Nilüfer Ersan

Articular Eminence Inclination, Height, and Condyle Morphology on Cone Beam Computed Tomography

Aim. The aim of the present study was to examine the relationship between articular eminence inclination, height, and thickness of the roof of the glenoid fossa (RGF) according to age and gender and to assess condyle morphology including incidental findings of osseous characteristics associated with osteoarthritis (OA) of the temporomandibular joint (TMJ) using cone beam computed tomography (CBCT). Materials and Methods. CBCT images of 105 patients were evaluated retrospectively. For articular eminence inclination and height, axial views on which the condylar processes were seen with their widest mediolateral extent being used as a reference view for secondary reconstruction. Condyle morphology was categorized both in the sagittal and coronal plane. Results. The mean values of eminence inclination and height of males were higher than those of females (P < 0.05). There were significant differences in the RGF thickness in relation to sagittal condyle morphology. Among the group of OA, the mean value of the RGF thickness for “OA-osteophyte” group was the highest (1.59 mm), whereas the lowest RGF values were seen in the “OA-flattening.” Conclusion. The sagittal osteoarthritic changes may have an effect on RGF thickness by mechanical stimulation and changed stress distribution. Gender has a significant effect on eminence height (Eh) and inclination.

Measurements of the Foramen Magnum and Mandible in Relation to Sex Using CBCT

The purpose of this study was to evaluate pre‐existing CBCT images of a large sample of adult females and males to provide data on foramen magnum and mandibular measures of sexual dimorphism for use as a reference sample in cases of establishing identity in unknown fragmentary skulls. The study group consisted of 161 adult patients. 3D images of the patients were assessed retrospectively. FM measurements were obtained from reformatted axial sections. Six mandibular measurements were taken. According to the results, the study identified four mandibular measurements as final predictors of sex which are as follows: the gonial angle (G‐angle) and ramus length (Ramus‐L), gonion–gnathion length (G–G‐L) and bigonial breadth (BG‐Br). It was found that the cross‐validated grouped overall predictive accuracy was 83.2% for FM and mandible measurements. It could correctly identify males in 77.3% and females in 87.4% of the cases. To assess sexual dimorphism, the gonial angle and ramus, gonion–gnathion lengths, and bigonial breadth of the mandible and sagittal diameter of the FM may be used on CBCT images.

In vitro detection of dental root fractures with cone beam computed tomography (CBCT).

Background: Since the diagnosis of non-displaced longitudinal fractures present difficulties for the dentist, three-dimensional evaluation is necessary. Objectives: The aim of this study is to demonstrate the accuracy of cone beam computed tomography (CBCT) in detecting dental root fractures in vitro. Materials and Methods: An in vitro model consisting of 210 recently extracted human mandibular teeth was used. Root fractures were created by mechanical force. The teeth were placed randomly in the empty dental alveoli of a dry human mandible and 15 different dental arcs were created. Images were taken with a unit Iluma ultra cone-beam CT scanner (Imtec Corporation, Germany). Three dental radiologists separately evaluated the images. Results: According to the fracture types and fracture presence, there was an overall statistically significant agreement between the key and readings. Kappa values for intra observer agreement ranged between 0.705 and 0.804 indicating that each observer gave acceptable ratings for the type and presence of fractures. Conclusions: Detailed information about root fractures may be obtained using CBCT.

Evaluation of Pneumatization in the Articular Eminence and Roof of the Glenoid Fossa with Cone-Beam Computed Tomography

BACKGROUND Detection of air cavities, so called pneumatizations, nearby to the temporomandibular joint (TMJ) area is important, as they represent sites of minimal resistance and facilitate the spread of various pathologies into the joint as inflammation, tumor or fractures and serve as a possible complicating factor in TMJ surgery. AIMS To determine the prevalence of pneumatization of the articular eminence (PAT) and roof of the glenoid fossa (PRGF) using cone-beam computed tomography (CBCT). STUDY DESIGN Cross-sectional study. METHODS Acquired images of 111 patients (222 TMJs) were evaluated. The presence of pneumatization was recorded at the articular eminence and roof of the glenoid fossa. Age and gender were recorded for all patients and type (unilocular or multilocular) and laterality were noted for the cases of pneumatization. RESULTS The mean age of the study group was 48.86±18.31 years. Among all the patients, 73 (65.8%) had PAT, while 13 (11.7%) had PRGF. Forty-two (37.8%) of the patients had PAT bilaterally; whereas 3 of them (2.7%) presented PRGF bilaterally. The percentage of PAT was higher for females (73.6%) than males (51.3%) (p<0.05). CONCLUSION CBCT images are an accurate and reliable means of detection of the exact size and type of pneumatization and the relationship of pneumatization to the adjacent tissues. This is especially significant before a surgical intervention is planned in this region, in order to make a sound diagnosis.

Perceived sources and levels of stress, general self-efficacy and coping strategies in preclinical dental students

Abstract Dental education programs are known to be highly stressful and stress can affect general health. The aims were to identify sources of stress among preclinical students and to evaluate their perceived levels of stress, self-efficacy and effective coping strategies in a private dental school. One hundred preclinical students in a Turkish private dental school were surveyed using dental environment stress (DES), perceived stress (PSS), general self-efficacy (G-SES) and brief coping scales (Brief-COPE). Age, gender, history of psychiatric treatment, factors that affected the choice of dentistry, choice rank of dental school, scholarship and income was recorded. ‘Exams and grades’ followed by ‘Fear of failing course or year’ were found to be the most stressprovoking factors. The most and the least stressprovoking DES domains were ‘Workload’ and ‘Social stressors’, respectively. ‘Social stressors’ affected male more than female (p < .05). The most and the least common coping strategies were found to be ‘Planning’, and ‘Drug’, respectively. Female used ‘Instrumental support’ more than male (p < .05). Demographic factors had impact on the perceived stress factors and levels, as well as coping strategies. Unlike previous studies establishing high stress levels in dental students, preclinical students displayed moderate level of stress. Clinical dental education might be more responsible for creating stress.

Diagnosis of unusual mandibular split fracture with cone-beam computed tomography

Mandibular fractures are relatively easy to diagnose in comparison with other craniofacial fractures. This report presents a trauma patient with an unusual split fracture in the mandibular corpus, which was missed on the panoramic radiograph; however, could be visualized with cone-beam computed tomography (CBCT). Panoramic radiograph may be misleading for accurate diagnosis of mandibular corpus fractures. We suggest that CBCT is crucial and should be mandatory for all suspected mandibular fractures in maxillofacial trauma patients.

Vital Abutman Dişlerin Protetik Tedavinin Tamamlanmasından Üç Yıl Sonraki Durumlarının Değerlendirilmesi

Amac: Bu calismada amac, dis hekimligi ogrencileri tarafindan yapilan sabit protezlere destek olarak kullanilan vital abutman dislerin, tedavi bitiminden uc yil sonraki periapikal durumlarinin radyografik olarak degerlendirilmesidir. Materyal-Method: Calismaya sabit protezin kalici simantasyonu esnasinda vital ve saglam durumda olan 67 hastaya (44 kadin, 23 erkek) ait 395 dis dahil edilmistir. Hastalarin ortalama yasi 50,8±11,8 olarak bulunmustur. Sabit protezin tipi, abutman dislerin turu,ve hastalarin tedavi ile ilgili memnuniyet durumlari kaydedilmistir. Abutman disler periapikal radyografiler uzerinde iki okuyucu tarafindan degerlendirilmis ve dislerin periapikal durumlari Periapikal Indeks Skalasi’na (PAI) gore skorlanmistir. Bulgular: Okuyucular tarafindan yapilan okumalar arasindaki uyum 0,87 olarak bulunmustur. Hastalarin 56’si (%83,5) yapilan tedaviden memnun olduklarini belirtmislerdir. Apikal periodontitis gorulme yuzdesinin en dusuk oldugu dis turu mandibular kesici dislerdir (%3,4, p<0,05). Maksiller dislerde (%20) apikal periodontitis gorulme yuzdesi mandibular dislerden (%10,6) daha yuksek bulunmustur (p<0,05). Sonuc: Hastalarin buyuk cogunlugunun yapilan sabit protezlerden memnun olmalarina ragmen, klinik olarak daha iyi bir sonuc alinabilmesi icin tedavi esnasinda dis hekimligi ogrencilerinin denetlenmesine daha cok onem verilmelidir.

Evaluation of digital periapical radiographs obtained by dental students

Corresponding author: Assist. Prof. Nilüfer Ersan Yeditepe University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Istanbul, Turkey. Bağdat Cad. No: 238/3/A 34728, Goztepe, Istanbul, Turkey Tel: +90 216 3636044 / 6414 Fax: +90 216 3636211 Email: nilufer.ersan@yeditepe.edu.tr SUMMARY Aim: The aim of this study was to evaluate the quality of digital periapical radiographs obtained using bisecting angle technique by 3rd grade dental students, who were theoretically taught on paralleling and bisecting angle techniques and had the practical experience only for the paralleling technique on dental phantom models. Materials and Methods: The quality digital periapical radiographs, taken with photostimulable phosphor plates (PSPs) by 3rd year dental students during the initial examination, was evaluated. The type of the teeth, errors on the radiographs related with angulation of the tube head, placement and exposure of the film, and the radiographs, which needed repetition, were recorded. Results: Overall 288 digital periapical radiographs (53 maxillary anterior, 26 mandibular anterior, 109 maxillary posterior, 100 mandibular posterior) were evaluated. The percentage of radiographs that needed repetition was found as 13.5%. The percentage of positioning errors related to the visibility of the apex was 20,1%. The percentage of the presence of conecut was 28,1%. Overall rate of angulation error was found to be 36,8%. Conclusions: The need for repetition of periapical radiographs taken by 3rd grade dental students seems to be high. Evaluation of the clinical performance of the dental students is needed to identify the deficiencies in teaching/learning process, and for improvement of the dentomaxillofacial radiology curriculum and provision of patient safety. Dental curriculum should be revised, so that the practical courses including bisecting angle technique as well as paralleling technique was taught both theoretically and practically.