Muhammed Akif Sümbüllü

A comparison of diode laser and Er:YAG lasers in the treatment of gingival melanin pigmentation

OBJECTIVES This study compared the use of diode and Er:YAG lasers in treating gingival melanin pigmentation (GMP) in terms of gingival depigmentation, local anesthesia requirements, postoperative pain/discomfort, depigmentation effectiveness, and total treatment duration. STUDY DESIGN Twenty patients (13 female, 7 male) referred with GMP were enrolled in the study. Patients were randomly divided into 2 groups. Group 1 was treated with a gallium aluminum arsenide diode laser with a continuous wavelength of 808 nm, and group 2 was treated with an Er:YAG laser with a continuous wavelength of 2,940 nm. Gingival depigmentation was performed by applying the laser at 1 W. Treatment was administered on a weekly basis until a normal pink gingival color was observable in clinical examination and photographs. In addition, patients were asked to evaluate the procedure by using a self-administered questionnaire. RESULTS Procedures were carried out without the need for any topical or local anesthetic, and no unpleasant events occurred during the actual procedure or the healing period. The total length of treatment was significantly shorter with the diode laser (group 1) than with the Er:YAG laser (group 2; P < .05). No melanin recurrence was detected during any follow-up session. CONCLUSIONS Diode and Er:YAG lasers administered at 1 W both result in satisfactory depigmentation of GMP.

Relationship among Schneiderian Membrane, Underwood's Septa, and the Maxillary Sinus Inferior Border

BACKGROUND Osseo-integrated implants are increasingly being used to restore functional dentition; however, in the posterior region, implant placement can be problematic because of inadequate bone height. In this condition, maxillary sinus floor elevation surgery has become the treatment of choice. The presence of anatomic variations within the maxillary sinus such as Underwoods septa and thin Schneiderian membrane decreases the success of the sinus floor elevation. PURPOSE In this study, we tried to determine the relationship between the anatomic variations of the maxillary sinus: Underwoods septa, Schneiderian membrane thickness, and the cortical thickness of the inferior border of the maxillary sinus. MATERIAL AND METHODS The left and right maxillary sinus images of 74 patients were obtained by using dental computed tomography (CT). The Schneiderian membrane and the cortical thickness of the inferior border of the maxillary sinus were measured on the coronal images of dental CT scans at the deepest portion of the sinus cavity. The presence of Underwoods septa was identified on the axial images. The correlations between these variables were assessed. RESULTS We found that there was only a negative correlation between the Schneiderian membrane thickness and the presence of Underwoods septa (r = -0.168 p = .042). CONCLUSION It is suggested that Underwoods septa may be the reason for the thinness of the Schneiderian membrane. However, future studies among larger groups are necessary for confirming the finding by using well-designed clinical studies.

Radiological examination of the articular eminence morphology using cone beam CT

OBJECTIVE The purpose of the present study was to investigate the articular eminence inclination and height according to age and gender in patients with temporomandibular joint (TMJ) dysfunction and healthy controls using cone beam CT (CBCT). METHODS The measurements were performed on CBCT records of 52 TMJ dysfunction patients (11 males and 41 females) and 41 control patients (17 males and 24 females). The eminence inclination and height were measured on the CBCT images. RESULTS The eminence inclination and height values were higher in males than in females in both TMJ dysfunction patient and control groups; however, these differences were not statistically significant (p>0.05). While no statistically significant differences were found in the eminence inclination and height values between the age groups (p>0.05) in the TMJ dysfunction patient group, there were statistically significant differences in the control group. The eminence inclination was highest between the ages of 21 and 30 years and showed a decrease after the age of 30 years. Additionally, the eminence inclinations of the control patients were statistically higher than those of the TMJ dysfunction patients. CONCLUSION There were no statistically significant differences in eminence inclination and height according to gender. The eminence inclination reaches its highest value between the ages of 21 and 30 years and shows a decrease after the age of 31 years in healthy patients. The eminence inclination was steeper in healthy control patients than in patients with TMJ dysfunction.

Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations

The aim of this study was to determine the prevalence of and associations between clinical signs and symptoms and cone beam computed tomography (CBCT) findings of temporomandibular joint osteoarthritis (TMJ-OA). Seventy-six patients (total 117 TMJ) with osteoarthritis were included in this study. Clinical signs and symptoms and CBCT findings were reviewed retrospectively. A considerable decrease in mandibular motions and mastication efficiency, and considerable increase in joint sounds and general pain complaints were observed. The most frequent condylar bony changes were erosion (110 joints, 94.0%), followed by flattening (108 joints, 92.3%), osteophytes (93 joints, 79.5%), hypoplasia (22 joints, 18.8%), sclerosis (14 joints, 12.0%), and subchondral cyst (four joints, 3.4%). Flattening of the articular eminence and pneumatization were each observed in five joints. Forty-one patients had bilateral degeneration and 35 had unilateral degeneration. Hypermobility was detected in 47 degenerative joints. Masticatory efficiency was negatively correlated with both condylar flattening and sclerosis, and general pain complaints was positively correlated with condylar flattening. Condylar erosion, flattening, osteophytes, pain, joint sounds, reduced jaw movements, and worsened mastication were common findings in TMJ-OA in the present study. Poor correlations were found between osseous changes and clinical signs and symptoms of TMJ-OA. CBCT is a powerful diagnostic tool for the diagnosis of TMJ-OA.

Associations between the articular eminence inclination and condylar bone changes, condylar movements, and condyle and fossa shapes

ObjectivesThe purpose of the present study was to determine the inclination and height of the articular eminence with respect to the condylar bone changes, condyle shape, fossa shape and condylar movements in patients with and without temporomandibular joint (TMJ) dysfunction using cone-beam computed tomography (CBCT).MethodsThe associations between the eminence inclination and the condylar bone changes, condylar movements, condylar shape and fossa shape were evaluated in patients with TMJ disorders and control patients without TMJ disorders. The measurements of the articular eminence inclination were established on central sagittal slices of the TMJ. The central coronal slices were used to determine the condyle and fossa shapes. The types of movements of the condyles were determined on open-mouth images, and mandibular hypermobility or hypomobility was noted for each joint.ResultsThere were no significant differences in the eminence inclination and height with respect to the condylar bone changes and condylar movements in the TMJ disorder group. However, there was a significant association between the eminence inclination and the fossa shape in the TMJ disorder group and significant associations between the eminence inclination and both the condyle and fossa shapes in the control group. The articular eminence inclination was steeper in the control group than in the TMJ disorder group.ConclusionsThe eminence inclination was steeper in the control patients than in the patients with TMJ disorders, and was not correlated with the condylar bone changes or condylar movements.

Are All Soft Tissue Calcifications Detected by Cone-Beam Computed Tomography in the Submandibular Region Sialoliths?

Heterotrophic soft tissue calcification occurs with the deposit of calcium salts in soft tissue rather than bone. The aim of this report is to describe cone-beam computed tomographic (CBCT) and ultrasonographic (US) findings of 2 cases of soft tissue calcifications that were initially diagnosed as submandibular or parotid sialolithiasis. Multiple soft tissue calcifications were evaluated by panoramic radiography, CBCT imaging, and US imaging in a 50-year-old male patient and a 30-year-old male patient. Calcifications were detected in the soft tissue of the submandibular area at axial, coronal, and multiplanar reformatted examinations and were prediagnosed as sialolithiasis. US examination was conducted to determine the complete relation between the soft tissues and the calcifications. In conclusion, high-resolution dental volumetric tomography with a low radiation dose is the optimal diagnostic tool to analyze the skeletal structure of the maxillofacial region in 3 dimensions. However, it is not sufficient to examine the soft tissues. US imaging is a useful diagnostic tool to evaluate the relation between the soft tissues and the calcifications in the submandibular area.

The importance of cone beam CT in the radiological detection of osteomalacia

Although osteomalacia is one of the most common osteometabolic diseases among the elderly, there is no case in the literature that presents the effects of osteomalacia in detail using cone beam CT (CBCT). While thin and porous bones are the most common radiographic sign of the disease, the radiological hallmarks are pseudofractures (Loosers zone). We coincidentally detected osteomalacia in a 23-year-old female and we showed the pseudofracture on CBCT images. In the present case, we aim to present the images of osteomalacia that were detected by CBCT in detail. CBCT has an important value in screening for osteomalacia.

A retrospective analysis of sphenoid sinus hypoplasia and agenesis using dental volumetric CT in Turkish individuals.

PURPOSE In adults, sphenoid sinus agenesis is an extremely rare anomaly. The objective of this study was to investigate the prevalence of sphenoid sinus hypoplasia and agenesis using dental volumetric computed tomography (DVCT) in a population of Turkish individuals. MATERIALS AND METHODS DVCT scans in the axial, coronal and sagittal planes of the sphenoid sinus of 384 patients were examined for evidence of sphenoid sinus agenesis and hypoplasia. RESULTS In the DVCT scans, bilateral agenesis of sphenoid sinus was not seen. Unilateral agenesis of sphenoid sinus was seen in 0.26% of the sample, and sphenoid sinus hypoplasia was seen in 0.52%. Unilateral hypoplasia of the sphenoid sinus was observed in 0.26% of the sample, and bilateral hypoplasia of sphenoid sinus was observed in 0.26%. CONCLUSION In this study, we found a low frequency of sphenoid sinus agenesis. Compared with sphenoid sinus agenesis, the frequency of sphenoid sinus hypoplasia was higher. DVCT may be used as a diagnostic tool to investigate the paranasal sinus.

Prevalence of the types of the petrotympanic fissure in the temporomandibular joint dysfunction

Background Petrotympanic fissure (PTF) is a fissure in the temporal bone that runs from the temporomandibular joint (TMJ) to the tympanic cavity (TC). In PTF, the discomallear ligament (DML) connects the malleus in the tympanic cavity and the articular disc and capsule of the temporomandibular joint. PTF with the DML is a possible cause of aural symptoms related to temporomandibular joint dysfunction (TMD). Purpose To investigate the prevalence of different types of PTF in TMD using dental volumetric tomography (DVT) and determine whether PTF type correlates with age. Material and Methods DVT scans in the sagittal planes of PTFs of 134 patients with TMD were examined for the types of PTF present. Three main PTF types were described: wide, tunnel-shaped structure (type 1); tunnel-shaped structure that is wide open in the PTF entrance to the mandibular fossa and gradually thins out in the tympanic cavity (type 2), tunnel-shaped structure that is wide open in the entrance of the mandibular fossa, with a middle region with a flat-shaped tunnel structure and a narrow exit in the tympanic cavity (type 3). Results In DVT scans, PTF types 1, 2 and 3 were seen in 67.2%, 1.5%, and 31.3% of cases, respectively. We found no significant relationship between age or gender and PTF type. Conclusion The low percentage of type 2 PTF and high percentage of type 1 PTF must be taken into consideration during pre-surgical planning related to TMD. However, future well-designed clinical studies involving larger numbers of subjects will be necessary to confirm the findings of this study.

No correlation between mandibular and non-mandibular measurements in osteoporotic men

Background: Screening for low bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) has been the traditional method for determining osteoporosis. Panoramic radiography is widely used in dentistry. Purpose: To determine the relationships between the values of dental panoramic indices (the mental index (MI), antegonial index (AI), panoramic mandibular index (PMI)) and the values of skeletal BMD (femoral BMD (f-BMD), and vertebral BMD (v-BMD)) in 25 osteoporotic men. Material and Methods: In the panoramic radiographs obtained from a total of 25 male individuals with osteoporosis, the means were calculated for MI, AI, and PMI values measured in the right and left mandible. DXA measurements of the femur and lumbar vertebrae BMD were also calculated. The correlation between these variables was assessed. Results: No correlation was found between the BMD values of the femur and lumbar vertebrae and values of MI, AI, and PMI. Conclusion: No significant correlation was found between the mandibular and non-mandibular measurements in men with osteoporosis. MI, AI, and PMI indices should not be used in the evaluation of the skeletal status, because they are not reliable tools in screening for osteoporosis.