Osman Sami Aglarci

A cone-beam computed tomography study of root canal morphology of maxillary and mandibular premolars in a Turkish population

Abstract Aim. The aim of this study was to evaluate the root canal number and configuration of maxillary and mandibular premolar teeth by gender, intervals for decades, tooth position and unilateral or bilateral occurrence in a Turkish population using Cone Beam Computed Tomography(CBCT) scanning. Methodology. CBCT images of 5496 maxillary and mandibular premolars from 849 patients were evaluated. The following was evaluated in all the images: numbers of roots and root canals, the morphology of the root canal configuration according to the Vertucci classification, male–female differences in the tooth position and male–female differences in unilateral or bilateral occurrence. The reliability data were analyzed with a chi-square test. Results. The most prevalent root canal frequency was the two canals (86.2%) and type IV (76.9%) configuration for maxillary first premolar, one canal (59.7%) and type I (54.5%) canal configuration for second premolar. The incidence of one canal was higher in females and the occurrence of two or three canals was more common in males. The incidence of one canal was higher on the left side of maxillary premolars and the incidence of two canals was higher on the right side. Most mandibular first (93.5%) and second (98.5%) premolars had one canal. In general, females had one root canal of the mandibular premolar, whereas males had two or three canals. The type I configuration was most common and the incidence was higher on the right side. There were some differences found in the frequency distribution of the number of root canals and configuration of maxillary and mandibular premolar teeth according to intervals for decades. Conclusion. CBCT scanning provides comprehensive information about the root canal morphology of maxillary and mandibular premolar teeth. These data may help clinicians in root canal treatment of premolar teeth.

Fabricating Complete Dentures with CAD/CAM and RP Technologies.

Two techological approaches for fabricating dentures; computer-aided design and computer-aided manufacturing (CAD/CAM) and rapid prototyping (RP), are combined with the conventional techniques of impression and jaw relation recording to determine their feasibility and applicability. Maxillary and mandibular edentulous jaw models were produced using silicone molds. After obtaining a gypsum working model, acrylic bases were crafted, and occlusal rims for each model were fabricated with previously determined standard vertical and centric relationships. The maxillary and mandibular relationships were recorded with guides. The occlusal rims were then scanned with a digital scanner. The alignment of the maxillary and mandibular teeth was verified. The teeth in each arch were fabricated in one piece, or set, either by CAM or RP. Conventional waxing and flasking was then performed for both methods. These techniques obviate a practitioners need for technicians during design and provide the patient with an opportunity to participate in esthetic design with the dentist. In addition, CAD/CAM and RP reduce chair time; however, the materials and techniques need further improvements. Both CAD/CAM and RP techniques seem promising for reducing chair time and allowing the patient to participate in esthetics design. Furthermore, the one-set aligned artificial tooth design may increase the acrylics durability.

A cone-beam computed tomography study of the root canal morphology of anterior teeth in a Turkish population.

Objective: The aim of this study was to determine the root and canal morphology of the maxillary and mandibular anterior teeth in a Turkish population by analyzing cone-beam computed tomography (CBCT) images. Materials and Methods: CBCT images of 417 females and 410 males with a mean age of ranging from 14 to 70 years were examined in this study. A total of 1453 maxillary central incisors, 1504 maxillary lateral incisors, 1523 maxillary canines, 1582 mandibular central incisors, 1603 mandibular lateral incisors, and 1604 mandibular canines were analyzed. The number of root canals and the canal configurations were investigated and then were classified according to Vertucci′s classification. The data were analyzed with the Pearson Chi-square test. Results: The Type 1 canal configuration was most prevalent in the maxillary anterior teeth (96.8-99.7%). The Types 2, 3, 4, and 5 canal configurations were observed within the range of 0-1.3%, 0-0.8%, 0-0.7%, and 0-1.8%, respectively. In the mandibular anterior teeth, the Type 1 canal configuration was most prevalent (77-95%). The Types 2, 3, 4, and 5 canal configurations were observed within a range of 0.2-2.7%, 0.2-1.6%, 0.9-5.9%, and 1.8-14.4%, respectively. The prevalence of two canals was higher in males than in females both in the maxillary and mandibular anterior teeth (P < 0.05). Conclusions: Type 1 was the most prevalent canal configuration of maxillary and mandibular anterior teeth in the Turkish population. Type 5 was the most frequently observed canal configuration of the two canalled teeth. The incidence of root canal numbers and configurations differed with sex.

Evaluation of the root and canal morphology of mandibular permanent molars in a south-eastern Turkish population using cone-beam computed tomography

Objective: The aim of this retrospective study was to determine the root and canal morphology of the mandibular first and second permanent molars in a Turkish population using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images of mandibular first (n = 966) and second molar (n = 1165) teeth from 850 Turkish patients were evaluated. The root canal configurations were classified according to the method of Vertucci. The data were analyzed by Pearson′s Chi-square test. Results: The majority of mandibular molars were two rooted with three canals; however, three roots were identified in 0.05% of the first molars and 0.01% of the second molars, and 100% of the additional root canals were of type I configuration. Mesial roots had more complex canal systems with more than one canal, whereas most distal roots had a type I configuration. Conclusions: Within the limitations of this study, it can be concluded that CBCT scanning provides supplemental information about the root canal configurations of mandibular molars in a Turkish population. This study may help clinicians in the root canal treatment of mandibular molars.

Is there a relationship between the presence of ponticulus posticus and elongated styloid process

This study aimed to determine if there is a possible relationship concerning the presence of ponticulus posticus (PP) in patients with elongated styloid process (ESP) on three-dimensional cone beam computed tomography (CBCT) images. The presence or absence of the PP (whether partial or complete) was determined and noted as a positive or negative finding. Then, the patients with PP were evaluated for ESP. For this purpose, 3-D CBCT scanning digital images of 542 patients having ESP (247 males and 295 females) were examined retrospectively. There was a significant relationship between the presence of PP and ESP (P=.03). The results of this study suggest that there is a significant correlation between the presence of PP and ESP. To our knowledge, this is the first study investigating the relationship between the two disorders in the literature.

Diagnosis, PET/CT imaging, and treatment of extranodal non-Hodgkin lymphoma in keratinized gingiva: a case report

A 58-year-old patient who smoked and had uncontrolled type 2 diabetes mellitus was referred to our clinic. The patient had a suspicious asymptomatic lesion that was diagnosed as B-cell non-Hodgkin lymphoma (NHL). Immunohistochemistry revealed intense and diffuse expression of CD20, CD10, BCL-6, and Ki-67. A positron emission tomography/computed tomography (PET/CT) scan showed focal pathological uptake of F-18-fluorodeoxyglucose only in the subcutaneous tissue anterior to the left maxillary sinus. After lesion excision and five courses of chemotherapy, PET/CT scans demonstrated complete resolution of the lesion. Smoking, uncontrolled diabetes mellitus, and periodontal disease might be predisposing factors for oral NHL.

Localization of the mandibular foramen of 8-18 years old children and youths with cone-beam computed tomography

The aim of this study was to determine the location of mandibular foramen (MF) of 8-18 years old Turkish individuals by analyzing cone-beam computed tomography (CBCT) images. CBCT images of 63 females and 64 males with an age range of 8-18 years were examined. The distance of the MF to the anterior border of the ramus (A), posterior border of the ramus (P), inferior point of the mandibular incisura (MI), superior point of the curvature of the mandibular notch (MN), and the straight line of the cusps of the mandibular permanent molars (O) were measured and recorded. Data were analyzed by one-way analysis of variance (ANOVA), the Bonferroni test, independent t-test, and Student′s t-test at a significance level of P < 0.05. The MN-MF, MI-MF, A-MF, and MN-MF values of females aged 9, 13, 14, and 18 were statistically higher than those of males aged 9, 13, 14, and 18 (P < 0.05). There were no significant differences in the O-MF values or A-MF values among the age groups (P > 0.05); however, the P-MF, MI-MF, and MN-MF values increased with age (P < 0.05). This study concluded that the location of the MF is just posterior to the middle of the ramus, 2.5-3.6 mm above the occlusal plane of the molars. The P-MF, MI-MF, and MN-MF values increase with age.

Endodontically related lesions on panoramic radiographs in a Turkish subpopulation

Objective: The purpose of this study was to evaluate the prevalence of detectable endodontically related lesions as determined from the reports of panoramic radiographs in a Turkish subpopulation. Materials and Methods: There were 19,625 reports of panoramic radiographs that were evaluated. Four investigators assessed the radiographs and reports that had been written. For each tooth of the subjects, the following items were surveyed: presence of periapical lesion, inadequate root canal treatment, external and internal root resorption. Results: The patients who had panoramic radiography reports were between the ages of 3 and 91 years (mean age 29,43 ± 18,83 years). 10,941 (56%) were female and 8684 (44%) were male patients. Inadequate root canal treatment was recorded in 588 (3%) radiography reports and it was more frequent in mandibular molar teeth. 2287 (11.7%) of the patients had periapical lesions and it was more frequent in maxillary incisor teeth and mandibular molar teeth. External resorption was observed in 61 (0.3%) patient records, while internal root resorption was reported in 14 (0.1%) reports. 81 inadequate root-filled teeth presented a periapical lesion. A positive strong linear correlation was found between the presence of inadequate root canal treatment and a periapical lesion among the patients (r = 0.098, P = 0.000). Conclusions: The results of this study suggest that external and internal root resorption were not frequent clinical conditions. The high frequency of periapical lesions and inadequate canal treatment in molar teeth indicate the need to improve the technical quality of root fillings, especially in molar teeth.

Posttreatment diagnosis of caries under fixed restorations: a pilot study.

STATEMENT OF PROBLEM Conventional radiographic techniques are insufficient for detecting caries under fixed restorations or for acquiring clear images of the disease. Advanced radiographic techniques such as cone beam computerized tomography may be a solution. PURPOSE The purpose of this study was to assess the viability of detecting and characterizing caries under complete-ceramic and metal-supported crowns by using cone beam computerized tomography. MATERIAL AND METHODS A grade 6 carious molar tooth according to the International Caries Detection and Assessment System criteria was selected. The tooth was prepared, and 3 different crowns were fabricated in a dental laboratory: yttria tetragonal zirconia polycrystal (Y-TZP) ceramic, lithium disilicate ceramic, and metal ceramic. The crowns were placed on the prepared tooth, and each specimen was subjected to cone beam computerized tomography. Opacity values were recorded and evaluated with 2-way ANOVA. Multivariate comparisons (Tukey was performed to assess the mean gray value differences of the materials between caries and dentin, and the Mann-Whitney U test was performed to assess the mean gray value differences between caries and dentin for each material (α=.05). RESULTS Carious borders and cavities were detected under the 3 ceramic crown specimens with a cone beam computerized tomography radiographic technique. The statistical analysis of the radiopacity mean gray value was at the borderline of significance for the specimen radiographies. Significant differences were found with respect to materials, location, and the interaction between these 2 factors (P<.001). CONCLUSIONS Cone beam computerized tomography can be used as a posttreatment diagnostic technique for detecting caries under high atomic numbered crowns and partial fixed dental prostheses.

A novel presentation of a supplemental premolar tooth with dens invaginatus and dens evaginatus and role of the CBCT in diagnosis

Dens evaginatus(DE) and dens invaginatus(DI) are rare developmental dental abnormalities. Though these variations in odontogenesis have been individually observed and reported, no case of concomitance of DE and DI in a supplemental premolar have been reported in the literature. For the clinicians, it is important to recognize these anomalies and to be knowledgeable about their management. The aims of this paper are to report the radiographic and tomographic findings of a novel case of DE with type II and IIIDI and to discuss the importance of early identification and efficient management of these anomalies.