Evaluation of morphological and morphometric characteristics of the temporomandibular joint in children with different skeletal models in the sagittal and vertical direction

OBJECTIVE

This study aims to evaluate differences in the morphological and morphometric features of hard tissue components of the temporomandibular joint (TMJ) in the cone beam computed tomography (CBCT) images of children with different skeletal models in the sagittal and vertical plane.

METHODS

Condyle dimensions, horizontal condylar angle, the distance of the condyle center to the midsagittal plane, condyle position, eminence height, eminence inclination, condyle, and fossa shape and symmetry were evaluated in CBCT images in 190 TMJs in 95 pediatric patients. Patients were classified as Class 1-2-3 in the sagittal direction, as hypodivergent, normodivergent, and hyperdivergent in the vertical direction. Children were divided into 10-13 and 14-17 age groups.

RESULTS

The left superior joint space in children with a different skeletal model in the sagittal plane was lower and found to be statistically significant in Class 3 children (p < 0.05). A statistically significant difference was found lower in the left articular eminence inclination and height in Class 3 children (p < 0.05). The most common oval fossa form was seen in Classes 2-3 children (p < 0.05). It was determined that the anterior joint space was lower in hyperdivergent children and the condyle was located more anteriorly. The mediolateral length of the condyle and the height of the articular eminence were positively correlated with age.

CONCLUSIONS

The results revealed that the difference in skeletal models seen in sagittal and vertical planes in children may cause morphological and morphometric changes in the hard tissue components of TMJ.

Oral mucosal lesions and risk factors in elderly dental patients

Background. The aim of this study was to determine the prevalence of oral lesions in terms of sex, age, educational status, medication use, systemic diseases, the duration of denture use and tobacco or alcohol use.

Methods. A total of 709 voluntary patients (375 males and 334 females), aged ≥60 years, were interviewed by one investigator for demographic data, systemic diseases, tobacco or alcohol use, denture use and the duration of denture use.

Results. The majority of the participants (87.6%) had one or more oral mucosal lesions. The prevalence of oral mucosal lesions was 46.3% in males and 41.3% in females (P=0.76). The most common oral mucosal lesion was a sublingual varicosity in both males and females. A statistically significant difference was observed between the three age groups (60–64, 65–69, and ≥70 years) with regard to the prevalence of oral mucosal lesions (P=0.02). There was a significant relationship between the presence of systemic diseases and oral mucosal lesions (P=0.01). There was also a significant relationship between denture use and oral mucosal lesions (P=0.001). Smoking and a history of smoking were also significant predictive factors for oral mucosal lesions (OR: 3.385, P=0.045).

Conclusion. Although the majority of oral mucosal lesions detected in the present study were benign, there were some patients with premalignant and malignant lesions. Therefore, periodic oral examinations for detection of precancerous and cancerous lesions are important, especially in the elderly, smokers and denture users.

General health and oral health status in elderly dental patients in Isparta, Turkey

The aim of this study was to describe the oral health, general health status and medication use of elderly dental patients 709 voluntary patients, aged 60 years and over, who attended Suleyman Demirel University Faculty of Dentistry for routine dental treatment between March 2008 and April 2009 in Isparta, Turkey, were interviewed for demographic data, systemic diseases, and lists of medications. The majority of the patients (84.4%) had poor oral hygiene according to the Oral Hygiene Index (OHI). The mean level of the study population's decayed, missing, and filled teeth (DMFT) index score was 19.1 ± 7.3. The prevalence of systemic diseases was high (90%). Women were affected by a significantly higher incidence of systemic diseases than men (96.4% vs. 84.3%; P < 0.001). The percentage of the elderly taking medication regularly was 72.6%. Drug adverse effects were determined in 25.5% of the study population, with more adverse effects observed in women (53.3%) than men (46.7%) (P < 0.001).Dentists must be aware of the dental implications that may arise from systemic diseases and medications and should properly modify elderly patients' treatment accordingly.

Comparison of different caries detectors for approximal caries detection

Background/purpose

Detection of approximal caries may be difficult using conventional methods including visual inspection (VI) and radiography. The purpose of this in vitro research was to evaluate the efficiency of light-emitting diode (LED) and laser fluorescence (LF) devices, and radiographic and visual examination in approximal caries diagnosis.

Materials and methods

One hundred and fifty-six approximal regions were evaluated. All approximal regions were investigated using LED and LF tools after radiography and VI were performed. Histological evaluation of teeth was performed using stereomicroscopy. The area under the receiver operating characteristic curve and accuracy, specificity, sensitivity values calculated regarding approximal caries diagnose.

Results

The specificity of the bitewing examination was higher for both T1 and T2 thresholds (0.97 and 0.99, respectively), and the LF device showed better sensitivity at each threshold compared with the other devices used for caries diagnosis (0.94 at T1 and 0.79 at T2). The receiver operating characteristic curves presented that the LF device was more successful than the other techniques at T1 threshold and VI was better than the other caries detection methods at T2 threshold. The kappa values for interobserver agreements were 0.43 (LF pen), 0.33 (LED device), 0.55 (VI), and 0.75 (bitewing examination).

Conclusion

The ability of bitewing radiography to identify sound surfaces was better than that of the other methods. The LF device was the most sensitive tool for detecting approximal surfaces with caries, followed by the LED device.

Paranasal sinus pathoses on cone beam computed tomography

Purpose:

The aim of this study was to investigate paranasal sinus pathoses detected on cone-beam computed tomography (CBCT) in an adult population.

Patients and Methods:

Three observers retrospectively inspected 353 consecutive CBCT scans obtained in a dentomaxillofacial radiology department for paranasal sinus pathoses. Descriptive statistics and chi-square tests were used to determine the prevalence of categorical parameters.

Results:

The age of the patients ranged from 18 to 85 years (mean 41.27±16.76). There were 172 (48.7%) females and 181 (51.3%) males. There was a significant difference between the genders (p=0.02), with males (53.5%) having more sinus pathoses than females (46.5%). When the left and right sinuses were considered together, pathoses were most commonly seen in the maxillary sinuses (57.1%), followed by the ethmoid (53.7 %), frontal (22.6%), and sphenoid sinuses (15.8%). Mucosal thickening was the most frequently observed abnormality (51.7%), followed by hypoplasia (17.5%) and sinusitis (17.3%).

Conclusion:

CBCT is a preferable imaging method for evaluation of paranasal sinuses. Dentomaxillofacial radiologists should examine the whole volume of CBCT images to ensure they do not overlook paranasal sinus pathoses.

Effect of Different Contact Materials on Approximal Caries Detection by Laser Fluorescence and Light-Emitting Diode Devices

OBJECTIVE

The aim of this in vitro study was to investigate the influence of the adjacent tooth surface on pen type laser fluorescence (LFpen) and light-emitting diode (LED) device readings in detecting approximal caries lesions in permanent teeth.

BACKGROUND DATA

Early detection of noncavitated dental caries is important, because disease progression can be easily halted at this stage with certain applications, such as fluoride therapy, antibacterial therapy, dietary changes, or low-intensity laser irradiation.

MATERIALS AND METHODS

A total of 87 permanent molars with 156 approximal surfaces were assessed with LED- and LF-based devices in contact with sound tooth surfaces (the control group) as well as approximal amalgam, composite, zirconia, and full ceramic restorations. All teeth were assessed once by one trained examiner. After the LF and LED assessments, the teeth were histologically evaluated using stereomicroscopy as the gold standard. The sensitivity, specificity, accuracy, and area under the receiver operating characteristics (ROC) curve were calculated according to the appropriate thresholds (T1, sound surface or enamel caries; T2, dentin caries).

RESULTS

For the LFpen device, higher sensitivity and accuracy was found when the adjacent surface was sound at the T1 threshold and no significant differences were found among accuracy at the T2 threshold. For the LED-based device, no significant differences were found among sensitivities at the T1 threshold. At the T2 threshold, specificity was higher when the adjacent tooth had a zirconia restoration.

CONCLUSIONS

It was found that both devices could be used effectively for evaluating approximal surfaces with adjacent restored teeth, regardless of the different kinds of restorative materials.

Subpontic osseous hyperplasia: Three case reports and literature review

Subpontic osseous hyperplasia (SOH) is an ectopic growth of bone occurring on the edentulous ridge beneath a fixed partial denture. The aim of this article is to present three patients with SOH with long-term follow-up and to make a current overview of the literature. Presented maxillary SOH is the second case in the dental literature. Intraorally the lesions were bone-hard and painless swellings in the subpontic space. Radiographically, the maxillary case was a nodular bone growth having similar radiodensity and trabeculation to the adjacent bone with a thin radiopaque border. Mandibular cases were bony growths, which were more radiopaque than the adjacent alveolar ridge. Follow-up radiographs revealed regression in two of the cases. Clinicians should take care not to cause the possible etiologies of SOH such as functional stresses and chronic irritation by the prosthetic treatments and be aware of SOH does not usually require treatment or a biopsy.

Multiple calcifying hyperplastic dental follicles: A case report

This report describes a 31-year-old female patient with six impacted teeth. The crowns of the impacted teeth were surrounded with cyst-like lesions with a mixed internal structure and well-defined cortical borders. Microscopic examination of the specimen obtained from the follicle of the left mandibular third molar tooth revealed loose to moderately dense collagenous connective tissue with abundant calcified material and sparse epithelial islands. A diagnosis of multiple calcifying hyperplastic dental follicles was made.

In vivo performance of two devices for occlusal caries detection

OBJECTIVE

The aim of this in vivo study was to compare the performance of light-emitting diode (LED)- and laser fluorescence (LF)-based devices with that of visual inspection (VI) in the diagnosis of occlusal caries.

METHODS

A total of 156 occlusal surfaces were investigated. Each occlusal surface was assessed with LED- and LF-based devices after a VI was performed. Pit and fissure opening was applied to the occlusal surfaces in which opacity or discoloration was distinctly visible after airdrying. The inter-examiner reliability of caries examination was assessed using the weighted κ statistics. The sensitivity, specificity, and accuracy of occlusal caries diagnosis using these methods were calculated according to the appropriate thresholds.

RESULTS

Acceptable inter-examiner agreement was found for the LED- and LF-based devices and VI (κ=0.61, κ=0.76, and κ=0.87, respectively). Higher specificity values were achieved at a T2 threshold for the LF-based device (0.76 and 0.80) and at a T1 threshold for the LED-based readings (0.60 and 0.62) and VI (0.90 and 0.93) for both observers. With regard to VI, higher sensitivity values were found at both thresholds for the two observers in comparing the three caries detection methods (0.98 at T1 and 0.96 at T2). The accuracy values for T1 were higher than those for the T2 values, for all three caries detection methods.

CONCLUSIONS

Caries lesions may be detected more accurately than clinically sound areas by both caries detection devices.