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ABSTRACT: Most periapical lesions are associated with microorganisms from infected root canal systems. Maxillary sinus can pose a diagnostic dilemma radiographically because of its anatomical variation which can mimic a periapical pathosis. The aim of this study was to describe two cases of aberrant anatomical variation of the maxillary sinus that presented radiographic similarities to a periapical cyst in order to call the attention of clinicians to the fact that several different diseases are able to mimic endodontic periapical lesions. An accurate assessment of this morphology was made with the help of cone-beam computed tomography (CBCT).
Case reports in dentistry. 01/2013; 2013:757645.
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ABSTRACT: Infantile malignant osteopetrosis (IMO) is an uncommon autosomal recessive disease characterized by dense, brittle, sclerotic, radiopaque bones, which generally results in neurological and hematological abnormalities. In general, IMO is fatal, as patients fail to grow and expire due to complications of the disease such as severe chronic anemia, bleeding, and/or infections. In children with IMO, the development of the dentition is seriously disturbed. Patients with infantile osteopetrosis have a variety of signs and symptoms, including osteomyelitis of the jaws, which frequently and generally resists treatment. Infections may eventually become lethal; hence, jaw infection control is an important aspect of the disease for dentists and oral surgeons to consider. The purpose of this case report was to present 2 rare cases of pediatric patients (one of them died due to respiratory failure at 10 years old) diagnosed with osteopetrosis complicated by osteomyelitis of the jaw.
Journal of dentistry for children (Chicago, Ill.) 01/2012; 79(2):93-9.
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ABSTRACT: To determine the prevalence of idiopathic osteosclerosis (IO) in the jaw by radiographic evaluation and to investigate the relationship between the findings in relation to age, gender, and localization.
The study included 2,211 panoramic radiographs obtained from the patients (915 men and 1,296 women) whose ages ranged from 10-77 and who visited the Department of Oral Diagnosis and Radiology in the Faculty of Dentistry, Erciyes University between 2008 and 2009.
Of 2,211 patients, 135 patients (6.1%) had IO. The prevalence obtained in our study was in the range reported in the literature. IO was detected more often in mandible rather than the maxilla. In addition, mandibular molar localization was the most common localization, and most of the lesions were associated with root apices.
In view of the findings, IO can be defined as developmental variations of normal bony architecture, which are unrelated to local stimuli. The lesions can arise at any age, any location with no sex predilection, and IO usually requires no treatment other than diagnosis. Because all these lesions were located in the jaw and could only is detected in panoramic evaluations, this indicates the importance of careful diagnostic evaluation of radiographies in dental examinations.
European journal of dentistry. 08/2011; 5(4):409-14.
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ABSTRACT: 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.
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.
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.
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.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 06/2011; 112(4):e11-7. · 1.50 Impact Factor
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ABSTRACT: The aim of this study was to determine the frequency of bifid mandibular condyle (BMC) using panoramic radiographs supported by different radiographic techniques. A retrospective study was carried out by evaluating panoramic radiographs of 18,798 patients referred to the Department of Dentomaxillofacial Radiology. T-tests were used to compare the frequency of BMC between left and right sides and between female and male patients. In this study, 98 patients (0.52%) were found to have BMC. Of these patients, 51 (52%) were females and 47 (48%) were males. Of the 98 patients, 71 (72.4%) had unilateral and 27 (27.6%) had bilateral BMC. A total of 125 BMCs were found in 98 patients. No statistically significant differences were found between the right and left BMCs or between female and male patients (P > 0.05). Because symptoms associated with BMC are either absent or minimal, it is usually discovered as an incidental finding during routine radiographic examination. Different appearances of BMC can be seen on panoramic radiographs. The exact orientation of the condyles can only be determined using 3D imaging techniques. BMC may be a more frequent condition in the Turkish population.
Journal of Oral Science 01/2011; 53(4):433-7.
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ABSTRACT: 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.
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.
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.
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.
American journal of orthodontics and dentofacial orthopedics: official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 08/2009; 136(1):37-43. · 1.33 Impact Factor
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ABSTRACT: 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 Arnett's 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 Arnett's 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.
The European Journal of Orthodontics 06/2009; 31(4):449-56. · 0.89 Impact Factor
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European journal of dentistry 05/2009; 3(2):155-7.
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ABSTRACT: The objectives of this study were to determine the prevalence, size, shape and location of the torus palatinus (TP) in dental outpatients in Cappadocia region of Turkey and to investigate the relationship between the findings in relation to age and gender.
The present study included 2660 patients, who attended the Department of Oral Diagnosis and Radiology in the Faculty of Dentistry at Erciyes University for their dental problems between December 2005 and May 2007. The presence or absence of TP was examined by clinical inspection and palpation.
The prevalence of TP in our large sample was low (4.1%) in comparison to other Turkish population. It was found to be significantly higher (P<.001) in females (5.7%) than in males (1.8%). Most TP were found in flat shape (62.7%), smaller than 2 cm (75.4%) and located at premolar-molar region (66.4%).
This study indicated that the prevalence of TP in Turkish population was low. Our results showed a significant relationship between the occurrence of TP and gender. According to the literature, it was firstly showed that flat TP was the most common type in our large population.
European journal of dentistry 10/2008; 2(4):269-75.
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ABSTRACT: The styloid process (SP) is a cylindrical, long cartilaginous bone located on the temporal bone. The normal SP length is approximately 20-30 mm. The styloid process elongation (SPE) can be assumed if either the SP or the adjacent stylohyoid ligament ossification shows an overall length in excess of 30 mm. Elongated SP is known as Eagle's syndrome when it causes clinical symptoms as neck and cervicofacial pain. It is supposed that this symptoms and signs are due to the compression of the SP on some neural and vascular structures. It may also cause stroke due to the compression of carotid arteries. This syndrome is diagnosed by both radiographical and physical examination. Instead of many hypotheses and studies, the exact etiology of elongated SP and the role of ectopic calcification are unknown. Ectopic calcification (EC) might have a role for the elongation of SP. Abnormal calcium (Ca), phosphorus (P) and vitamin D metabolism is very common in patients with end-stage renal disease (ESRD). Therefore, this calcification in nonosseous soft tissue due to abnormal serum Ca and P levels is commonly associated with this disorder. EC due to the abnormality in this metabolism which is related to the duration of dialysis is also very important for this calcification. Therefore, a study in patients with ESRD investigating the prevalence of SP and the correlation between dialysis period and the SP length may help us explaining the role of EC in the elongation of SP. Because, this disease might be a good model for the investigation of the EC in this elongation. However, further studies and large samples are also needed to clarify the etiology of this disorder.
European journal of dentistry 08/2008; 2(3):224-8.
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ABSTRACT: The aim of this study is to determine the prevalence of styloid process elongation (SPE) detected on panoramic radiographs (PRs) in Cappadocia region population in Turkey and to investigate the SPE incidences in relation to the age subgroups.
Between 2004 to 2007 years, a random sample of 750 PRs was collected from the data files and any questionable PR was excluded. Therefore, 698 PRs were included in the present study. The subjects were divided into six age subgroups: 10-19, 20-29, 30-39, 40-49, 50-59 and 60 years and older. Fifty-four (7.7%) patients demonstrated SPE at least one side.
There were statistical differences between 10-19, 20-29 age subgroups and 30-39, 50-59 age subgroups in terms of the SPE prevalence, but not other subgroups.
According to our knowledge, this is the highest prevalence in comparison to the other Turkish reports and the first study in terms of the SPE prevalence in Cappadocia region population. Also, the subgroup analyse suggested that the age may not have a role in the elongation of the SP.
European journal of dentistry 02/2008; 2(1):18-22.
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ABSTRACT: 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.
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).
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).
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 Habbet's mandibular asymmetry indices.
The Angle Orthodontist 01/2008; 78(1):32-7. · 1.21 Impact Factor
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ABSTRACT: 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.
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
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.
The use of third molars as a developmental marker is appropriate, especially when comparing the obtained standard deviation with other skeletal age calculation techniques.
The Angle Orthodontist 11/2007; 77(6):1040-5. · 1.21 Impact Factor
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ABSTRACT: The aim of this study is to determine retrospectively the presence of carotid artery calcifications (CACs) detected on panoramic radiographs (PRs) in a group of Turkish population. Further, the relationships between CACs and gender, life style, and medical history were evaluated.
During the years 2004 to 2006, a random sample of 1282 PRs was collected from patients older than 40 years who were being treated by the School of Dentistry, Erciyes University. Of these 1282 PRs, 750 PRs were included in this study. Medical data was collected from the archival records of the dental school.
About 38 (5.06%) CACs were found on the PRs of 12 (4.5%) males and 26 (5.4%) females. The CAC prevalence was not significantly different between the males and females (P=0.583). These calcifications were unilateral in 26 (68.4%) and bilateral in 12 (31.6%) subjects. Of those in the positive group, there were 12 subjects (31.58%) with hyperlipidemia, 12 subjects (31.58%) with hypertension, 7 subjects (18.4%) with diabetes mellitus, 6 subjects (15.8%) with cardiovascular disease, and 6 subjects (15.8%) with smoking history.
This study has the highest CACs prevalence in comparison to the other studies. Therefore, dentists caring for subjects with dental problems should carefully evaluate their PRs for the evidence of CACs, and refer them for medical evaluation as indicated. So, incidental findings could provide life-saving information.
European journal of dentistry 08/2007; 1(3):132-8.
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ABSTRACT: The aim of this study was to document the prevalence of hypodontia in the permanent dentition among a group of Turkish sample who sought orthodontic treatment and to compare present results with the specific findings of other populations. The occurrence was evaluated in relation to gender, specific missing teeth, the location and pattern of distribution in the maxillary and mandibular arches and right and left sides.
Orthodontic files of 2413 patients (1557 females-mean age: 17.78+/-5.41 years old and 856 males-mean age:17.02+/-5.47 years old) which included orthopantomograms, study models, and anamnestic data were examined for evidence of hypodontia.
The prevalence of hypodontia was 7.54% (8.09% for female and 6.54% for male). Hypodontia was found considerably more frequently in the maxilla than in the mandible. Similarity in the distribution of missing teeth between the right and left sides was detected. The most frequently missing teeth were the maxillary lateral incisors, followed by the mandibular and maxillary second premolars. The majority of patients had one or two teeth missing, but seldom three or more.
Present data for hypodontia were within the wide range reported in the literature. The findings of patients with hypodontia involving the anterior teeth and others missing more than two teeth in the same quadrant were an indication of a great need for orthodontic treatment. By early detection of missing teeth, alternative treatment modalities can be planned and performed with a multidisciplinary team approach.
European journal of dentistry 08/2007; 1(3):167-73.
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Ismail Sari,
Fevzi Altuntas,
Ismail Kocyigit, Yildiray Sisman,
Bulent Eser,
Aydin Unal,
Turgay Fen,
Ayten Ferahbas,
Ahmet Ozturk,
Ali Unal,
Mustafa Cetin
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ABSTRACT: Oral chronic graft versus host disease (cGVHD) is common and a major cause of morbidity and loss of quality of life in long term survivors. Cyclosporine with prednisone remains the first line therapy for oral manifestations of cGVHD. However, even with routine administration of systemic agents, many patients with oral manifestations of cGVHD do not have resolution of their disease and may benefit from incorporation of local therapy. Budesonide is a highly potent steroid which has minimal systemic side effects and being used for oral cGVHD. We designed a retrospective study to compare treatment results of patients with oral cGVHD who received topical budesonide in addition to systemic therapy that consists of combined prednisone and cyclosporine (Group A, n = 12), with the treatment results of patients who were administered the same systemic therapy alone (Group B, n = 11) to determine whether budesonide mouthwash had any advantage on response rates. Three mg topical budesonide/10 ml saline was used 3-4 times a day for up to 6 months in group A. Diagnosis, clinical staging, and treatment response scoring for cGVHD were performed according to National Institutes of Health (NIH) consensus criteria. At the baseline examination, there were no statistically significant differences in terms of median oral cGVHD examination scores between two groups. After treatment, there was statistically significant decrease in median oral cGVHD examination scores compared to baseline (P < 0.001 and 0.021), and significant differences were found between two groups (P < 0.032). Overall response rate was 83% and 36% for group A and B, respectively (P = 0.036). However, no statistically significant differences were found between median pain scores of two groups before and after treatment (P = 0.740 and P = 0.091). No major systemic side effects and oral candidiasis were observed in two groups of patients. We concluded that topical budesonide might be added to systemic therapy to obtain better response rates in patients with oral cGHVD.
American Journal of Hematology 05/2007; 82(5):349-56. · 4.67 Impact Factor
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ABSTRACT: A single median maxillary central incisor (SMMCI) is a rare dental anomaly that may occur alone or be associated with growth deficiency or other systemic abnormalities. The best known association is with holoprosencephaly (HPE). HPE is a complex brain malformation that affects both the forebrain and the face. Early diagnosis of SMMCI is important, since it may be a sign of other severe congenital or developmental abnormalities. Therefore, systematic follow-up and close monitoring of the growth and development of SMMCI patients is crucial. The purpose of this paper was to report the cases of 2 children, each with a single median maxillary central incisor, and describe important symptoms of this syndrome that have not yet been reported.
Pediatric dentistry. 34(2):150-5.
