Mahmut Koparal

Alterations in maxillary sinus volume among oral and nasal breathers.

Background Oral breathing causes many changes in the facial anatomical structures in adult patients. In this study we aimed to determine the effects of long-term oral breathing (>5 years) on the maxillary sinus volumes among adult male patients. Material/Methods We accessed medical records of 586 patients who had undergone cone beam computed tomography (CBCT) for any reason between September 2013 and April 2014. Patients who had undergone cone-beam dental volumetric tomography scans for any reason and who had answered a questionnaire about breathing were screened retrospectively. Cone beam dental volumetric tomography (I-Cat, Imaging Sciences International, Hatfield, PA, USA) was used to take the images of the maxillo-facial area at a setting of 120 kVp and 3.7 mA. This study involved male patients older than 21 years of age. Results The study included a total of 239 male patients, of which 68 were oral breathers and 171 were nasal breathers. The mean age of the oral breathers was 48.4 years and that of the nasal breathers was 46.7 years and the difference was not statistically significant (p>0.05). The mean maxillary sinus volumes of the oral and nasal breathers were 9043.49±1987.90 and 10851.77±2769.37, respectively, and the difference in maxillary sinus volume between the 2 groups was statistically significant (p<0.001). Conclusions The volume of maxillary sinus in oral breathers (>5 years) was significantly lower than in nasal breathers, but it remains unclear whether this is due to malfunctioning of the nasal cavity or due to the underlying pathological condition.

Long-term effects of antihypertensive medications on bone mineral density in men older than 55 years

Introduction In this study, we investigated the effects of long-term antihypertensive treatment with calcium channel blockers or beta blockers on the bone mineral density of maxilla, as determined by cone-beam computed tomography (CBCT). Material and methods This retrospective study was conducted on CBCT images of men older than 55 years who had received different dental indications. Data were grouped into three categories according to the antihypertensive medication history of the patients: group A included patients who had been taking beta-blocker treatment for more than 5 years, group B included patients who had been taking calcium channel blocker treatment for more than 5 years, and the control group included patients who had never used any hypertensive medications before. Results Statistically significant differences were observed between the beta blocker and calcium channel blocker groups. Conclusion In hypertension treatment, beta blockers may be preferred to calcium channel blockers in patients at high risk for osteoporosis and bone resorption.

A comparison of the effects of methylprednisolone and tenoxicam on pain, edema, and trismus after impacted lower third molar extraction.

Background The aim of the present study was to compare the effects of preemptive intravenous tenoxicam and methylprednisolone administrations on extraction of impacted third molars. Material/Methods This was a placebo-controlled, randomized, double-blind, clinical trial. A total of 60 adult patients ages 18–40 years with the complaints of impacted third molar teeth were included in the study. Results The postoperative swelling ratios (p<0.05) and pain scores (p<0.05) were significantly better in both study groups than in the control group and there was no statistically significant difference between methylprednisolone and tenoxicam groups with regards to the edema and pain relief. Conclusions Preoperative administration of 80 mg methylprednisolone achieves better control of trismus than tenoxicam without any significant differences in edema and pain control in impacted third molar teeth extraction.

Displaced lower third molar tooth into the submandibular space: Two case reports.

The aim of this article is to emphasize that the accidental displacement of a lower third molar during extraction is a rare, but potentially serious complication. We present two case reports on a lower third molar tooth dislodged into the submandibular space following its removal from the sockets and the subsequent management of this rare complication. Differences in the direction of displacement, the size of fragment, delay in retrieval, and tissue reactions can all influence this potential serious complication and hence no one technique is uniformly applicable. Though a rare complication, clinicians must be aware of possible lower third molars dislodgement into tissue spaces and the necessity to initiate prompt and appropriate management.

Evaluation of calcified carotid atheroma on panoramic radiographs and Doppler ultrasonography in an older population

Aim The aim of this study is to determine the reliability of panoramic radiograph (PR) as a screening tool for the detection of calcified carotid atheroma (CCA) by comparing it with Doppler ultrasonography (DU) examination. A second aim was to evaluate the relationship among CCA, systemic diseases, smoking, and body mass index in an older population. Materials and methods A total of 1,650 PRs of patients aged over 45 years (736 males and 914 females) were randomly selected. All the patients had been referred to the Faculty of Dentistry, Afyon Kocatepe University, Afyonkarahisar, Turkey, during 2013–2014 for routine PR screening. Medical data were collected from the archival records of the dental school. The patients were divided into two groups: Group A (study group), CCA findings were confirmed by DU (n=59); and Group B (control group), CCA findings were not confirmed by DU (n=34). Results Of the 1,650 individuals, 93 (5.63%) were detected to have CCA on PR. The population consisted of 43 males and 50 females with mean age of 59.84±10.92 years. No difference was determined in respect of CCA between the sexes (P=0.745). There was a significant difference between Group A and Group B in respect of hypertension (P=0.004). But there was no difference between Group A and Group B in respect of age (P=0.495), BMI (P=0.756), diabetes (P=0.168), and smoking (P=0.482) distribution. Conclusion Although PR cannot be used as an initial diagnostic method when searching for CCA, dentists should be aware of CCA on a routine PR, particularly in older patients who may also have the risk factors of obesity, diabetes mellitus, hypertension, and smoking. Recognizing of CCA especially in hypertensive patients could potentially increase the length and quality of life for individuals.

The effect of ectodermal dysplasia on volume and surface area of maxillary sinus

PurposeEctodermal dysplasia (ED) is a congenital syndrome characterized by abnormal development of ectodermal structures, such as skin, hair, nails, teeth, or salivary glands. Patients with ED demonstrate craniofacial dysmorphology, midfacial hypoplasia and hypodontia. The aim of this study is to evaluate volume and surface area of maxillary sinus and craniofacial structures in patients with ectodermal dysplasia (ED) using cone-beam computed tomography (CBCT) images.MethodsThe CBCT images of 20 patients with ED (study group) and 20 healthy individuals (control) which are equal in terms of age and gender were evaluated. After a three-dimensional analysis and segmentation of each maxillary sinus, the volume and surface area were calculated. Craniofacial dimensions were measured on the sagittal planes of the CBCT images. The results of the ED and control groups were statistically compared.ResultsThe right and left sinus volumes and surface areas were significantly lower in the ED group than in the control group (p < 0.05) while the SNA was significantly higher (p < 0.05). ANB and SN-GoMe were also lower in patients with ED than in controls (p < 0.05). The difference in SNB values between the two groups was not significant (p > 0.05).ConclusionsThe volumes and surface areas of both maxillary sinuses were found to be smaller in patients with ED compared to healthy individuals. Class III malocclusion with maxillary retrusion is a characteristic craniofacial feature of these patients.

COMBINED TREATMENT OF A LARGE AGGRESSIVE CENTRAL GIANT CELL GRANULOMA

Santral Dev Hucreli tumorler; cene tumorleri icinde kadinlarda ve mandibulada sik gorulurler ve yasamin ikinci dekatinda daha siktirlar. Tedavisinde lokal kuretaj, parsiyel rezeksiyon ve total rezeksiyon uygulanabilir. Bu vaka raporunda 32 yasinda kadin hasta anterior mandibulada agri sikayetiyle klinigimize basvurdu. Fiziksel muayenede servikal lenfadenopati saptanmadi. Intraorol muayenede ulserasyon saptanmadi fakat vestibul bolgede hassasiyet mevcuttu. Bununla beraber dislerde ve dudakta his kaybi yoktu. Bu vaka raporunda 32 yasinda kadin hastada mandibula basisinde yaygin kemik kaybina neden olan santral dev hucreli tumorun parsiyel rezeksiyon ile tedavisi sunuldu.

Conservative treatment of recurrent temporomandibular joint dislocation with autologous blood injection

Aim: Temporomandibular joint (TMJ) dislocation is very distressing condition and is common in society. TMJ may be treated by conservative methods but the cases with persistent may require surgical.Autologous blood injection(ABI) to TMJ is a nonsurgical method provides more effective outcomes compared to other methods and has been long studied in the literature. ABI is based on the injection of the blood drawn from the antecubital fossa into the superior joint space. The inflammatory changes develop in the joint and maturation of blood after the administration of ABI limit the mandibular movements.Eminectomy seems to provide a permanent solution for the surgical treatment of TMJ, it is a risky method since the mandibular area is neighbored by critical anatomical structures.Therefore conservative methods should be tried before initiating advanced surgical techniques. Materials and Methods: This study included patients had a long history of 3 or more episodes of dislocation during daily activities (e.g. eating, drinking, laughing, and yawning), rejected undergoing surgery, and had no history treatment due to this complaint. Of these, 23 patients with TMJ dislocation underwent ABI to TMJ. Results: At 1-year follow-up, no complication was observed in any patient and the complaints resolved in all but 2 patients. Conclusion: We consider that autologous blood injection to TMJ is a useful to be used in the treatment of recurrent TMJ with no need for surgical treatment.