Özlem Üçok

To examine the effects of high voltage electrical stimulation (HVES) on pain intensity, maximum mouth opening (MMO), cervical mobility, head position, pressure pain thresholds (PPTs), bite force, joint sounds, and jaw muscle strength in individuals with temporomandibular disorders (TMDs). Thirty-four individuals with TMDs were randomly divided into the exercise group (EG) (n = 17) and the HVES group (HG) (n = 17). For 4 weeks, EG received exercise therapy alone, while HG received HVES (12 sessions in total, 3 days a week to anterior temporalis and masseter) in conjunction with exercise. After the treatment, in both groups, pain intensity significantly decreased (p < .001); MMO (7.27 mm in HG and 3.61 mm in EG), cervical mobility, head position, PPTs, bite force, and jaw muscle strength significantly increased (p = .043 to < .001). Joint sounds significantly decreased in the HG (p = .008). Left bite force (p = .040) and left medial pterygoid PPT (p = .013) increased more in EG. The change in left bite force in EG over time was significant (p = .040; η_p² = .126). The effect sizes of treatments were medium to large (from .527 to 1.602) for the evaluated parameters. Although exercise alone was effective in many parameters evaluated, additional application of HVES provided further improvement for pain, MMO, cervical mobility, PPTs, jaw muscle strength and joint sounds. HVES can be routinely used in clinics for individuals with TMDs.

Aim: Oral cancer ranks among the most prevalent cancers worldwide. Imaging methods play a vital role in assessing patients. This study aimed to evaluate the age, sex, and localization distribution as well as panoramic and cone-beam computed tomography (CBCT) image findings in patients with oral malignancy with bone involvement. Materials and Method: Patients who were histopathologically diagnosed with malignant oral lesions at Gazi University, Faculty of Dentistry, Department of Oral Pathology between 2009 and 2023 were reviewed. Patients with oral malignancies whose panoramic images or CBCT images were available in the radiology archive were included in this study. Age-sex distribution was recorded. Localization of lesions and radiological features such as internal structures, borders, and effects on surrounding tissues were evaluated. Results: The mean age of the patients was 58.2 years; nine of them were female and thirteen were male. The incidence of malignancies included in this study was higher in men than in women, and the mandible/maxilla ratio was equal. The most common primary tumor was squamous cell carcinoma (SCC) (n=12). SCC lesions caused destruction in the cortical borders of neighboring structures in the region where they were located and showed the potential to spread toward these regions. Mucoepidermoid carcinoma was observed as an unilocular radiolucent lesion with clear borders, and it was determined that it destroyed the cortical bone. Conclusion: Panoramic radiography and CBCT images are valuable imaging methods in the evaluation of bone involvement of oral malignancies.

Objective: The aim of this study was to compare buccal cortical bone thickness measurements on cone beam computed tomography (CBCT) scans of human dry mandibles with direct measurements and to evaluate the effect of different head positioning on measurements. Methods: In total, direct linear measurements were made at reference points on the buccal bone surfaces in toothless sockets in 26 human dry mandibles. CBCT scans were performed in the central position and with four different types of head position (to the right-left, to the anterior-posterior). Thickness measurements were performed on cross-sectional sections from relevant areas where heated gutta-percha was placed. Measurements were summarized as mean±standard deviation. Differences between measurements were analyzed by ANOVA and Friedmann test. Results: Compared to direct measurements, buccal cortical bone thickness in CBCT scans was higher in the incisor and premolar regions, while lower values were obtained in the molar region. These differences were statistically significant but less than 0.2 mm (p0.005). Intraobserver agreement for buccal bone thickness was found to be high (ICC=0.902-0.976). Conclusion: It demonstrated a clinically acceptable difference between direct measurements and CBCT measurements of mandibular buccal cortical bone thickness. Additionally, no differences in measurements were observed between different types of head positions.

Purpose: This study aims to investigate the effect of 4 different scanning protocols offered by the VistaScan Mini Easy scanner on image quality at different exposure times. Materials & Methods: Four number size-2 photostimulable phosphor plates were exposed with 5 different exposure times while keeping other parameters constant. The exposed plates were scanned without delay using 4 different scanning protocols. 10 lp/mm, 20 lp/mm, 25 lp/mm, and 40 lp/mm are offered by the VistaScan Mini Easy scanner. The mean gray value was calculated using the ImageJ program by identifying three non-overlapping regions of interest from the background and each step in the obtained images. The mean of all mean gray values determined for the background and steps on a plate was also considered the mean gray value of that plate. Results: When plate mean gray values at 0.20 s and 0.40 s were examined, a statistically significant difference was observed between the scanning protocols (p<0.001, p=0.001 respectively). It was determined that the plate mean gray value at 40 lp/mm in 0.20 s was lower than that of other scanning protocols. The plate mean gray value at 20 lp/mm in 0.20 s was higher than that at 25 lp/mm. It was determined that the plate mean gray value at 10 lp/mm in 0.40 s was lower than that of the other groups. Conclusion: The effect of spatial resolution on diagnostics in digital imaging per se is a subject under investigation and still not agreed upon. Therefore, more studies on spatial resolution are needed.

Aim: Reactive hyperplasias are often encountered tumor-like exophytic lesions of the oral mucosa, but they are not a neoplasm. Local factors such as dental calculus, food residue stuck between teeth, incompatible prosthetic restoration, and systemic factors such as hormonal changes play a role in the etiology of these hyperplasia. The aim of this presentation is to evaluate the possible etiological factors, clinical, and radiological findings of 10 reactive hyperplasia cases seen in different regions of the mouth. Case report: Ten patients (seven females and three males) with a mean age 40.2 applied to our clinic with complaints of swelling in the mouth. In the medical anamnesis, it was learned that three (30%) patients had recently given birth and the related swelling started to occur in the second trimester of pregnancy, three (30%) patients had different diseases such as heart, hypertension, diabetes, and cholesterol, and were under regular medication for systemic disease. There is no finding on extraoral examination. In intraoral examination, mass lesions which red and/or pink, lobular/nodular, painless, pedunculated and/or sessile, and smooth and/or ulcerated was seen on the maxilla of six patients, mandible of three patients, and lower lip mucosa of one patient. Poor oral hygiene in seven (70%) patients, prosthetic restoration in the lesion-related area in two (20%) patients, and attrition incisal tooth surface and diastema in one (10%) patient were found. Radiographic examination revealed that minimal resorption on the alveolar crest in the lesion-related area of only three (30%) patients was seen. All lesions were histopathologically examined after surgical excision. According to the clinic, radiographic and histopathological features, diagnosis of the lesions was made as pyogenic granuloma (four cases; 40%), peripheral ossifying fibroma (three cases; 30%), traumatic fibroma (two cases; 20%) and peripheral giant cell granuloma (one case; 10%). Conclusion: It was concluded that the lesions examined in this case series were mostly caused by local factors. The clinical findings observed in the patients were red nodular mass, painless, soft, and smooth-surfaced. In the radiographic examination, no finding was detected in most of the lesions.

Aim: Cemento-osseous dysplasia (COD) is usually asymptomatic and slowly progressive benign fibro-osseous lesion characterized by the replacement of normal bone with fibrous tissue. The aim of this presentation is to evaluate the clinical and radiographical findings of six COD cases that were detected incidentally during radiographic examination. Case Report: Six female patients who four (%66) of them with different dental complaints and two (%33) of them for routine control examination of the previously diagnosed COD with a mean age of 38 applied to our clinic. It was learned that the patients did not have any systemic disorders in their medical anamnesis. There is not any finding on extraoral examination. In intraoral examination, teeth associated with COD lesions were vital as a result of the electric pulp test, and there is no other finding related to the lesion. In the radiography examination, different sizes radiolucent, mixed, and radiopaque lesions were detected in the mandible on control panoramic radiographs. The lesions were examined in detail with cone-beam computed tomography. Local thinning and resorption were observed in the buccal and lingual cortical bone in the relevant region. Histopathological examination revealed that the lesions were definitively diagnosed as SOD in four patients. Based on clinical, radiographic, and histopathological examinations, three (%50) of the lesions were diagnosed as periapical COD and the others (%50) were diagnosed with fluoride COD. All patients were followed up periodically for six months. Conclusion: The findings of this case series showed that all lesions examined were clinically asymptomatic and mixed on radiography. Due to insufficient vascular support of the bone in the COD area, there is a risk of infection and osteomyelitis may occur. Therefore, dentists should be aware of the clinical and radiographic features of COD in clinical practice and follow the patients periodically.

Objectives Like other bones, the mandible and cervical vertebrae are affected by several systemic diseases. The aim of this study is to evaluate the effects of osteoporosis (OP), diabetes mellitus (DM), and dialysis-indicated advanced chronic kidney disease (CKD), which are the most effective systemic diseases on the bone metabolism, on the trabecular microstructure of the mandible and cervical vertebrae using cone beam computed tomography (CBCT). Methods 81 patients who signed our informed consent form are involved in the study. 18 of them were diagnosed with osteoporosis, 18 of them with diabetes mellitus, 18 of the patients had dialysis-indicated CKD, and 27 of them were in the control group without any systemic diseases. Nine patients in the control group, patients with CKD and patients with DM were men, and nine were women. All patients with osteoporosis and 18 of the patients in the control group were women. Using CBCT images, microstructural parameters of trabecular thickness (Tb.Th), trabecular spacing (Tb.Sp) and volume fraction (bone volume/total volume, BV/TV) were measured. Results Tb.Th and BV/TV values were higher in the control group, while Tb.Sp was higher in the osteoporosis group. The difference in BV/TV parameters was statistically significant (p = 0.02). In the DM group, Tb.Th and BV/TV values were lower and Tb.Sp values were significantly higher than in the control group (p = 0.001). In patients with advanced CKD, Tb.Th and BV/TV values were lower, while Tb.Sp values were higher than in the control group. Differences in Tb.Sp parameters were statistically significant (0.004). Conclusion Systemic diseases affect bone tissue at different levels, and to evaluate these effects, cortical and trabecular bone parts must be investigated separately, and findings must be combined with patients' clinical symptoms. CBCT is suitable for microstructural evaluation of trabecular bone and the mandible carries valuable data for this purpose.

This study was conducted to show the relationship between pain catastrophizing and activity pain severity with bite force and jaw muscle strength in individuals with temporomandibular disorders (TMD). Forty-three individuals (mean age 29.79±8.34 years) with a diagnosis of TMER were included in the study. Pain catastrophizing levels of individuals with the Pain Catastrophizing Scale (PCS), activity pain with the Visual Analog Scale (VAS), bite force with a pinch meter, and jaw muscle strength with Lafayette manual muscle testing device were measured. The relationship between the variables was examined with the Pearson Correlation test. Statistically significant negative correlations were found PCS between bite forces (central: -0.519; right: -0.518; left: -0.515) and jaw muscle strengths (opening: -0.688; closing: -0.635; right excursion: -0.609, left excursion: -0.645; protrusion: -0.621); activity pain intensity between bite forces (central: -0.429; right: -0.453; left: -0.451) and jaw muscle strengths (opening: -0.511; closing: -0.420; right excursion: -0.343, left excursion: -0.463; protrusion: -0.471) (p

Purpose This study sought to assess the relationships between a morphological characteristic of the superior semicircular canal (SSC) and both the roof thickness of the glenoid fossa (GF) and bone changes of the temporomandibular joint (TMJ) on three-dimensional images. Methods Cone-beam computed tomography (CBCT) images of 200 individuals (105 females and 95 males; 400 temporal bone regions) were examined by two different observers. The correlations between the bone thickness overlying the SSC and the thickness of the roof of the GF with TMJ’s bone pathologies were analyzed. Results The superior semicircular canal dehiscence (SSCD) was significantly associated with dehiscence of the roof of the GF. The relationship between the dehiscence of the SSC and the roof thickness of the GF was found to be strongly correlated (p < 0.05). There were no statistically significant differences between the bone changes of TMJ and the presence or absence of the SSCD. Conclusions A correlation between the bone thickness overlying the SSC and the roof thickness of the GF was found. However, there was no relationship between the bone thickness overlying the SSC and bone changes of TMJ.

İstanbul Üniversitesi | Tarihten Geleceğe Bilim Köprüsü - 1453