Evaluation of maxillary sinus volumes and pathologies in children with and without cleft lip and palate using cone beam computed tomography

OBJECTIVE

The aim of this study is to evaluate the maxillary sinus (MS) volume and pathologies, nasal septum (NS) deviation, and MS septa formation in children with and without cleft lip and palate (CLP); also to investigate the possible causes of MS pathologies.

MATERIALS AND METHODS

Cone Beam Computed Tomography (CBCT) images of 200 (100 CLP, 100 control) children (5-18 years old) were evaluated from the computer database of Marmara University Faculty of Dentistry. Children with a history of maxillofacial trauma, diseases that affect bone metabolism, orthognathic surgery, extrinsic pathologies of the MS, and accompanying syndromes were excluded. NS deviation, MS septa formation, volume, and pathologies evaluated using Mimics® software. In statistical evaluations; Student t test, paired sample t test, Chi-Square test, Fisher's Exact Chi-Square test, Continuity Correction, Chi-square analysis in one-eyed layout, McNemar test, and logistic regression analysis were used.

RESULTS

Total MS volume was smaller in the CLP group (21 232 mm3) than in control children (23 763 mm3) (P:0.026). NS deviation and MS pathology were more frequent in the CLP. In logistic regression analysis, there was no significant relation between the presence of NS deviation and pathology in MS. The presence of CLP increased the risk of MS pathology by 2.6 times.

CONCLUSION

We found that children with CLP have less MS volume and an increased rate of NS deviation and MS pathology compared to the control group. Further radiological and clinical studies are needed to explain the predisposing factors of MS pathology in children with CLP.

Radiological Associations between Posterior Edentulism and Condylar Bony Changes: A Retrospective Study

This retrospective study aimed to investigate the relationship between posterior edentulism and condylar bone changes in patients aged 35-60 years. The CBCT images of 259 patients, including 131 posterior edentulous and 128 posterior dentulous patients, were analyzed to identify the types of condylar bone changes. The frequency of flattening, sclerosis, erosion, and reduced joint space was found to be higher in posterior edentulous patients. Regression analysis revealed that combined premolar and molar loss and being female were significant predictors of condylar erosion (p = 0.006; OR: 3.264; 95% CI: 1.401 - 7.603, p=0.031; OR: 2.652; %95 CI: 1.095 - 6.424). The study provides support for the domino effect phenomenon in temporomandibular joint pathology, indicating that posterior edentulism can have a significant impact on the occurrence of erosive condylar changes. The findings suggest that prosthetic and temporomandibular joint treatment approaches should consider the association between posterior edentulism and condylar bone changes, particularly in female patients with combined premolar and molar loss. Therefore, close attention should be paid to the management of these patients to minimize the risk of temporomandibular joint pathology.

Incidence of dental barotrauma and temporomandibular joint problems of divers in Turkey

Introduction

In this study, we aimed to examine dental barotrauma and temporomandibular joint (TMJ) complaints in a large group of divers.

Methods

This survey study included scuba divers older than 18. The questionnaire contained 25 questions about the demographic characteristics of divers, dental health behaviors, and diving-related dental, sinus and/or temporomandibular joint pain.

Results

The study group consisted of 287 instructors, recreational and commercial divers (mean age 38.96 years) (79.1% males). A total of 46% of divers reported a frequency of tooth brushing less than twice a day; 28% never receive a routine dental examination; 22.6% experienced dental pain after and/or during diving, mostly in the upper posterior teeth (40%); 17% required dental treatment; 77% of these cases are restoration fracture. TMJ symptoms after diving were statistically significantly higher in women (p=0.04). Jaw and masticatory muscle pain in the morning (p≺0.001) limitation of mouth opening (p=0.04) and joint sounds in daily life (p≺0.001) were recorded as exacerbated after diving; the results were found to be statistically significant.

Conclusion

In our study, the localization of barodontalgia was consistent with the distribution of caries and restored tooth areas in the literature. Dive-related TMJ pain was also more common in those with pre-dive problems such as bruxism and joint noise. Our results are important to remind us of the necessity of preventive dentistry practices and early diagnosis of problems in divers. Divers should take personal precautions, such as brushing their teeth twice a day and avoiding the need for urgent treatment. The use of a personalized mouthpiece is also recommended for divers to prevent dive-related temporomandibular joint diseases.

A diving physician's experience of dental barotrauma during hyperbaric chamber exposure: case report

Previous cases of dental barotrauma have been reported in pilots and divers. We report a case of dental barotrauma and barodontalgia in a diving physician accompanying patients during hyperbaric oxygen treatment, and due to pressure changes in the hyperbaric chamber. The physician developed sharp pain localised to the right maxillary molars but radiating to the face, ear and head during decompression from 243 kPa (2.4 atmospheres absolute). The pain intensified following completion of decompression and was consistent with irreversible pulpitis. Clinical examination and panoramic radiography suggested fracture of a heavily restored tooth due to barotrauma. This was managed by tooth extraction. The physician subsequently discontinued accompanying the patients during their hyperbaric oxygen treatment sessions. Dentists and maxillofacial surgery specialists suggest waiting for a minimum of four weeks or until the tooth socket and/or oral tissue has healed sufficiently to minimise the risk of infection or further trauma before exposure to further pressure change. Although seemingly rare, and despite the comparatively slow pressure changes, dental barotrauma can occur in hyperbaric chamber occupants.