Morphological assessment of the stylohyoid complex variations with cone beam computed tomography in a Turkish population

BACKGROUND

The aim of this investigation was to evaluate the length, thickness, sagittal and transverse angulations and the morphological variations of the stylohyoid complex (SHC), to assess their probable associations with age and gender, and to investigate the prevalence of it in a wide range of a Turkish sub-population by using cone beam computed tomography (CBCT).

MATERIALS AND METHODS

The CBCT images of the 1000 patients were evaluated retrospectively. The length, thickness, sagittal and transverse angulations, morphological variations and ossification degrees of SHC were evaluated on multiplanar reconstructions (MPR) adnd three-dimensional (3D) volume rendering (3DVR) images. The data were analysed statistically by using nonparametric tests, Pearson's correlation coefficient, Student's t test, c2 test and one-way ANOVA. Statistical significance was considered at p < 0.05.

RESULTS

It was determined that 684 (34.2%) of all 2000 SHCs were elongated (> 35 mm). The mean sagittal angle value was measured to be 72.24° and the mean transverse angle value was 70.81°. Scalariform shape, elongated type and nodular calcification pattern have the highest mean age values between the morphological groups, respectively. Calcified outline was the most prevalent calcification pattern in males. There was no correlation between length and the calcification pattern groups while scalariform shape and pseudoarticular type were the longest variations.

CONCLUSIONS

We observed that as the anterior sagittal angle gets wider, SHC tends to get longer. The most observed morphological variations were linear shape, elongated type and calcified outline pattern. Detailed studies on the classification will contribute to the literature. (Folia Morphol 2018; 77, 1: 79-89).

Comparison of the influence of FOV sizes and different voxel resolutions for the assessment of periodontal defects

OBJECTIVES

This study assessed the influence of different voxel resolutions of two different CBCT units on the in vitro detection of periodontal defects.

METHODS

The study used 12 dry skulls with a maxilla and a mandible. Artificial defects (dehiscence, tunnel, fenestration) were separately created on the anterior, premolar and molar teeth using burrs. A total of 14 dehiscences, 13 fenestrations, 8 tunnels and 16 non-defect controls were used in the study. Images were obtained from two different CBCT units in six voxel sizes (voxel size: 0.080, 0.100, 0.125, 0.150, 0.160 and 0.200 mm3). Kappa coefficients were calculated to assess both intra- and interobserver agreements for each image set.

RESULTS

Overall intraobserver kappa coefficients ranged between 0.978 and 0.973 for the 0.080-mm3 images and between 0.751 and 0.737 for the 0.160-mm3 images, suggesting notably high intraobserver agreement for detecting periodontal defects. CBCT performed significantly better at detecting fenestrations (p<0.05) than tunnel and dehiscence defects. No statistically significant difference was found between the detection of dehiscence and tunnel defects (p>0.05).

CONCLUSIONS

A voxel size of 0.150 mm3 was identified as the cut-off point for overall detection of periodontal defects. CBCT should be considered the most reliable imaging modality for the diagnosis of periodontal defects.

Accuracy of CBCT images in the assessment of buccal marginal alveolar peri-implant defects: effect of field of view

OBJECTIVES

To investigate the reliability and accuracy of cone beam CT (CBCT) images obtained at different fields of view in detecting and quantifying simulated buccal marginal alveolar peri-implant defects.

METHODS

Simulated buccal defects were prepared in 69 implants inserted into cadaver mandibles. CBCT images at three different fields of view were acquired: 40 × 40, 60 × 60 and 100 × 100 mm. The presence or absence of defects was assessed on three sets of images using a five-point scale by three observers. Observers also measured the depth, width and volume of defects on CBCT images, which were compared with physical measurements. The kappa value was calculated to assess intra- and interobserver agreement. Six-way repeated analysis of variance was used to evaluate treatment effects on the diagnosis. Pairwise comparisons of median true-positive and true-negative rates were calculated by the χ² test. Pearson's correlation coefficient was used to determine the relationship between measurements. Significance level was set as p < 0.05.

RESULTS

All observers had excellent intra-observer agreement. Defect status (p < 0.001) and defect size (p < 0.001) factors were statistically significant. Pairwise interactions were found between defect status and defect size (p = 0.001). No differences between median true-positive or true-negative values were found between CBCT field of views (p > 0.05). Significant correlations were found between physical and CBCT measurements (p < 0.001).

CONCLUSIONS

All CBCT images performed similarly for the detection of simulated buccal marginal alveolar peri-implant defects. Depth, width and volume measurements of the defects from various CBCT images correlated highly with physical measurements.

Radiographic detection of artificially created horizontal root fracture using different cone beam CT units with small fields of view

OBJECTIVES

To compare limited cone beam computerized tomography (CBCT) units with different field of views (FOVs) and voxel sizes in detecting artificially created horizontal root fracture (HRF) in extracted human teeth.

METHODS

Artificial HRF was created in the horizontal plane in 40 teeth. Another 40 intact teeth served as a control group. 80 teeth were placed in the respective maxillary anterior sockets of a human dry skull in groups. Six image sets were obtained: (1) Accuitomo 170, 40 × 40 mm FOV (0.080 mm(3)); (2) Accuitomo 170, 60 × 60 mm FOV (0.125 mm(3)); (3) Kodak 9000, 50 × 37 mm FOV (0.076 mm(3)); (4) Kodak 9000, 50 × 37 mm FOV (0.100 mm(3)); (5) Vatech Pax-Duo3D 50 × 50 mm FOV (0.080 mm(3)) and (6) Vatech Pax-Duo3D 85 × 85 mm FOV (0.120 mm(3)). Images were evaluated twice by five observers. Kappa values were calculated for observer agreement. Areas under the receiver operating characteristic (ROC) curves (Az values) were calculated, and the Az values for each image type were compared using t-tests (α = 0.05).

RESULTS

Intraobserver kappa coefficients ranged from 0.81 to 0.95 for the Accuitomo 170 images, from 0.80 to 0.92 for the Kodak 9000 images and from 0.76 to 0.95 for Vatech PanX-Duo3D. The Az values for different image types and observers ranged from 0.93 to 0.97 for Accuitomo 170 images, from 0.93 to 0.98 for Kodak 9000 images and from 0.93 to 0.97 for the Vatech PanX-Duo3D images. No statistically significant differences (p > 0.05) were found between the Az values.

CONCLUSIONS

Limited CBCT units performed similarly in detecting simulated HRF.

Diagnostic accuracy of different imaging modalities in detection of proximal caries

OBJECTIVE

The purpose of this study was to assess the in vitro diagnostic ability of visual inspection, film, charge-coupled device (CCD) sensor, photostimulable phosphor (PSP) sensor and cone beam CT in the detection of proximal caries in posterior teeth compared with the histological gold standard.

METHODS

Visual inspection, film, CCD, PSP and cone beam CT images were used to detect proximal caries in the mesial and distal surfaces of 138 teeth (276 surfaces). Visual inspection and evaluation of all intraoral digital and conventional radiographs and cone beam CT images were performed twice by three oral radiologists. Weighted kappa coefficients were calculated to assess intra- and interobserver agreement for each image set, and scores were compared with the histological gold standard using receiver operating characteristic (ROC) analysis to evaluate diagnostic ability.

RESULTS

Intraobserver kappa coefficients calculated for each observer for each method of detecting caries ranged from 0.739 to 0.928. Strong interobserver agreement ranging from 0.631 to 0.811 was found for all detection methods. The highest Az values for all three observers were obtained with the cone beam CT images; however, differences between detection methods were not statistically significant (P > 0.05).

CONCLUSION

Visual inspection, film, CCD, PSP plates and cone beam CT performed similarly in the detection of proximal caries.

Dentin hypersensitivity: a randomized clinical comparison of three different agents in a short-term treatment period

OBJECTIVE

Dentin hypersensitivity, or what patients may describe as "sensitive teeth," is defined as a short, sharp pain arising from exposed dentin in response to thermal, evaporative, tactile, electrical, osmotic or chemical stimuli. It is widely accepted that dentin hypersensitivity is an uncomfortable condition that also affects function and quality of life. This study determines the differences in efficiency of three desensitizing products when compared with a placebo.

METHODS

A randomized controlled clinical trial was conducted to compare three different professional dentin desensitizer agents in 52 patients. The age and sex of the patients was recorded. Gluma Desensitizer (Heraeus Kulzer), UltraEZ (Ultradent Products, Inc) and Duraphat (Colgate Oral Pharmaceuticals, Inc, New York, NY, USA) were used as desensitizer agents and distilled water was used as the placebo. The baseline measurement of the dentin hypersensitivity was made by using a visual analog scale (VAS). Twenty-four hours and seven days after application of the desensitizer agents and placebo, a new VAS analysis was conducted for patients' sensitivity level. The desensitizer agents were compared in terms of mean values, and ANOVA was used for testing differences among the groups (p<0.05).

RESULTS

The results showed that the mean pain scores of the placebo group were significantly higher than that of the study groups (p<0.05). The VAS analysis revealed a significant decrease in dentin hypersensitivity over time with the use of agents (p<0.05). No statistically significant difference was found among the three desensitizing agents (p>0.05).

CONCLUSIONS

These three desensitizing agents, which contain different active ingredients, were effective in relieving dentin hypersensitivity. However, no superiority was found in dentin sensitivity relief among the agents.