Mustafa Gümüşok

Root and canal symmetry in the mandibular anterior teeth of patients attending a dental clinic: CBCT study

The aims of this study were to evaluate the number of roots/root canals in the mandibular anterior teeth of a Turkish population, to assess the relationship between gender or age and the frequency of two canals in a single root, and to determine the symmetry in root/root canal numbers between contralateral sides among patients. Cone-beam computed tomography images (n = 1128; 6253 teeth) taken at the Department of Dentomaxillofacial Radiology of the Faculty of Dentistry of Gazi University were examined by three observers and a supervisor, all of whom were blinded to patient gender and age. Axial, sagittal, and cross-sectional slices with a thickness of 1 mm were used. Numbers of roots and canals for each type of tooth were recorded. Most teeth had a single root and single root canal. Roots with two canals were more frequent in the incisors (14.9%, 17.2%, and 6.1% of the central incisors, lateral incisors, and canines, respectively). Teeth with two roots were more frequent in the canines (3.1% vs. 0% or 0.1%). Females more often had canines with double root canals (p < 0.001). When at least one tooth had two root canals, bilateral symmetry between contralateral teeth was found in 45.0%, 29.0%, and 28.0% of cases for central incisors, lateral incisors, and canines, respectively. Patients older than 56 years had fewer teeth with double root canals (p ≤ 0.001). A small proportion of the mandibular anterior teeth had two roots or root canals. Double root canals were mostly unilateral. Age and gender were associated with the number of root canals.

Mucosal melanoma of the head and neck: recurrence characteristics and survival outcomes

OBJECTIVE The aim of this study was to review oncologic outcomes and recurrence characteristics of head and neck mucosal melanomas (HNMMs) managed at a tertiary referral center. STUDY DESIGN Clinical records of 10 patients who were managed for HNMMs between 2001 and 2013 were retrospectively analyzed. RESULTS The median age was 66 years (range 28-76 years) and male/female (M/F) ratio was 1:5. The 3-year disease-free survival (DFS) rates and overall survival (OS) rates were 11.7% and 35%, respectively; and the 5-year DFS rates and OS rates 11.7% and 23.3%, respectively. The median DFS and OS periods were 12 months (range 2-36 months) and 17 months (range 7-96 months), respectively. The rates of development of local, regional, and systemic recurrences were 20%, 50%, and 80%, respectively. Lungs were involved in all patients who had distant metastasis. CONCLUSIONS This study shows that HNMMs has a very aggressive course and that distant metastases are common. For this reason, systemic control of the disease is an important aim of treatment.

EVALUATION OF KERATOCYSTIC ODONTOGENIC TUMORS USING CONE BEAM COMPUTED TOMOGRAPHY

Purpose: The aim of this retrospective study is to determine the radiological features of keratocystic odontogenic tumors (KCOT) using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images of 28 patients who had histopathologically-confirmed KCOT were retrospectively reviewed from the archives of the Department of Dentomaxillofacial Radiology, Gazi University Faculty of Dentistry. The location and size of KCOT, cortical expansion, cortical perforation, relation with the impacted teeth, and the impact on the mandibular canal were evaluated. Results: The mean age of patients at initial diagnosis was 34.5 years. Patients with an impacted tooth were significantly younger than those without an impacted tooth (p<0.05). Among KCOTs, 21% were localized in the maxilla whereas 79% were found in the mandible. The lesions localized in the mandible were mostly found in the retromolar-ramus region. Of these patients, 93% had cortical expansion and 75% had bone perforation. Of the 22 mandibular lesions, 20 were in close proximity of the mandibular canal and 18 (90%) of these lesions had caused destruction in the mandibular canal. Conclusion: KCOTs exhibit their aggressive nature in the jaw bone. CBCT is a useful radiological imaging method to examine the radiologic characteristics of KCOTs such as bone destruction and their spatial relations with the neighboring anatomic structures.

MELKERSSON-ROSENTHAL SYNDROME: A CASE REPORT

Melkersson-Rosenthal Syndrome (MRS) is a rare disorder consisting of a triad of persistent or recurrent orofacial edema, relapsing facial paralysis and fissured tongue. It is rarely possible to observe all aspects of the classical triad at the same time, since these symptoms may appear in different times of life cycle. The most common symptom is orofacial edema. Although etiology of MRS is unclear, various factors such as infections, genetic predisposition, immune deficiency, food intolerance and stress have been held responsible. MRS is diagnosed based on clinical features. This case report describes a 39 years old male patient with recurrent swelling of the upper lip. Clinical examinations showed classical triad of MRS. The diagnosis and treatment procedures were presented with special emphasis to the clinical features of this rare condition.

Imaging of accessory mental foramen before implant therapy

It is critical to determine the location and variation of mental foramen (MF) during the implant treatment. Multiple numbers of MF can be seen in the mandible, and they are called as accessory MF (AMF). Detecting the anatomic variations including AMFs with radiological examinations before surgical applications are important to prevent neurovascular complications. Cone-beam computed tomography (CBCT) is a beneficial method to determine the anatomical structures such as MF and its anatomical variations. The aim of this case report was to present the diagnosis of AMF localized at the left side of the mandible of a 44-year-old woman patient who was applied for implant therapy. Treatment planning and postoperative evaluation were performed with CBCT.

PERIPHERAL OSTEOMA OF THE MANDIBLE: A CASE REPORT

Osteomas are benign tumors which are composed of mature compact or cancellous bone. They can be either peripheral, central or extraskeletal. The peripheral osteoma arises from surface of the bone (periosteal) whereas the central osteoma arises from the bone medullary (endosteal) and the extra-skeletal soft tissue osteoma usually develops within the muscle. Osteomas are most commonly found in the skull and facial bones. Multiple osteomas may be associated with Gardner’s Syndrome. These lesions are usually painless and recurrence is uncommon after local excision. In this case report clinical, radiographic findings and treatment of a 24-year-old male patient with peripheral osteoma in the anterior mandible are presented.

Focal cemento-osseous dysplasia

Focal cemento-osseous dysplasia (FCOD) is a benign fibro-osseous lesion which changes cancellous bone tissue with each fibrous tissue and cementum-like material, or both together. The teeth that are related to the lesion are vital, and FCOD is generally asymptomatic. FCOD is, usually, found during routine radiographic examination. The etiology and pathogenesis of FCOD are unknown. This lesion is evaluated to be a reactive or a dysplastic process in the periapical tissues. Radiologic images of FCOD change depending on the amount of mineralization. Radiological appearance of FCOD is either only complete radiolocent or only complete radio-opaque or mixed radiolucent, radio-opaque together. In this case report an FCOD is presented, which is located between the first premolar and the second molar on the left side mandible of a 60-year-old female patient. The lesion caused perforation and expansion of alveolar bone. The diagnosis, treatment and 1 year follow-up after surgery are reported.