Tomasz Kulczyk

Maxillary sinuses and midface in patients with cleidocranial dysostosis

The cleidocranial dysplasia is general skeletal disorder with an autosomal dominant inheritance. It is manifested by many craniofacial abnormalities, of which the maxillary hypoplasia is the most evident. The aim of the study was to use CBCT to evaluate the volume of the maxillary sinuses and the dimensions of maxillae in patients with CCD and compare them with healthy individuals. Files of four children with cleidocranial dysplasia were investigated. Volume of every maxillary sinus as well as two dimensional measurements of distances between particular points of interest located on surface of maxilla were calculated from reconstructed CBCT examination. Data were compared with a control group. Statistical analysis was performed. Linear and volumetric data obtained using CBCT was collected and compared with a control group. All affected children had both maxillary sinus volume and maxillary dimensions smaller than control values. The maxillary sinuses were underdeveloped up to half of normal values. The largest differences were recorded in vertical linear dimensions of the maxillae. Horizontal dimensions were also lower. There are morphological modifications of bone tissue which accompany CCD. It seems that these changes occur on the midfacial region and to a greater extent concern the maxillary sinus volume.

Analysis of human dentition from Early Bronze Age: 4000-year-old puzzle

This paper presents the first ever paleodontological investigation of human remains from an archeological site in Central Europe dating from the Early Bronze Age and attributed to the Strzyzow Culture. It corroborates the knowledge gained from archeological, anthropological and genetical investigations. Our study aimed to assess dental status, dental morphology and dental pathologies as well as tooth wear and enamel hypoplasia based on visual inspection and stereomicroscopic investigation. The research was supported by CBCT imaging to obtain digital images and 3D reconstructions as well as 2D radiographs essential for dental age estimation. All of the 191 teeth discovered showed morphological similarity, with adult teeth showing similar color, shape and size. A maxillary molar presenting with a unique root morphology and a mandibular molar with a rare occlusal surface were found. Both permanent and deciduous dentition presented significant tooth wear. A few specimens displayed signs of dental caries, periapical pathology and antemortem tooth loss. Three individuals exhibited linear enamel hypoplasia. CBCT provided high-quality 2D images useful for dental age estimation by non-destructive methods. Estimated dental age correlated with the age estimated by other anthropological methods. In one case, this was crucial because of insufficient material for anthropological analysis. The presented studies have proved that besides the skeleton, teeth can be used as a fundamental tool in assessing the overall health and living conditions of paleopopulations. It would seem that there is potential for considerable development to be made in the research and investigation of paleodontological material using CBCT.

The Association between Maxillary Sinus Dimensions and Midface Parameters during Human Postnatal Growth

Objective The aim of the study based on CT images was to assess the age-related changes in maxillary sinus diameters in relation to diameters of the facial skeleton. Materials and Methods The retrospective analysis of CT images of the head of 170 patients aged 0–18 years (85 females and 85 males) was performed. Specific orientation points (zy, zm, pr, ns, n, and P) were identified in every patient and the following distances were measured: zy-zy, maximum facial width; zm-zm, midfacial width; n-pr, upper facial height; ns-pr, alveolar facial height; and ns-P, distance not indicated in craniometry. Results The maxillary sinuses of every patient were bilaterally measured in three planes. Three diameters were obtained: maximum transverse (horizontal) diameter called MSW, maximum vertical diameter called MSH, and maximum anteroposterior diameter (length) called MSL. In females, the correlation of MSW, MSH, and MSL and zy-zy, as well as n-pr distances, is very strong. Moreover, the significant correlation was found between all measurements of maxillary sinus and ns-pr as well as ns-P distances in females. The correlation between MSL and all measurements of midface as well as MSH and MSW and all measurements except ns-P is stronger in females than in males. In males, all measurements of maxillary sinus correlate with ns-P distance very strongly. Conclusions The statistical analysis (correlation and determination coefficient) showed that all measurements of maxillary sinuses correlate with midface dimensions.

Re: Enigmatic morphological traits in human teeth from early bronze age

Dr. Stamfelj’s letter to Editor raises several concerns with the article ‘‘Analysis of human dentition from Early Bronze Age: 4000-year-old puzzle’’ by Przystańska et al. We are extremely glad for the interesting comments. We are pleased that our research article has provided stimulus for further discussion. We agree with Dr. Stamfelj that the ASUDAS [1] is used for scoring dental morphology. Dental morphology is shared by paleontologists, odontologists, dental anthropologists, geneticists and dentists [2]. Paleontologists have developed nomenclatures intended to impart phylogenetic information on homologies in crown structure, while dental anatomists and dentists use positional terms for major cusps and other features of the tooth crown that are unambiguous [2]. Although assessment of tooth morphology was the part of aim of our study, the paper focuses more on the pathologies and age determination. Our intention was to make it more familiar for wider group of readers, than only dental anthropologists; therefore, we decided to use anatomical nomenclature commonly used in dental clinical practice. This could have been explained in the paper and we are grateful to get the opportunity to clarify it in this short reply. Dr. Stamfelj correctly pointed out that Fig. 2 provides information not harmonizing with the text. It presents actually maxillary, not mandibular permanent molar. We found this error undetected. The author of the letter to the editor also presents his opinion on the root morphology of molars described in our study. Assessment of tooth morphology, especially when the corresponding alveolar socket (bony fragment) is lacking, is a complicated and demanding task, even for experienced specialist, and the observations are always burdened with uncertainty. Realizing the difficulties, the presented study was undertaken by a large interdisciplinary team including experienced anthropologists and odontologists, also specialized in human dental morphology and radiology. Therefore, the results are presented by consensus and were previously critically reviewed and discussed among the members of our team as well as researchers who had the opportunity to see the results during the thematic conferences. Taking into account the narrow scientific community and vast number of articles published in the field, we appreciate the alternative interpretation of Dr. Stamfelj which extends the discussion.