Fahrettin Kalabalık

Background/Objectives: Three-dimensional data that evaluate tooth morphology and dental arch dimensions together across sagittal skeletal patterns are limited. This cone-beam computed tomography (CBCT) study compared tooth morphology and dental arch dimensions among skeletal Class I, II, and III malocclusions and examined their relationships. Methods: This retrospective, cross-sectional study included 111 individuals (37 per group; 24 females and 13 males in each group), selected from archived CBCT records in reverse chronological order with sex-frequency matching. Skeletal class was based on the ANB angle. Crown length, root length, and mesiodistal width of the central incisors, canines, second premolars, and first molars, together with arch perimeter and intercanine, inter-second premolar, and intermolar widths, were measured. Groups were compared using patient-clustered Gaussian generalized estimating equations with Holm-adjusted contrasts and Benjamini–Hochberg false discovery rate (FDR) correction across 35 outcomes; 108 tooth–arch associations were adjusted for class, age, and sex. All analyses were exploratory. Results: Five of 35 outcomes showed nominal class effects (p < 0.05), mainly in the mandible (central incisor and canine crown lengths, arch perimeter, and intercanine width), but none remained significant after FDR correction (q ≥ 0.169). In exploratory contrasts, mandibular arch perimeter was greater in Class III than in Class I (2.20 mm; 95% CI 0.56–3.85). In the primary models, no mesiodistal width or root length differed nominally. Nine of 108 tooth–arch associations remained significant after FDR correction (standardized β 0.27–0.36), six involving premolar and molar mesiodistal widths. Conclusions: No difference in tooth morphology or arch dimensions among skeletal classes remained significant after multiplicity correction; the nominal mandibular findings are exploratory. The findings are descriptive, cannot establish causality, and do not support class-specific treatment recommendations.

Background/Objectives: The canalis sinuosus (CS) and its accessory canals (ACs) are neurovascular canals of the anterior maxilla at risk during surgery. We examined their prevalence, side distribution, diameter, localization, and course on cone-beam computed tomography (CBCT) and explored associations with age and sex. Methods: Two observers independently read CBCT images of 603 adults from a single center. Canals were recorded only if they measured at least 0.5 mm, and ACs only if their continuity with the CS could be traced. Age, sex, and side were examined with generalized estimating equations and Benjamini–Hochberg correction. Results: The CS was present in 53.2% of patients, bilaterally in 97.5% of them. ACs were seen in 59.5% of CS-positive patients (31.7% overall). Most ended in the lateral incisor region (26.5%) and ran straight vertically (63.4%). In exploratory analyses, age was associated with the presence of both canals (q = 0.040), whereas sex and side showed no significant association; the CS was wider in men (β = 0.227 mm; q < 0.001). Conclusions: At least one AC was present in 31.7% of patients, and 43.4% of ACs ended at lateral incisor or canine sites. When CBCT is available before anterior maxillary surgery, the planned site should be examined for these canals; demographic associations need confirmation.

Background: Primary teeth play a crucial role in guiding permanent dentition; however, data regarding root apex closure in primary molars remain limited. The aim of this study was to evaluate the age-related root apex closure status of primary second molars in children aged 2–7 years using panoramic radiographs and to obtain clinically guiding data for pediatric dental treatment planning. Materials and Methods: This cross-sectional, descriptive, and retrospective study evaluated panoramic radiographs. A total of 1628 panoramic radiographs obtained from 1628 patients were evaluated, each representing one individual with primary second molars. The relationships between age groups, gender, and root apex closure status were analyzed statistically with a significance level set at p < 0.05. Results: No root apex closure was observed in either maxillary or mandibular primary second molars in the 2–2.99-year age group. In the 3–3.99-year group, a limited number of closed apices were detected only in mandibular primary second molars. A marked increase in the proportion of closed apices was observed in both jaws in the 4–4.99-year group. In the 5–5.99- and 6–6.99-year groups, root apex closure was completed in the majority of maxillary and mandibular primary second molars. Although statistically significant gender-related differences were detected in certain age groups, these differences were not consistent across all age categories. Conclusions: Root apex closure in primary second molars demonstrates a clear age-dependent pattern between 2 and 7 years of age. The findings are expected to provide clinically relevant guidance for pediatric endodontic treatment planning and contribute to the limited literature regarding root development in primary teeth.

Background: The aim of this study is to investigate the prevalence of the retromolar canal (RMC) and retromolar foramen (RMF) using cone-beam computed tomography (CBCT), and to evaluate the course and anatomical structure of the RMC. Methods: The study group consisted of CBCT images of 1008 subjects (541 females and 467 males). The prevalence and types of the RMC, as well as the frequency of the RMF, were analyzed according to age and sex. A significance level of 0.05 was accepted for all statistical analyses. Results: According to the findings, 575 (57.0%) RMCs and 298 (29.5%) RMFs were identified in 1008 subjects. Bilateral RMCs were observed in 327 subjects (32.4%), while unilateral RMCs were present in 248 subjects (24.6%). When 2016 retromolar regions were examined, a total of 902 RMCs and 400 RMFs were identified. No statistically significant difference was observed between the right and left retromolar regions or between sexes regarding the overall prevalence of RMCs (p > 0.05). The most frequently observed RMC type was Type A1, and a statistically significant difference was found between RMC types and sex. Conclusions: This study suggested that the RMC is a common anatomical variation that may have surgical relevance. Due to the presence of a neurovascular bundle passing through it, both the RMC and RMF should be considered in surgical and anesthetic procedures involving the retromolar region. CBCT is a reliable tool for detecting these structures and assessing their morphology.

Aim: A precise understanding of the morphometric characteristics of the infraorbital foramen (IOF) is essential for ensuring safe and effective surgical interventions and regional anesthesia in children and adolescents with cleft lip and palate (CLP). This study aimed to investigate the morphometric characteristics of the IOF using CBCT in children and adolescents with unilateral cleft lip and palate (UCLP) and to compare the cleft side (CS) with the non-cleft side (NCS). Materials and Method: CBCT scans of 48 individuals with UCLP were analyzed, evaluating a total of 96 IOFs. Reference anatomical landmarks included the supraorbital margin (SOM), infraorbital margin (IOM), nasion (N), anterior nasal spine (ANS), tuber maxilla (TM), sella (S), lateral margin of the apertura piriform (LAP), jugale (J), and midline (M). Distances from the IOF to these landmarks were measured and compared between the CS and NCS. Soft tissue thickness over the IOF was also assessed, and the IOF shape was evaluated separately for each side. Results: The V-oval form was the most common IOF shape on both sides. No significant differences were found in vertical or horizontal diameters between the CS and NCS (p > 0.05). Distances from the IOF to IOM, SOM, S, N, LAP, and midline were significantly shorter on the CS (p < 0.05), whereas distances to ANS and J were significantly longer on the CS (p < 0.05). No significant differences were observed in IOF-TM distances or soft tissue thickness (p > 0.05). Conclusions: In individuals with UCLP, the IOF exhibits significant side-specific variations relative to key anatomical landmarks. These differences should be considered in infraorbital nerve block administration and surgical planning to improve accuracy and safety.

Background/Objectives: Adenoid hypertrophy (AH), one of the most common pathologies in children, is a major cause of mouth breathing. Mouth breathing causes dry mouth, which removes the beneficial effects of saliva necessary for oral health. Therefore, an oral microflora favorable to caries is promoted. The primary objective of this study is to evaluate the oral health of children diagnosed with AH between the ages of 3 and 14 and to determine the early childhood oral health impact scale. Methods: This descriptive study was conducted between November 2019 and November 2020, involving 16 boys and 14 girls diagnosed with AH at the Department of Otorhinolaryngology, Faculty of Medicine, Atatürk University. These children, diagnosed with adenoid hypertrophy, were referred to the Department of Pedodontics, Faculty of Dentistry, Ataturk University, for the evaluation of their oral health prior to surgery. Oral examinations were performed on the pediatric participants under dental unit light by the same pedodontist, and their demographic data and DMFT/dmft scores were recorded. Data for the Early Childhood Oral Health Impact Scale (ECOHIS-T) were obtained from volunteers with communication skills and their parents. SPSS 21.0 software was used in the statistical evaluation of the data. A Chi-square test was used to assess differences between groups. Results: The mean age of the children was 5.9 ± 2.6 years. There was no statistically significant difference between AH grades 2, 3, and 4 in terms of dentition periods, gender, and occlusion (p = 0.177, p = 0.495). The scores of the first nine and last four questions of the ECOHIS-T were found to be higher in children with grade 4 AH (p = 0.011, p = 0.043). The DMFT index was also higher in children with grade 4 AH (p = 0.010). Conclusions: Tooth decay is more prevalent in children with severe adenoid hypertrophy. This condition was also observed to negatively affect their quality of life. Regular check-ups and preventive care are needed to improve the quality of life of these children.

Background/Objectives: The infraorbital canal (IOC) is a critical anatomical structure that passes through the anterior surface of the maxilla and opens at the infraorbital foramen, containing the infraorbital nerve, artery, and vein. Accurate localization of this canal in maxillofacial, dental implant, and orbital surgeries is of great importance to preventing nerve damage, reducing complications, and enabling successful surgical planning. The aim of this study is to perform automatic segmentation of the infraorbital canal in cone-beam computed tomography (CBCT) images using an artificial intelligence (AI)-based model. Methods: A total of 220 CBCT images of the IOC from 110 patients were labeled using the 3D Slicer software (version 4.10.2; MIT, Cambridge, MA, USA). The dataset was split into training, validation, and test sets at a ratio of 8:1:1. The nnU-Net v2 architecture was applied to the training and test datasets to predict and generate appropriate algorithm weight factors. The confusion matrix was used to check the accuracy and performance of the model. As a result of the test, the Dice Coefficient (DC), Intersection over the Union (IoU), F1-score, and 95% Hausdorff distance (95% HD) metrics were calculated. Results: By testing the model, the DC, IoU, F1-score, and 95% HD metric values were found to be 0.7792, 0.6402, 0.787, and 0.7661, respectively. According to the data obtained, the receiver operating characteristic (ROC) curve was drawn, and the AUC value under the curve was determined to be 0.91. Conclusions: Accurate identification and preservation of the IOC during surgical procedures are of critical importance to maintaining a patient’s functional and sensory integrity. The findings of this study demonstrated that the IOC can be detected with high precision and accuracy using an AI-based automatic segmentation method in CBCT images. This approach has significant potential to reduce surgical risks and to enhance the safety of critical anatomical structures.

Background/Objectives: There are various challenges in the segmentation of anatomical structures with artificial intelligence due to the different structural features of the relevant region/tissue. The aim of this study was to detect the nasolacrimal canal (NLC) using the nnU-Net v2 convolutional neural network (CNN) model in cone beam-computed tomography (CBCT) images and to evaluate the successful performance of the model in automatic segmentation. Methods: CBCT images of 100 patients were randomly selected from the data archive. The raw data were transferred to the 3D Slicer imaging software in DICOM format (Version 4.10.2; MIT, Massachusetts, USA). NLC was labeled using the polygonal type of manual method. The dataset was split into training, validation and test sets in a ratio of 8:1:1. nnU-Net v2 architecture was applied to the training and test datasets to predict and generate appropriate algorithm weight factors. The confusion matrix was used to check the accuracy and performance of the model. As a result of the test, the Dice Coefficient (DC), Intersection over Union (IoU), F1-Score and 95% Hausdorff distance (95% HD) metrics were calculated. Results: By testing the model, DC, IoU, F1-Scores and 95% HD metric values were found to be 0.8465, 0.7341, 0.8480 and 0.9460, respectively. According to the data obtained, the receiver-operating characteristic (ROC) curve was drawn and the AUC value under the curve was determined to be 0.96. Conclusions: These results showed that the proposed nnU-Net v2 model achieves NLC segmentation on CBCT images with high precision and accuracy. The automated segmentation of NLC may assist clinicians in determining the surgical technique to be used to remove lesions, especially those affecting the anterior wall of the maxillary sinus.