Sebnem Kursun

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 root canal sealer filling quality using a single-cone technique in oval shaped canals: An In vitro Micro-CT study

The aim of this study was to evaluate and compare the presence of voids in oval root canals filled with different root canal sealers (EndoSequence BC Sealer, Smartpaste bio, ActiV GP) and to compare those with root canals filled with AH Plus sealer using micro-CT. In total, 40 freshly extracted human single-root maxillary premolars were used. Specimens instrumented with the EndoSequence NiTi rotary instrument were assigned randomly into four groups. In each group, root canals were filled with single-cone gutta-percha and one of the tested sealers. Each specimen was then scanned using micro-CT at a voxel resolution of 13.47 μm. Proportions of sections with voids in cross-sectional images and void volumes for each sealer were calculated in the apical, middle, and coronal thirds. Differences according to root canal sealers were evaluated statistically using the Kruskal-Wallis test and the Mann-Whitney U-test at a significance level of 5%. The analysis showed a decrease in void formation in the apical third, with a significant difference between the apical and coronal thirds among bioceramic sealers, ActiV GP, and AH Plus (p < 0.05) but no significant difference between the apical and middle thirds or between the middle and coronal thirds was found for the sealers tested (p > 0.05). All root canal sealers tested resulted in voids. The bioceramic sealers (EndoSequence BC Sealer, Smartpaste bio) produced similar voids which had the fewest in the apical third of root canals among the sealers tested which can be related due to root canal anatomy variations.

Delayed diagnosis of oral squamous cell carcinoma: a case series

IntroductionIn malign neoplasms, oral cancer is one of the important causes of mortality and morbidity. Squamous cell carcinoma is the most common form of oral cancers in adults and is related to risk factors such as smoking and alcohol consumption.Case presentationIn this article, we present three case reports of oral squamous cell carcinomas with delayed diagnosis. The first patient was a 52-year-old Turkish man, the second patient was a 61-year-old Turkish man and the third patient was a 60-year-old Turkish woman. All were referred to the Ankara University Faculty of Dentistry with pain, swelling and various complaints in their jaws.ConclusionEarly diagnosis is of vital importance for the prognosis of the patients with oral squamous cell carcinomas. For this reason, dentists play a crucial role in the early detection and prevention of oral cancers.

Survival Rate of Short, Locking Taper Implants with a Plateau Design: A 5-Year Retrospective Study

Background. Short implants have become popular in the reconstruction of jaws, especially in cases with limited bone height. Shorter implants, those with locking tapers and plateau root shapes, tend to have longer survival times. We retrospectively investigated the cumulative survival rates of Bicon short implants (<8 mm) according to patient variables over a 5-year period. Materials and Methods. This study included 111 consecutively treated patients with 371 implants supporting fixed or removable prosthetics. Data were evaluated to acquire cumulative survival rates according to gender, age, tobacco use, surgical procedure, bone quality, and restoration type. Statistics were performed using chi-square, Mann-Whitney, and Kruskal Wallis H tests. Results. The survival rate was 97.3% with, on average, 22.8 months of follow-up. Patients older than 60 years had higher failure rate than the other age groups (P < 0.05). Placed region, age, and bone quality had adverse effects on survival rate in the <8 mm implant group with statistically significant difference (P < 0.05). Conclusions. Approximately 23-month follow-up data indicate that short implants with locking tapers and plateau-type roots have comparable survival rates as other types of dental implants. However, due to limitations of study, these issues remain to be further investigated in future randomized controlled clinical trials.

Evaluation of the superior semicircular canal morphology using cone beam computed tomography: a possible correlation for temporomandibular joint symptoms

OBJECTIVE This study aimed to assess the superior semicircular canal (SSCC) morphology and to determine whether superior semicircular canal dehiscence (SSCD) correlates with temporomandibular joint (TMJ) symptoms. STUDY DESIGN Clinical data and cone beam computed tomography (CBCT) scans of 175 patients were retrospectively examined by 2 observers. Distribution and thickness measurements of the different types of bone cover of the SSCC were performed. RESULTS Five radiologic SSCC patterns were identified from CBCT data: 147 cases (42%) were defined as normal (0.6-1.7 mm thickness); 62 cases (17.71%) had a papyraceous pattern (<0.5 mm); 77 cases (22%) showed a thick pattern (>1.8 mm); and 42 cases (12%) had a pneumatized pattern. Observer 1 and 2 diagnosed SSCD in 22 of 350 (6.28%) temporal bones individually and had no discordances between the 2 reviews. All patients with SSCD were identified as having TMJ signs and symptoms (P < .05). CONCLUSIONS Maxillofacial radiologists should be informed about these structures, which can be helpful for the interpretation of CBCT scans.

Submandibular displacement of a mandibular third molar root during extraction: a case report

A 46-year-old female patient with complaints of pain and swelling on right submandibular region and limitation on mouth opening was reported. She had undergone an unsuccessful surgical procedure under local anesthesia performed by a general practitioner for removal of impacted mandibuler right third molar 1 week earlier. On clinical examination floor of the mouth was tender to palpation. Panoramic and the periapical radiographs showed presence of a radiopaque mass similar to that of a tooth root. Computed tomography scans were obtained for detailed radiographic examination, thereby the presence of a high density area in the submandibular region was detected. Under general anesthesia the displaced root was removed and the postoperative course was uneventful.

Evaluation of Optic Canal and Surrounding Structures Using Cone Beam Computed Tomography: Considerations for Maxillofacial Surgery.

AbstractThe optic canal connects the anterior cranial fossa and the orbit and maintains the optic nerve and the ophthalmic artery. Within the extent of the surgical approach of the region, risk of iatrogenic injury of the neural and vascular structures increases. The aim of this retrospective morphometric study is to investigate the radiological anatomy of orbita, optic canal, and its surrounding using cone beam computed tomography (CBCT) scans in a group of Turkish population.Cone beam computed tomography images of a total of 182 patients were evaluated by 2 observers. Anatomical parameters regarding optic canal and orbita were measured for all patients from axial, sagittal, and three-dimensional reconstructed images. To assess intraobserver reliability, the Wilcoxon matched-pairs test was used. Pearson &khgr;2 test and Student t test were performed for statistical analysis of differences, sex, localization, and measurements (P < 0.05).Repeated CBCT evaluation and measurements indicated no significant inter and intra-observer difference were found (P > 0.05). The orbita width and height were larger for the males than females (P < 0.05). No significant difference was observed for optic canal shape, dimensions of infraorbital foramen (IOF) and supraorbital foramen (SOF), SOF-midline distance, and SOF-IOF distance according to sex and location (P > 0.05). Examination CBCT scans revealed that the shape of the optic canal was 70% funnel and 28% Hourglass shape, 2% amorph type round.These results provide detailed knowledge of the anatomical characteristics in the orbital area which may be of assistance for surgeons preoperatively. Cone beam computed tomography scans can be an alternative modality for multislice computed tomography with submillimeter resolution and lower dose in preoperative imaging of the orbit.

Evaluation of foramen tympanicum using cone-beam computed tomography in orthodontic malocclusions.

AbstractThe foramen tympanicum is a persistent anatomic formation of the temporal bone due to a defect in ossification normal bone physiology in neonatal or postnatal period. This study determined the occurrence and location of the foramen tympanicum in a Turkish sample using cone-beam computed tomography. Scans of 370 sites in 185 patients were retrospectively analyzed to determine foramen tympanicum occurrence, sizes, and locations according to their orthodontic malocclusions. Measurements were done on axial and sagittal sections to identify the dimensions. Differences in foramen tympanicum incidence by measurements, sex, side, malocclusions, and location were statistically evaluated. Foramen tympanicum was determined in 42 (22.7%) of 185 patients. No statistical difference was found considering location and sex (P > 0.05), but it was found more bilaterally in female patients within significance level at P = 0.024. Mean sizes did not differ significantly by sex but were found to be greater in females. In axial diameter, the average measurement was found wider on the right side of all patients (P = 0.017). The findings showed a greater foramen tympanicum dimension among class II than among class I and III subjects (P < 0.05). Knowledge about these structures is helpful for the interpretation of imaging (especially cone-beam computed tomography) and provides valuable information especially before orthognathic surgery to avoid intraoperative reconstruction and complications.