patients (561 females, 549 males) aged 4.6-23 years were randomly chosen after intraoral clinical examination. The subjects were classified according to their sagittal occlusal relationships and four dentition stages -deciduous, early mixed, late mixed, and permanent dentition. The statistical significance of the occurrence of malocclusion types in dentition stages was evaluated by Chi-square and Fischers exact tests. Class I malocclusion was observed at the highest rate in all dentition stages. Class III malocclusion was observed at the highest rate in the permanent dentition, whereas Class II malocclusion was observed at the highest rate in the late mixed dentition. The rates of Class I, II, and III malocclusions were similar in males and females. Our study reveals that the prevalence of malocclusion and need for orthodontic treatment has increased in the population towards the permanent dentition.

Variations of midline facial soft tissue thicknesses among three skeletal classes in Central Anatolian adults

Facial reconstruction is a technique employed in a forensic investigation as a last resort to recreate an individuals facial appearance from his/her skull. Forensic anthropologists or artists use facial soft tissue thickness (FSTT) measurements as a guide in facial reconstructions. The aim of this study was to develop FSTT values for Central Anatolian adults, taking into consideration sex and skeletal classes; first, to achieve better results obtaining the likenesses of deceased individuals in two or three-dimensional forensic facial reconstructions and, second, to compare these values to existing databases. Lateral cephalograms were used to determine FSTT values at 10 midline facial landmarks of 167 adults. Descriptive statistics were calculated for these facial soft tissue thickness values, and these values were compared to those reported in two other comparable databases. The majority of the landmarks showed sex-based differences. Males were found to have significantly larger landmark values than female subjects. These results point not only to the necessity to present data in accordance with sexual dimorphism, but also the need to consider that individuals from different geographical areas have unique facial features and that, as a result, geographical population-specific FSTT values are required.

Morphometric analysis of the foramen magnum using cone beam computed tomography

Background/aim: The aim of this study was to perform morphometric analysis of the foramen magnum (FM) using cone-beam computed tomography (CBCT). Materials and methods: This study included CBCT images of 190 individuals (88 males and 102 females). The sagittal and transverse diameters and circumference of the FM were measured. The shape of FM was classified as round, hexagonal, oval, egg-shaped, tetragonal, pentagonal, irregular A, and irregular B. The data were statistically analyzed with chi-square and t-tests to assess the level of significance for sex and age. Results: The means of its sagittal and transverse diameters and also circumference were higher in males than in females. Statistically significant differences were found between males and females for all variables (P < 0.05). No statistically significant difference (P > 0.05) was found between age groups for all variables. The round type was the most common, in 21.6% of the patients. Conclusion: CBCT images can provide valuable information regarding FM and the measurements of its sagittal and transvers diameters and also its circumference may be reliably used for sexual dimorphism in anthropometric analysis and forensic medicine.

The applicability of Kvaal methods and pulp/tooth volume ratio for age estimation of the Turkish adult population on cone beam computed tomography images

Abstract The contraction of the pulp chamber with secondary dentin apposition is a significant morphological dental age predictor in adults. The aim of this study is to evaluate the applicability of Kvaal’s method and pulp/tooth volume ratio on cone-beam computed tomography (CBCT) images and develop a valid method for the Turkish adult population. In this study, 211 single-rooted teeth, extracted for orthodontic and periodontal reasons, of 134 patients with ages ranging from 16 to 71 years, were used. Each sample was scanned using CBCT. According to the reported technique (Kvaal’s method), teeth were analysed on CBCT images. Additionally, pulp/tooth volume ratio was calculated using ITK-SNAP 3.4.0 software. The relationship between age and morphological variables was calculated by the Pearson correlation coefficient. Multiple linear regression models were established for each tooth, age as dependent variable, and morphological variables as independent variables. The determination of coefficients of the Kvaal’s modified regression models were found in a range from 0.296 to 0.550. The pulp volume and the pulp/tooth volume ratio showed statistically significant differences between age groups (p < 0,001). Pulp volume and pulp/tooth volume ratio is a significant index for age. Linear measurement and ratios on CBCT images were insufficient estimates of the age of the Turkish population.

Repeatability of facial soft tissue thickness measurements for forensic facial reconstruction using X-ray images

The repeatability of facial soft tissue thickness measurements at 10 standard anatomical landmarks was evaluated using lateral X-ray images obtained from 50 adult subjects. The intra-and inter-observer error rates were calculated after four practitioners took measurements using Denta Pacs 8.1 software. The results indicated high inter- and intra-observer repeatability, suggesting X-ray images can be used to measure facial soft tissue thicknesses for the purpose of craniofacial reconstruction and superimposition.

Maturation of 2 nd and 3 rd Molars and Any Relation Between Maturation of 2 nd Molars and Congenital Absence of 3 rd Molars in Turkish Population

ABS TRACT Objectives: To assess the maturation stages of permanent maxillary and mandibular 2nd and 3rd molar teeth according to age and establish any relation of congenital absence of 3rd molar regarding maturation stages of 2nd molars. Material and Methods: Digital panoramic radiographs present in the archive of the radiology department taken from 1070 patients (678 females, 392 males; age range 4-20 years) were evaluated. The maturation stages of the teeth were assessed according to the Demirjians method (a-h stages). In addition, ‘no follicle’ and ‘follicle’ stages were also evaluated. Symmetry in maturation between teeth on the left and right quadrant was also evaluated. Descriptive statistics, Mann Whitney U test, Wilcoxon rank sum test and probability values were used for statistical analysis. Results: All maxillary and mandibular molar teeth of males reached to the h stage earlier than females (p<0.05). Maxillary and mandibular 2nd molars showed symmetric maturation among females and males (p>0.05). Contrary, maxillary and mandibular 3rd molars in males and maxillary 3rd molars in females did not show symmetric maturation (p<0.05). The probability of 3rd molar absence was too high in cases when the maxillary and mandibular 2nd molar teeth reached to the f stage and the follicle 3rd molar is absent among females and males. Conclusion: All 2nd and 3rd molar teeth of males completed their maturation earlier than females. These reference values for maturity of 2nd and 3rd molar teeth could be useful in age determination and the evaluation for congenital agenesis of 3rd molars.

Idiopathic antral exostoses: Two rare cases in maxillary sinus

During routine panoramic radiographic examinations, a series of incidental findings may be observed in maxillary sinuses. One of these findings may be exostoses which are the outgrowths of compact and cancellous bone. In this case report, we represent two cases of exostosis of the maxillary sinus evaluated using cone-beam computed tomography. Although antral exostoses have no clinical importance, except if they cause obstruction of sinus ostium, their differential diagnosis must be achieved from other pathologies with similar radiographic properties such as anthroliths and osteomas.