Mehmet Eray Kolsuz

Efficacy of Platelet-rich Plasma as a Scaffold in Regenerative Endodontic Treatment

INTRODUCTION Current research is concerned with discovering better scaffolds for use in regenerative endodontic treatment. This study aimed to clinically and radiographically evaluate the efficacy of platelet-rich plasma (PRP) used as a scaffold in regenerative endodontic treatment and compare it with that of a conventional blood clot (BC) scaffold. METHODS A total of 20 necrotic, single-rooted immature teeth were randomly distributed into 2 groups. After disinfecting the root canal space with triple antibiotic paste (1:1:1 ciprofloxacin, metronidazole, and cefaclor), a tissue scaffold was created by using either PRP or BC and covered with white mineral trioxide aggregate. Clinical and radiographic follow-up examinations were performed once every 3 months during an 18-month period. Differences in root area were calculated from preoperative and postoperative radiographs. Fisher exact and Mann-Whitney U tests were used to evaluate differences between groups, with P value <.05 considered to be statistically significant. RESULTS All 20 teeth were clinically asymptomatic during 18-month follow-up period; however, 1 tooth in the BC group exhibited periapical pathosis and was judged radiographically unsuccessful. Complete apical closure was observed in a mean of 8.1 months in the PRP group compared with 9 months in the BC group. The PRP group exhibited 9.86% increase in root area, compared with 12.6% increase in the BC group. The difference in success rates between the groups was not statistically significant (P > .05). CONCLUSIONS PRP successfully created a scaffold for regenerative endodontic treatment; however, treatment outcomes did not differ significantly between PRP and conventional BC scaffold.

Comparison of intraoral radiography and cone-beam computed tomography for the detection of periodontal defects: an in vitro study

BackgroundThis study aimed to compare the diagnostic accuracy of cone-beam computed tomography (CBCT) unit with digital intraoral radiography technique for detecting periodontal defects.MethodsThe study material comprised 12 dry skulls with maxilla and mandible. Artificial defects (dehiscence, tunnel, and fenestration) were created on anterior, premolar and molar teeth separately using burs. In total 14 dehiscences, 13 fenestrations, eight tunnel and 16 without periodontal defect were used in the study. These were randomly created on dry skulls. Each teeth with and without defects were images at various vertical angles using each of the following modalities: a Planmeca Promax Cone Beam CT and a Digora photostimulable phosphor plates. Specificity and sensitivity for assessing periodontal defects by each radiographic technique were calculated. Chi-square statistics were used to evaluate differences between modalities. Kappa statistics assessed the agreement between observers. Results were considered significant at P < 0.05.ResultsThe kappa values for inter-observer agreement between observers ranged between 0.78 and 0.96 for the CBCT, and 0.43 and 0.72 of intraoral images. The Kappa values for detecting defects on anterior teeth was the least, following premolar and molar teeth both CBCT and intraoral imaging.ConclusionsCBCT has the highest sensitivity and diagnostic accuracy for detecting various periodontal defects among the radiographic modalities examined.

Evaluation of genial tubercle anatomy using cone beam computed tomography

The purpose of this study was to characterize the anatomy of the genial tubercle using cone beam computed tomography (CBCT). The morphology and detailed anatomy of the genial tubercle were assessed retrospectively in 201 patients (101 females, 100 males) using CBCT images. The parameters examined were the height (GH) and width (GW) of the genial tubercle, the distance from the lower incisors to the superior border of the tubercle (I-SGT), the distance from the inferior margin of the tubercle to the inferior margin of the mandible (IGM-IBM), and the anterior mandible thickness (AMT). Statistical analysis was performed to assess relationships among these parameters, gender, and orthodontic malocclusion (P < 0.05). The values obtained were GH 7.3-8.7 mm, GW 7.9-9.2 mm, I-SGT 7.1-9.1 mm, IGM-IBM 8.3-10.1 mm, and AMT 14.0-16.2 mm. GH, GW, and I-SGT showed no significant differences between genders (P > 0.05). However, IGM-IBM was larger for class III than for class I and class II male patients, and larger than for class I female patients. AMT in class III patients was greater than in class I and II patients (P < 0.05). The use of CBCT, which employs less radiation, is important for dental professionals, especially those performing surgery for obstructive sleep apnea (OSA), in order to avoid possible surgical complications.

Comparison of the burr and chemically induced periodontal defects using different field-of-view sizes and voxel resolutions

OBJECTIVE This study assessed the use of different voxel resolutions in a cone beam computed tomography (CBCT) unit for the detection of artificially induced periodontal bone defects created using burr, burr and chemicals, and only chemicals. STUDY DESIGN Seven dry skulls were used in this study. In total, 65 dehiscence defects, 43 fenestration defects, and 76 control sites with no periodontal defects were examined. Images were obtained from a CBCT unit (3 D Accuitomo; J Morita Mfg. Corp., Kyoto, Japan), using 3 field-of-view (FOV) sizes (4 × 4 cm; 6 × 6 cm; and 8 × 8 cm) and 4 scan modes (standard, high-definition, high-fidelity, and low-dose). RESULTS Overall, κ coefficients for interobserver agreement on burr-induced periodontal defects ranged from 0.336 to 0.795, with the lowest κ value (indicating a fair degree of agreement) obtained for images acquired in standard mode with a voxel size of 0.160 mm3. κ coefficients for the detection of periodontal defects were highest (indicating moderate to high degrees of interobserver agreement) for smaller voxel sizes and high-resolution images. Statistical comparison among groups (burr, burr + chemicals, and chemicals only) was performed using 1-way analysis of variance with post hoc tests. CONCLUSIONS The CBCT scan mode may affect the diagnosis of periodontal defects. The technique used to create periodontal defects also affected diagnosis. For this kind of experiment, burr-induced or burr + chemical-induced defects should be used, rather than those induced solely using a chemical technique.

KIBT İLE TESADÜFEN BULUNAN PARSİYEL EMPTY SELLA TANISI: İKİ VAKA RAPORU

Empty sella syndrome is defined as a herniation of the subarachnoid space within sella, hence, flattening of the pituitary gland. Most of the empty sella cases are found incidentally which this syndrome can be easily missed during maxillofacial radiological examinations. The aim of this paper is to describe two cases of partial empty sella and discuss the differential diagnosis for this condition. Both patients administered to our clinic with pain in the forehead and maxilla. In addition to clinical examination two patients (37 year old male, 70 year old female) were imaged using panoramic radiography, cone beam computed tomography and magnetic resonance imaging. Panoramic radiographies showed no findings in terms of empty sella. However, in CBCT imaging, both patients showed an expansion in the sella turcica and protrusion into sphenoid sinus. These were more precisely located using 3D CT reconstructions. MR imaging showed intermediant signal on T1-weighted images and high signal on T2- weighted images. MRI findings showed the partial anterior prolapsus of pituitary gland with cerebrospinal fluid leak in posterior border of sella turcica. According to MRI findings, definitive diagnosis was partial empty sella syndrome. Maxillofacial radiologists should be aware of this kind of abnormalities while reporting the entire FOV. Keywords: Empty Sella Syndrome, CBCT, MRI, sella turcica, pituitary gland INCIDENTAL DIAGNOSIS OF PARTIAL EMPTY SELLA ON CBCT: TWO CASE REPORTS OZ Empty sella sendromu, subaraknoid bolgenin sella icerisine herniyasyonu bundan dolayi da hipofiz bezinin duzlesmesi olarak tanimlanmistir. Bir cok empty sella vakasi tesadufen tespit edildigi icin bu sendrom maksillofasiyal radyolojik inceleme sirasinda kolaylikla gozden kacabilir. Bu makalenin amaci iki parsiyel empty sella vakasini sunmak ve bu durum ile ilgili ayirici tanilari tartismaktir. Her iki hasta da maksilla ve alin bolgesinde agri ile klinigimize basvurdu. Klinik muayeneye ek olarak her iki hastadan da (37 yas erkek, 70 yas kadin) panoramik radyograf, konik isinli bilgisayarli tomografi ve manyetik rezonans goruntuleme ile goruntuler alindi. Panoramik radyografide empty sellaya iliskin herhangi bir bulguya rastlanmadi. Ancak, KIBT goruntulerinde her iki hastada da sella tursikada ekspansiyon ve sfenoid sinus icerisine protruzyon goruldu. Bu bulgular 3 boyutlu rekonstruksiyon goruntulerinde tam olarak lokalize edildi. Manyetik rezonans goruntulemede T1 agirlikli goruntulerde orta duzeyde sinyal ve T2 agirlikli goruntulerde ise yuksek sinyal alindi. MRG bulgulari sella tursikanin arka sinirinda serebrospinal sivi sizintisi ile birlikte hipofiz bezinin parsiyel anterior prolapsusu oldugunu gosterdi. MRG bulgulari ile parsiyel empty sella kesin tanisi kondu. Maksillofasiyal radyologlar goruntuleme alanina giren tum yapilari rapor ederken bu tip patolojilere de dikkat etmelidirler. Anahtar Kelimeler: Empty sella sendromu, KIBT, MRG, sella tursika, hipofiz bezi

Preauricular pilomatricoma: An uncommon entity in a dental pediatric patient

Highlights • Pilomatricomas are common lesions although rarely encountered in dental practice. Dental professionals especially oral surgeons and pediatric dentists should be aware of the condition during their practice.• Common differential diagnosis of preauricular pilomatricoma does not involve temporomandibular joint disease. This condition should be added to differential diagnosis.• Meticulous examinations should be made and misdiagnosis with temporomandibular joint disease should be eliminated.