Umut Aksoy

Evaluation of the mental foramen and accessory mental foramen in Turkish patients using cone-beam computed tomography images reconstructed from a volumetric rendering program

This study determined the occurrence and location of the mental foramen (MF) and accessory mental foramen (AMF) in Turkish patients using cone‐beam computed‐tomography (CBCT) with 3D‐imaging software. CBCT scans of 386 sites in 193 (92 male, 101 female) patients were retrospectively analyzed to determine MF and AMF occurrence, sizes, and locations. Digital imaging and communications in medicine (DICOM) data were transferred to surface‐rendering software to generate 3D images. Distances between the MF and AMF and from both foramina to the alveolar ridge and to the closest tooth were measured. Differences in AMF incidence by sex, side, and location were evaluated using chi‐squared tests, and MF and AMF measurements were evaluated using Mann–Whitney U‐tests. AMFs were observed in 6.5% of patients and were most commonly in an anteroinferior location. Mean AMF size did not differ significantly by sex or side [males: horizontal = 1.5 mm (1.0–2.4 mm), vertical = 1.4 mm (0.8–2.4 mm); females: horizontal = 1.5 mm (0.8–3 mm), vertical = 1.3 mm (0.8–2.1 mm); P > 0.05]. Males showed significantly greater mean vertical and horizontal MF dimensions compared with females [males: horizontal = 3.9 mm (1.0–7.0 mm), vertical = 3.6 mm (1.2–7.0 mm); females: horizontal = 3.5 mm (1.3–5.6 mm), vertical = 3.3 mm (0.8–5.8 mm); P < 0.05]. Awareness of the AMF is important to avoid mental nerve damage during surgical intervention and anesthetic applications. CBCT is useful for AMF detection, distributes less ionizing radiation, and allows 3D imaging. Clin. Anat. 25:584–592, 2012.

Cone-Beam Computed Tomographic Evaluation of Spontaneously Healed Root Fracture

INTRODUCTION Dental trauma can lead to injuries in teeth and their supporting structures, which occurs most commonly in young patients and varies in severity from enamel fractures to avulsions. Root fractures are relatively uncommon among dental traumas, mostly affecting the permanent dentition. It has been reported that root fractures can undergo healing, whereas pulp necrosis can also occur. METHODS In this report, we present a case of the utilization of cone-beam computed tomography (CBCT) in the detection of possible cervical or internal resorption secondary to a mid-horizontal fracture in a 36-year-old male patient. The fractured teeth spontaneously healed and were diagnosed radiographically after 28 years. Initially, conventional radiographs showed fractured fragments with radiolucent lines. Because of possible invasive cervical resorption and doubt over internal resorption in the conventional images, it was decided to examine the teeth with cone-beam computed tomography with three-dimensional reconstructions. RESULTS The images clearly showed the displaced fragments of the root fracture. Despite the appearance in the conventional radiograph, no evidence of cervical or internal resorption was detected in the teeth other than the healed root fracture. CONCLUSION It was concluded that CBCT images should be obtained for root fractures, especially those in which cervical or internal resorption is suspected from routine conventional radiographs.

Influence of the Quality of Endodontic Treatment and Coronal Restorations on the Prevalence of Apical Periodontitis in a Turkish Cypriot Population

Objectives: The aim of this study was to assess the prevalence of periapical lesions in root canal-treated teeth in a Turkish Cypriote population and to investigate the influence of the quality of root canal fillings and coronal restorations on the prevalence of periapical lesions. Subjects and Methods: The sample for this cross-sectional study consisted of 1,006 adult patients seeking routine dental care. Patients who had received dental care in the last 2 years were excluded. Radiographs of 2,200 root canal-treated teeth were evaluated. The teeth were grouped according to the radiographic quality of the root canal filling and the coronal restoration. Periapical status was assessed using periapical index (PAI) scores. Results: Of the 2,200 root canal-treated teeth, 1,364 (62%) had apical periodontitis as compared with 1,364 (5.5%) of the total sample. Root-filled teeth classified as adequately treated had apical periodontitis in 223 (26.6%) cases compared with 1,192 (87.7%) in teeth classified as inadequately root filled. PAI 1 scores of adequate root canal treatment were significantly higher than in inadequate root canal treatment, regardless of the quality or presence of coronal restorations (p < 0.01). Conclusion: Our findings showed a high prevalence of periapical pathology with or without endodontic treatment and poor technical standard of both root fillings and coronal restorations of root-treated teeth. Hence, we suggest the need for better education for dental health providers so that they can perform better root canal treatments and coronal restorations.

CBCT evaluation of multiple idiopathic internal resorptions in permanent molars: case report.

BackgroundInternal inflammatory root resorption is a rare condition in permanent teeth, which requires the presence of necrotic and infected pulp tissue within the coronal portion of the root canal system as well as inflamed pulp tissue apical to the resorptive defect. The aetiology of internal root resorption is not completely understandable, trauma and chronic pulpitis are considered the main risk factors.Case presentationWe report a rare case of the multiple idiopathic resorption in the permanent maxillary and mandibular molars in a healthy 33-year-old female patient. In addition to clinical examination the patient was imaged using conventional radiography techniques and cone beam computed tomography (CBCT).The patient had recurrent throbbing pain in her # 46. The radiographic examination including “panoramic radiography and CBCT” revealed that radiographic evidence of internal resorption in #37 #36 #35 #34 #33 #47 #46 #45 #44 #43 #16 #15 #14 #13 and also including in unerupted #17, #26, #27, #28 teeth. The definitive diagnosis was made with the histopathological examination of the extracted tooth.ConclusionsInternal root resorption is a rare clinical process that should be examined using different radiographic modalities. CBCT seems to be useful in evaluation of the lesions with superior diagnostic performance.

Cone-beam CT evaluation of root canal morphology of maxillary and mandibular premolars in a Turkish Cypriot population

Objectives:Because of economic and political issues, Turkish Cypriots have been emigrating from Cyprus since the 1920s, especially to the United Kingdom, other European countries and Australia. Recently, according to the UK House of Commons, Home Affairs Committee, ~300,000 Cypriot Turks were living in the United Kingdom. However, this ethnic population residing in the United Kingdom has been insufficiently analysed. Although many Turkish Cypriots have been living abroad, little is known about the dental characteristics of this group. Premolar teeth, especially maxillary premolars, pose great challenges in endodontic treatment because of the number of roots and canals, and the variation in the configurations of the pulp cavity. Thus, it was considered valuable to determine the morphological characteristic of premolar teeth in a Turkish Cypriot population to aid clinicians in performing endodontic treatment in this ethnic population.Materials and Methods:The sample for this cross-sectional study consisted of a retrospective evaluation of cone-beam CT scans of 263 adult patients (age range 16–80 years). The number of roots and their morphology, the number of canals per root and the canal configuration were examined. The root canal configurations were also classified according to the scheme of Vertucci in the maxillary and mandibular premolar teeth. Pearson’s χ2-test was performed among canal configurations, sides and gender (P⩽0.05).Results:In the present study, most root canal configurations were type IV (76.8%) and type I (49.4%) in the maxillary first and second premolars, respectively, whereas most root canal configurations were type I (93%) in both mandibular first and second premolars. In total, four (0.9%) teeth in the maxillary first premolars and two (0.4%) teeth in the maxillary second molar premolars had three roots.Conclusions:This is the first population-based study to focus solely on Turkish Cypriots’ root canal anatomy. Our findings will be valuable for dental professionals who treat many Turkish Cypriot patients, in the United Kingdom, Australia and other countries.

A cone-beam computed tomography study of the anatomical relationships between mandibular teeth and the mandibular canal, with a review of the current literature

The purpose of this study was to evaluate age‐ and sex‐related changes in the anatomical relationships between the roots of the molars and premolars and the mandibular canal using cone‐beam computed tomography (CBCT) images. A total of 243 patients (116 males, 127 females) aged 16–83 years for whom previous CBCT scans were available were enrolled in this study. The patients were subcategorized by sex and age (Group I, <21 years; Group II, 21–40 years; and Group III, >40 years). The distances between the mandibular canal and the molars and premolars were measured. The mandibular canal was significantly closer to the root apices of the second and third molars than to the apices of other evaluated teeth (p < 0.05). All measurements were significantly higher in male than in female subjects (p < 0.05). Group I subjects exhibited significantly shorter distances between the mandibular canal and root apices of the first and second premolars, and the molars, than those of Group II and III subjects (p < 0.05). Direct contact relationships were found in 1.6%, 3.3%, 3.3%, 16%, and 32.2% of teeth (running from the first premolar to the third molar, respectively). Age and sex influenced the anatomical relationships between mandibular teeth and the mandibular canal, and these should be considered when planning endodontic and surgical procedures to avoid potential nerve injury.

Determination of the Minimum Inhibitory Concentrations of Alexidine and Chlorhexidine Against Enterococcus faecalis and Candida albicans: An In Vitro Study

Introduction: The root canal system must be mechanically instrumented and chemically cleaned using various antimicrobial irrigants in a sequential manner or in combination for the elimination of necrotic pulp tissue and reducing the number of root canal bacteria. For this reason, new methods and materials are continuously being developed to achieve the objectives of endodontic treatment. Materials and Methods: E. faecalis (ATCC 29212) and C. albicans (ATCC 90028) standard strains were used for this study. Colonies of E. faecalis and C. albicans were harvested from the agar plates and suspended in 4 mL of phosphate buffered saline (PBS). Microorganisms were diluted to obtain a suspension of approximately 108 colony-forming units/mL (CFU/mL) in sterile PBS using McFarland standard tubes no. 0.5. Results: After a two-minute contact time, all alexidine (ALX) concentrations used in this study eradicated all E. faecalis strains, while chlorhexidine (CHX) didn’t kill 100% of E. faecalis at 0.25% and lower concentrations even after a five-minute contact time. ALX also eradicated C. albicans at all concentrations even after a one-minute contact time. CHX showed antifungal activity against C. albicans at all concentrations higher than 0.031% after a one-minute contact time. Conclusion: A 0.0156% concentration of ALX can be a good alternative to CHX as an irrigation solution in endodontic treatment when used for one minute against E. faecalis and C. albicans.

Cone beam computed tomography evaluation of maxillary molar root canal morphology in a Turkish Cypriot population

ABSTRACT The aim of this retrospective study was to review, analyse and characterize the root canal morphology of maxillary molars, using cone beam computed tomography (CBCT), in a group of the Turkish Cypriot population. The sample for this cross-sectional study consisted of retrospective evaluation of CBCT scans of 290 adult patients (age range 16–80). The number of roots and their morphology, the number of canals per tooth and the root canal configurations were also classified according to the method of Vertucci. Pearsons chi-square test was performed for canal configurations, sides and gender (p < 0.05). Among the 373 first molars, there was no single-rooted specimen, 2 (0.53%) teeth had 2 roots, 365 (97.8%) teeth had 3 roots and 6 ones (1.6%) had 4 roots. Among the 438 second molars, 14 (3.1%) were single-rooted, 26 (5.9%) teeth had 2 roots, 392 (89.4%) teeth had 3 roots and 6 teeth (1.3%) had 4 roots. No sex difference was found in the frequency of additional canals both in the maxillary first and second molars. Occurrence of additional canals did not differ with age. These results provide detailed knowledge of the root canal anatomy of the maxillary molar teeth in this particular population, which is of clinical importance for dental professionals when performing endodontic treatment.