THE ANATOMICAL AND MEASUREMENT STUDY OF ROSENMÜLLER FOSSA AND OROPHARYNGEAL STRUCTURES USING CONE BEAM COMPUTED TOMOGRAPHY

The objective of this study was to assess Rosenmüller fossa (RF) anatomy and neighboring structures using cone beam computed tomography (CBCT). A total of 1000 patients were analyzed using CBCT. The reference points were based on the spina nasalis posterior (Snp) and basion. The length between RF and neighboring structures were measured.The mean distance from Snp to the posterior pharyngeal wall was 17.7 mm. The mean distance from right to left torus levatorius was 25.69 mm. The mean depth of right RF was 5.54 mm while the mean depth of left RF was 5.26 mm. RF, also described as the lateral pharyngeal recess, is a source location of nasopharyngeal carcinoma development. Its location is on the lateral pharyngeal wall posterior to the cartilaginous part of the eustachian tube, the torus tubarius. The knowledge of RF is important to diagnose and perform treatment planning of nasopharyngeal carcinoma.

Morphological Measurement and Anatomical Variations of the Clivus Using Computed Tomography

Objectives The aim of this study was to evaluate the clivus morphology, including fossa navicularis magna (FNM), canalis basilaris medianus (CBM), and craniopharyngeal canal (CC), on computed tomography (CT) images.

Design This is a retrospective study.

Setting Faculty of Dentistry, Department of Dentomaxillofacial Radiology.

Participants The CT images of 500 patients (253 males; 247 females) were evaluated.

Main Outcome Measures The prevalence of FNM, CBM, and CPC; the length, width, and depth of FNM; and CBM types were recorded. Also, a morphological analysis of the clivus (length of the clivus, angle between the clivus and the posterior margin of the foramen magnum, angle between the clivus and the dens axis, and anteroposterior diameter of the foramen magnum) was performed.

Results FNM was identified in 5.4%, CBM in 4%, and CC in 0.8% of the study group. Type 5 CBM was not found. Type 6 was the most common CBM type. There was no significant correlation between the age and gender of patients with FNM. There were significant differences between the clivus length, the angle between the clivus and the dens axis, the anteroposterior diameter of the foramen magnum, and gender. Also, there was a significant difference between the angle between the clivus and the foramen magnum and age.

Conclusions The anatomical variations of the clivus are rare and important for the oral and maxillofacial radiologist to make the differential diagnosis. These anatomical variations should not be confused with pathologic formations. The morphological measurements and anatomical variations of the clivus can be evaluated in detail on CT images.

The Relationship Between an Accessory Maxillary Ostium and Variations in Structures Adjacent to the Maxillary Sinus without Polyps

Introduction  The maxillary sinus and its variations are very important to dentistry and rhinology.

Objective  To investigate the effect of the accessory maxillary ostium (AMO) on the variations of adjacent structures of the maxillary sinus.

Methods  The computed tomography (CT) images of 400 patients were retrospectively evaluated. The prevalence of AMO was calculated. The relationship between morphological variations of adjacent structures of maxillary sinus such as agger nasi cell (ANC), Haller cell (HC), nasal septum deviation (NSD), hypertrophy of inferior concha (HIC), pneumatization of middle concha (PMC), mucus retention cyst (MRC), mucosal thickening (MT), and maxillary sinusitis (MS), as well as the presence of AMO, were investigated.

Results  Presence of AMO was diagnosed in 42 patients (10.5%), having been found in 4.5% of the patients only on the right side, in 1.25% of the patients only on the left side, and in 4.75% of the patients on both sides. There is an increasing incidence of ANC, HC, NSD, HIC, and PMC in the presence of AMO and MS. There is a decreasing incidence of MRC in the presence of AMO. Furthermore, AMO does not affect the incidence of MT.

Conclusion  This study showed that most parameters, except for MRC and MT, had increasing incidence in the presence of AMO. It is important for radiologists and rhinologists to have knowledge about the location of AMO and the presence of variations of MS adjacent structures to avoid surgical complications.

Effects of nocturnal complete denture usage on cardiorespiratory parameters: A pilot study

STATEMENT OF PROBLEM

Sleeping without conventional complete dentures (CCDs) has been stated by some to induce negative effects on the cardiorespiratory functions of edentulous patients with obstructive sleep apnea (OSA), although others have reported the exact opposite. Therefore, a consensus on nocturnal CCD usage is lacking.

PURPOSE

The purpose of this clinical study was to assess the effects of nocturnal denture usage on cardiorespiratory stability by using pulse oximetry (PO).

MATERIALS AND METHODS

Thirty CCD wearers were enrolled in the study. The first nocturnal pulse oximetry (FNPO) recordings were made on 3 different nights while the participants were sleeping without dentures (WOD). Oxygen desaturation index (ODI) and other PO parameters of the participants, including total respiratory event (TRE), basal SpO₂ (BSpO₂), time≤88 (T88), average low SpO₂ (ALSpO₂), total pulse event (TPE), average pulse rate (APR), and heart rate variability index (HRVI), were processed and the obtained data were recorded as WOD condition values. According to the ODI scores, the OSA status of the participants was grouped as normal (ODI<5), mild (5<ODI<15), moderate (15<ODI<30), or severe (ODI>30). Complete dentures were fabricated by an experienced prosthodontist and a dental laboratory technician by following conventional procedures. At the end of the first month of the follow-up period, the second nocturnal PO recordings (SNPO) were made on 3 different nights while the participants slept wearing dentures (WID), and the data obtained were recorded as WID condition values. The comparison of mean PO values obtained from WOD and WID were analyzed with the Wilcoxon signed- rank test (α=.05).

RESULTS

Significant differences were found between WOD and WID values in terms of TRE (P=.01), ODI (P=.001), ALSpO2 (P=.006), TPE (P=.001), and HRVI (P=.001) parameters. The significance of the improvements in the WID condition increased with the severity of OSA.

CONCLUSIONS

Improvements were observed in substantial cardiorespiratory parameters such as the ODI and HRVI of the participants wearing dentures nocturnally.

A DETAILED CBCT STUDY OF 'CORONOID FORAMINA' AND ACCESSORY FORAMINA OF THE MANDIBLE: A UNIQUE ANATOMIC VARIATION

The aim of the study was to evaluate accessory foramina (AF) located on the medial aspect and to present a unique finding of 'coronoid foramina' (CF) along with AF on the mandible. The cone beam computed tomography images of the mandible in 979 patients were retrospectively evaluated for the presence of CF and AF. AF was found in 39 (3.98%) patients. AF located on the medial surface below and above mandibular foramen was found in 15.38% and 84.62% of patients, respectively. CF was confirmed in 20 (2.04%) patients. Mandibular AF is important for surgical procedures in the posterior region of the mandible and for mandibular nerve anesthesia. This study including CF will be useful for further studies due to the lack of literature on the issue.

Prevalence and characteristics of pneumatizations of the articular eminence and roof of the glenoid fossa on cone-beam computed tomography

OBJECTIVE

The aim of this study was to determine the prevalence and characteristics of pneumatization of the articular tubercle (PAT) and pneumatization of the roof of the glenoid fossa (PRGF) in a large population using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

This study was designed to evaluate the CBCT images of 1000 patients. The prevalences of the pneumatizations by age, sex, locularity, and laterality were determined. The significance of differences between variables was evaluated by the Chi-square test and analysis of variance.

RESULTS

PAT was detected in 28.4% of the zygomatic bone sides and PRGF in 29.6%. Bilateral PAT was detected in 176 (17.6%) patients and bilateral PRGF in 195 (19.5%). The mean age of patients with PAT was 47.33 years and that of patients with PRGF was 45.62 years. Multilocular appearance was observed significantly more often than unilocular type for both pneumatizations (p < 0.01). Unilateral PAT cases were slightly, but significantly, higher than bilateral PAT cases (p = 0.047), while no significant difference was observed between unilateral and bilateral PRGF cases.

CONCLUSIONS

In conclusion, PAT and PRGF can be assessed more accurately on CBCT images than on plain radiographs. During routine radiological investigations, maxillofacial radiologists should be aware of zygomatic air cells.

Incidental Findings in Cone-Beam Computed Tomographic Images: Calcifications in Head and Neck Region

Background/Aim: The use of CBCT in dentistry has been increasing popularity nowadays. CBCT images provide valuable information from anatomic structures and pathologies. Images obtained with CBCT allow for more appropriate treatment planning. The purpose of this study was to assess the calcifications which were found incidentally on CBCT images and to reveal the frequency and characteristics. Material and Methods: A total of 691 CBCT images which obtained from the patients were assessed. Demographic data and calcifications which were found out of primarily interest area were noted. The incidental findings were categorized and analyzed using descriptive statistics. Results: 945 calcifications were discovered on 318(46.02%) of the 691 patients’ images. 373(53.98%) scans showed no calcificated findings. The age range of patients was from 5 to 84 years. The most common calcification was tonsillolith (86.03%), followed by stylohyoid calcifications (6.24%), antrolith and subdermal calcifications (2.33%). Conclusion: Calcified lesions in head and neck region were commonly seen in CBCT images. Although the most of the calcifications are asymptomatic and require no treatment but correct identification of these findings will reduce unnecessary further diagnostic assessments and will provide more appropriate treatment plans. It will also provide the ability comprehensively evaluation of underlying diseases and practitioners will have life-saving information by early diagnosis.

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).

A multi-centre evaluation of multiple supernumerary premolar prevalence

AIM

The occurrence of multiple supernumerary teeth is rare and often found in association with syndromes such as cleidocranial dysplasia, Gardner's syndrome or cleft lip and palate. Few examples of non-syndromal multiple supernumerary teeth have been reported. The aim of this multi-centre study was to investigate the prevalence of supernumerary premolar teeth in non-syndromic patients and to investigate the association between the presence of supernumerary premolar teeth and malocclusion type in a Turkish population.

MATERIALS AND METHODS

The clinical records and panoramic radiographs of 10,700 patients (referred to three different university hospitals) were retrospectively examined for the presence of supernumerary premolars. Age, gender, orthodontic malocclusion type, the number of supernumerary premolars (two or more), the distribution, location, position (vertical, horizontal, inverted, mesio-angular), surgical approach, and related complications (pain, cystic changes, root resorption, or eruption disturbance of adjacent teeth) were recorded.

RESULTS

Forty-two cases (13 Class I, 17 Class II, 12 Class III) of multiple mandibular supernumerary premolars in patients without an associated syndrome were detected. A total of 97 (27 Class I, 41 Class II, 29 Class III) supernumerary premolar teeth were found, with a prevalence of 0.39%. No statistical difference was found related to gender, malocclusion type and supernumerary premolars (p > 0.05). The majority of the extra premolars were located in the mandible, which was statistically significant (p < 0.05).

CONCLUSION

The present study revealed that the prevalence of multiple supernumerary teeth was 0.39%. The most frequently impacted premolars were found in the mandible and more often associated with Class II malocclusions in the examined Turkish population.

Comparing the Effect of Different Voxel Resolutions for Assessment of Vertical Root Fracture of Permanent Teeth

BACKGROUND

The teeth with undiagnosed vertical root fractures (VRFs) are likely to receive endodontic treatment or retreatment, leading to frustration and inappropriate endodontic therapies. Moreover, many cases of VRFs cannot be diagnosed definitively until the extraction of tooth.

OBJECTIVES

This study aimed to assess the use of different voxel resolutions of two different cone beam computerized tomography (CBCT) units in the detection VRFs in vitro.

MATERIALS AND METHODS

The study material comprised 74 extracted human mandibular single rooted premolar teeth without root fractures that had not undergone any root-canal treatment. Images were obtained by two different CBCT units. Four image sets were obtained as follows: 1) 3D Accuitomo 170, 4 × 4 cm field of view (FOV) (0.080 mm(3)); 2) 3D Accuitomo 170. 6 × 6 cm FOV (0.125 mm(3)); 3) NewTom 3G, 6˝ (0.16 mm(3)) and 4) NewTom 3G, 9˝ FOV (0.25 mm(3)). Kappa coefficients were calculated to assess both intra- and inter-observer agreements for each image set.

RESULTS

No significant differences were found among observers or voxel sizes, with high average Z (Az) results being reported for all groups. Both intra- and inter-observer agreement values were relatively better for 3D Accuitomo 170 images than the images from NewTom 3G. The highest Az and kappa values were obtained with 3D Accuitomo 170, 4 × 4 cm FOV (0.080 mm(3)) images.

CONCLUSION

No significant differences were found among observers or voxel sizes, with high Az results reported for all groups.

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.

A multi-centre evaluation of multiple supernumerary premolar prevalence

Aim

The occurrence of multiple supernumerary teeth is rare and often found in association with syndromes such as cleidocranial dysplasia, Gardner's syndrome or cleft lip and palate. Few examples of non-syndromal multiple supernumerary teeth have been reported. The aim of this multi-centre study was to investigate the prevalence of supernumerary premolar teeth in non-syndromic patients and to investigate the association between the presence of supernumerary premolar teeth and malocclusion type in a Turkish population.

Materials and methods

The clinical records and panoramic radiographs of 10,700 patients (referred to three different university hospitals) were retrospectively examined for the presence of supernumerary premolars. Age, gender, orthodontic malocclusion type, the number of supernumerary premolars (two or more), the distribution, location, position (vertical, horizontal, inverted, mesio-angular), surgical approach, and related complications (pain, cystic changes, root resorption, or eruption disturbance of adjacent teeth) were recorded.

Results

Forty-two cases (13 Class I, 17 Class II, 12 Class III) of multiple mandibular supernumerary premolars in patients without an associated syndrome were detected. A total of 97 (27 Class I, 41 Class II, 29 Class III) supernumerary premolar teeth were found, with a prevalence of 0.39%. No statistical difference was found related to gender, malocclusion type and supernumerary premolars (p > 0.05). The majority of the extra premolars were located in the mandible, which was statistically significant (p < 0.05).

Conclusion

The present study revealed that the prevalence of multiple supernumerary teeth was 0.39%. The most frequently impacted premolars were found in the mandible and more often associated with Class II malocclusions in the examined Turkish population.

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.

Conventional multi-slice computed tomography (CT) and cone-beam CT (CBCT) for computer-assisted implant placement. Part I: relationship of radiographic gray density and implant stability

PURPOSE

The relationship of conventional multi-slice computed tomography (CT)- and cone beam CT (CBCT)-based gray density values and the primary stability parameters of implants that were placed by stereolithographic surgical guides were analyzed in this study.

MATERIALS AND METHODS

Eighteen edentulous jaws were randomly scanned by a CT (CT group) or a CBCT scanner (CBCT group) and radiographic gray density was measured from the planned implants. A total of 108 implants were placed, and primary stability parameters were measured by insertion torque value (ITV) and resonance frequency analysis (RFA). Radiographic and subjective bone quality classification (BQC) was also classified. Results were analyzed by correlation tests and multiple regressions (p < .05).

RESULTS

CBCT-based gray density values (765 ± 97.32 voxel value) outside the implants were significantly higher than those of CT-based values (668.4 ± 110 Hounsfield unit, p < .001). Significant relations were found among the gray density values outside the implants, ITV (adjusted r(2)  = 0.6142, p = .001 and adjusted r(2)  = 0.5166, p = .0021), and RFA (adjusted r(2)  = 0.5642, p = .0017 and adjusted r(2)  = 0.5423, p = .0031 for CT and CBCT groups, respectively). Data from radiographic and subjective BQC were also in agreement.

CONCLUSIONS

Similar to the gray density values of CT, that of CBCT could also be predictive for the subjective BQC and primary implant stability. Results should be confirmed on different CBCT scanners.

Cross-sectional evaluation of the periapical status as related to quality of root canal fillings and coronal restorations in a rural adult male population of Turkey

Background

To determine the prevalence of periapical lesions in root canal-treated teeth in a rural, male adult, Turkish population and to investigate the influence of the quality of root canal fillings on prevalence of periapical lesions.

Methods

The sample for this cross-sectional study consisted of 552 adult male patients, 18-32 years of age, presenting consecutively as new patients seeking routine dental care at the Dental Sciences of Gulhane Military Medicine, Ankara. The radiographs of the 1014 root canal-treated teeth were evaluated. The teeth were grouped according to the radiographic quality of the root canal filling and the coronal restoration. The criteria used for the examination were slightly modified from those described by De Moor. Periapical status was assessed by the Periapical Index scores (PAI) proposed by Orstavik.

Results

The overall success rate of root canal treatment was 32.1%. The success rates of adequately root canal treatment were significantly higher than inadequately root canal treatment, regardless of the quality or presence of the coronal restoration (P < .001). In addition, the success rate of inadequate root canal treatment was also significantly affected by the quality of coronal restorations.

Conclusions

Our results revealed a high prevalence of periapical lesions in root canal treatment, which is comparable to that reported in other methodologically compatible studies from diverse geographical locations. In addition, the results from the present study confirm the findings of other studies that found the quality of the root canal treatment to be a key factor for prognosis with or without adequate coronal restoration.

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.

Florid cemento-osseous dysplasia: a case report

Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. It usually exhibits as multiple radiopaque cemetum-like masses distributed throughout the jaws. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Computed tomography, because of its ability to give axial, sagittal, and frontal views, is useful in the evaluation of these lesions. This paper presents the case of a patient who was diagnosed with FCOD on the basis of clinical and radiographic findings.

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.