Yildiray Sisman

Third-Molar Development in Relation to Chronologic Age in Turkish Children and Young Adults

OBJECTIVE To assess estimation of chronologic age based on the stages of third-molar development following the eight stages (A-H) method of Demirjian et al and to compare third-molar development by sex and age with results of previous studies. MATERIALS AND METHODS The final sample consisted of 900 orthopantomograms from young Turkish subjects of known chronologic age (range, 8-25 years; mean age, 15.18 +/- 4.81 years) and sex (380 males with a mean age of 14.51 +/- 4.55; 520 females with a mean age of 15.67 +/- 4.94). Statistical analysis was performed using the Mann-Whitney U-test and the Wilcoxon test between sex and age. Regression analysis was performed to obtain regression formulas for dental age calculation with the chronologic age RESULTS Statistically significant differences (P < .05) in third-molar development between males and females were revealed regarding the calcification stages D and G. Third-molar genesis was attained earlier in males than in females. Statistical analysis showed a strong correlation between age and third-molar development for males (r(2) = .65) and for females (r(2) = .61). New equations (Age = 8.92 + 1.50 Development stage) were derived for estimating chronologic age. CONCLUSION The use of third molars as a developmental marker is appropriate, especially when comparing the obtained standard deviation with other skeletal age calculation techniques.

Mandibular Asymmetry in Class II Subdivision Malocclusion

OBJECTIVE To evaluate the condylar and ramal mandibular asymmetry in a group of patients with Class II subdivision malocclusion to identify possible gender differences between male and female subjects. MATERIALS AND METHODS Mandibular asymmetry measurements (condylar, ramal, and condylar-plus-ramal asymmetry values) were performed on the panoramic radiographs of 80 subjects (34 male and 46 female). The study group consisted of 40 Class II subdivision patients (18 male and 22 female; mean age 14.53 +/- 3.14 years). The control group consisted of 40 subjects with normal occlusion (16 male and 24 female; mean age 14.43 +/- 3.05 years). The Kruskal-Wallis test was used to determine the possible statistically significant differences between the groups for condylar, ramal, and condylar-plus-ramal asymmetry index measurements. Identified differences between groups were further analyzed using the Mann-Whitney U-test at the 95% confidence interval (P < .05). RESULTS No gender-related difference was found for any of the asymmetry indices. Comparison of condylar, ramal, and condylar-plus-ramal asymmetry index values and gonial angle measurements for Class I and Class II sides in the Class II subdivision group and for right and left sides in the Class I group showed no statistically significant differences. However, the Class II subdivision group has longer values for condylar, ramal, and condylar-plus-ramal height measurements and only these differences were statistically significant (P < .001). CONCLUSIONS Except for condylar ramal and condylar-plus-ramal height measurements, Class II subdivision patients have symmetrical condyles when compared to normal occlusion samples according to Habbets mandibular asymmetry indices.

Condylar and ramal vertical asymmetry in unilateral and bilateral posterior crossbite patients and a normal occlusion sample

INTRODUCTION Our objective was to evaluate the condylar, ramal, and condylar-plus-ramal mandibular vertical asymmetry in a group of adolescent subjects with normal occlusion and unilateral and bilateral posterior crossbite malocclusions. METHODS Mandibular asymmetry index measurements (condylar, ramal, and condylar-plus-ramal) were made on the panoramic radiographs of 126 subjects (51 boys, 75 girls). The study groups consisted of 46 unilateral (19 boys, 27 girls; mean age, 13.06 +/- 3.52 years) and 40 bilateral (16 boys, 24 girls; mean age, 12.72 +/- 3.22 years) posterior crossbite patients and a group of 40 subjects (16 boys, 24 girls; mean age, 14.43 +/- 3.05 years) with normal occlusion. One-way analysis of variance (ANOVA) was used to determine possible statistically significant differences between the groups for condylar, ramal, and condylar-plus-ramal asymmetry index measurements at the 95% confidence interval. RESULTS No group showed statistically significant sex- or side-specific differences for posterior vertical height measurements (P > 0.05). Asymmetry indexes (condylar, ramal, and condylar-plus-ramal) were similar, and no statistically significant differences were found among the unilateral and bilateral posterior crossbite groups and the normal occlusion sample. CONCLUSIONS No statistically significant sex- or side-specific mandibular asymmetry was found among the 3 groups. Condylar asymmetry index values were significantly high compared with the 3% threshold value in each of the 3 groups, but comparisons between groups were not statistically significant.

Detection of incidental carotid artery calcifications during dental examinations: Panoramic radiography as an important aid in dentistry

OBJECTIVE This study aimed to determine the diagnostic reliability of panoramic radiographs (PRs) in the detection of carotid artery calcifications (CACs) during routine dental examination by comparing them with color Doppler ultrasound (CDUS) examination as the criterion standard. The correlations between CAC formation and systemic diseases, body mass index, smoking, and age were also examined. STUDY DESIGN A total of 70 patients >40 years old diagnosed with CACs from PRs obtained during routine dental examination between January 2008 and September 2009 and 35 patients with no CACs (control group) were referred for further ultrasound examination. RESULTS Compared with CDUS examination of 210 carotid arteries in 105 patients, PRs were found to have sensitivity, specificity, and accuracy rates of 79.8%, 81.1%, and 80.5%, respectively, in the diagnosis of CACs. CACs were found to be significantly correlated with chronic diseases, such as hypertension, hyperlipidemia, and heart disease, but not with diabetes mellitus or renal disease. In addition, correlations were found between CACs and smoking and beween CACs and menopause. CONCLUSIONS The findings of PRs and ultrasound are consistent enough to warrant the referral of patients prediagnosed with suspected CACs from PRs for further medical evaluation.

Anterior Stafne bone defect mimicking a residual cyst: a case report.

Stafne bone defects (SBDs) are asymptomatic lingual bone depressions of the lower jaw that are frequently caused by soft tissue inclusion. The common variant of SBDs exists at the third molar region of the mandible below the inferior dental canal and has been mostly diagnosed incidentally during routine radiographic examination. The anterior variant of a SBD (ASBD) is relatively uncommon and is located in the premolar region of the mandible. Sublingual salivary glands are thought to be responsible for ASBDs. However, other structures such as lymphoid or vascular tissues might be associated with ASBDs. In the present report, an ASBD which was mimicking a residual cyst was diagnosed with the aid of a three-dimensional CT scan. ASBDs might be confused with other odontogenic or non-odontogenic pathologies because of their location and lower occurrence rate. Advanced imaging modalities, especially CT scans, are useful to assess such lesions in order to avoid unnecessary surgery.

Standards of soft tissue Arnett analysis for surgical planning in Turkish adults

The aims of this study were (1) to establish standards for Arnett soft tissue cephalometric analysis of Anatolian Turkish young adults and (2) to identify possible gender differences between males and females. After analysing the cephalometric radiographs of 350 individuals, 133 subjects (67 males, mean age 22.6 +/- 2.2 years, and 66 females, mean age 22.1 +/- 2.6 years) with normal antero-posterior and vertical skeletal relationships were selected. The true vertical line was established. The landmarks were marked and soft tissue facial analysis was performed. For statistical evaluation, an independent-samples t-test was used. The lower lip thickness of the Turkish population was lower and menton thickness was greater than Arnetts norms. Turkish subjects have depressed orbital rims, cheek bones, subpupils, upright and thin upper and lower lips, retruded incisors, and pogonion and point B. Most of the Turkish mean harmony values were within the range of Arnetts harmony standards. Soft tissue thicknesses were greater and facial lengths, except upper incisor exposure, were longer in Turkish males than females. These differences between ethnic groups should be taken into consideration when formulating orthodontic/orthognathic treatment plans for patients with dentofacial deformity.

Detection and characterization of the mandibular accessory buccal foramen using CT

OBJECTIVE To investigate the frequency and characteristics of the mandibular accessory buccal foramen (ABF) with CT. METHODS A retrospective study was carried out using the CT records of 504 patients referred to the Erciyes University Medical School (Kayseri, Turkey) between 2007 and 2010. Presence, location, diameter, area and number of ABFs and their continuity with mandibular canal and distance to the mental foramen were evaluated using axial, sagittal and three-dimensional CT images. Statistical analysis was performed using SPSS® v. 15 (SPSS Inc., Chicago, IL), and t-tests were used for statistical analysis. RESULTS 14 ABFs were observed in 10 (2%) of 504 patients. The frequency of ABFs was found to be 2.6% in males and 1% in females. The mean distance between the ABF and the mental foramen was 5.0 mm [standard deviation (SD) ± 2.48]. The mean long axis of the ABFs was 1.4 mm (SD ± 0.4) and the mean area of them was 1.5 mm(2) (SD ± 0.8). The mean area of the mental foramen on the side with the ABF was 4.1 mm(2) (SD ± 2.71). CONCLUSIONS This study presents a relatively lower frequency of ABFs than that in the literature. These foramina could have more complex neurovascular structures than was previously thought. Thus, in special cases where a direct surgical exploration during the planned surgery is not indicated, CT or cone beam CT examination to determine the possible presence of ABFs may be indicated.

Assessment of pharyngeal airway volume in adolescent patients affected by bilateral cleft lip and palate using cone beam computed tomography

OBJECTIVE To test the null hypothesis that there were no significant differences for pharyngeal airway volumes between the adolescent patients affected by bilateral cleft lip and palate (BCLP) and well-matched controls using cone beam computed tomography. MATERIALS AND METHODS The study sample consisted of 16 patients (11 female and 5 male; mean [SD] age 14.1 [2.1] years) affected by BCLP and 16 patients (10 female and 6 male; mean [SD] age 13.4 [2.0] years) as age- and sex-matched control group. Craniofacial measurements and pharyngeal airway dimension, area, and volume measurements of patients in both groups were calculated and statistically examined using Students t-test and multiple linear regression analyses. RESULTS Statistically significant differences were found between the BCLP and control groups for SNB (P < .05), SN-GoGn (P < .05), Co-A (P < .05), PAS (P < .01), minAx (P < .01), and oropharyngeal airway volume (P < .05). The most predictive variables for oropharyngeal airway volume were found as PAS (r  =  .655 and P  =  .000) and minAx (r  =  .787 and P  =  .000). CONCLUSIONS The null hypothesis was rejected. Oropharyngeal (P < .05) and total (P > .05) airway volumes were found to be less in the BCLP group, and thus the treatment choice in these patients should have positive effects on the pharyngeal airway.

Evaluation of root morphology and root canal configuration of premolars in the Turkish individuals using cone beam computed tomography

Objective: The aim of the present study is to assess the root and root canal morphology of maxillary and mandibular premolars in a Turkish population by using cone beam computed tomography (CBCT). Materials and Methods: In this study, CBCT images of 2134 premolars (987 maxillary, 1147 mandibular) were obtained from 404 patients. Details of gender, age, number of roots and canals, and canal configuration in each root were recorded. The canal configuration was classified and evaluated according to Vertuccis criteria. Results: The majority of maxillary premolars had two separate roots; although, three roots were identified in 1% of maxillary first premolars. However, most of the mandibular premolars had a single root. The two canals (69.9%) and type I (62.6%) and type II (34.1%) configuration for upper first premolar, one canal (82.1%) and type I (77.6%) canal configuration for second premolar was the most prevalent root canal frequency. The most prevalent root canal frequency was the one canal (96.2%) and type I (94.2%) and type V (3.2%) configuration for mandibular first premolar, one canal (98.9%) and type I (98.9%) canal configuration for second premolar. There was no difference in the root canal configurations and the numbers of canals between the left and the right side of both females and males (P > 0.05). Conclusions: Recognition of morphology and anatomy of the root canal system is one of the most important factors for successful endodontic treatment. Preoperative CBCT examination allows determination of root canal configuration of premolar teeth and helps clinicians in root canal treatment.

Investigation of elongated styloid process prevalence in patients with torus palatinus

The aim of the current study was to determine the presence of styloid process elongation (SPE) detected on panoramic radiographs in patients with torus palatinus (TP). Between December 2005 and November 2007, a total of 149 patients with TP are investigated for routine dental examination in the outpatient clinic. Any patient who had disorders related to calcium and phosphorus metabolism was excluded. All medical data were obtained from the files. Twenty (15%) subjects demonstrated SPE at least one side. These patients consisted of 15 women (14.3% of all women) and five men (17.8% of all men). In our previous report performed in normal population at the same region, the prevalence had been found to be 7.7% in 698 dental patients. Although the number of the patients is different in both studies, there is a marked difference in terms of the SPE prevalence between the two reports. This prevalence difference might be related to concomitant disorder.