The Relationship Between the Mandibular Bone Quality Assessed by Digital Panoramic Radiography and Serum Biological Parameters in Patients Planning Dental Implant Surgery

Abstract Objectives: The aim of this study was to evaluate the bone density of the implant site with panoramic radiomorphometric indices [mandibular cortical index (MCI), mental index (MI)] and to investigate the relationship between bone density and vitamin D, HDL, LDL. Materials and method: Forty patients with mandibular first molar or second molar tooth deficiency who underwent implant surgery planning were included. Blood samples and panoramic MCI and MI were used to evaluate mandibular bone density. Results: There was a significant weak positive correlation between MI and Vitamin D and LDL (r = 0.329, p = 0.038; r = 0.341, p = 0.031). Vitamin D, LDL and HDL measurements were not statistically different between MCI groups (p=0.100, p=0.119, p=0.840, respectively). Conclusions: Vitamin D may be important in addition to radiographic and clinical parameters, and patients should be evaluated in this respect. Further studies are needed to include more patients investigating the relationship between vitamin D and bone quality. Keywords: dental implants, bone remodeling, vitamin D, HDL cholesterol, LDL cholesterol Özet Amaç: Bu çalışmanın amacı, panoramik radyomorfometrik indeksler [mandibular kortikal indeks (MKI), mental indeks (MI)] kullanılarak implant bölgelerinde kemik densitesini değerlendirmek ve kemik densitesi ile D vitamini, HDL ve LDL arasındaki ilişkiyi incelemektir. Gereç ve Yöntemler: Çalışmaya mandibular birinci molar veya ikinci molar diş eksikliği olup implant cerrahisi planlanan 40 hasta dahil edilmiştir. Mandibular kemik densitesini değerlendirmek için kan örnekleri ve panoramik MKI ve MI kullanılmıştır. Bulgular: MI ile D vitamini ve LDL arasında anlamlı zayıf pozitif korelasyon bulunmuştur (r = 0.329, p = 0.038; r = 0.341, p = 0.031). MKI grupları arasında D vitamini, LDL ve HDL değerleri bakımından istatistiksel olarak fark bulunamamıştır (sırasıyla p = 0.100, p = 0.119, p = 0.840). Sonuçlar: D vitamini klinik ve radyolojik parametrelere ek olarak önemli bir faktör olabilmektedir ve hastalar bu açıdan değerlendirilmelidir. D vitamini ile kemik kalitesi arasındaki ilişkiyi araştıran daha çok sayıda hastanın dahil edildiği çalışmalara ihtiyaç vardır. Anahtar Kelimeler: diş implantları, kemiğin yeniden şekillendirilmesi, vitamin D, HDL kolesterol, LDL kolestero

Comparison of Panoramic, Lateral Skull Projection and CBCT Images in Detection of Mandibular Condyle Fractures

Objectives: Condyle fractures constitute 17.5–52% of all mandibular fractures. Our first aim was to investigate whether panoramic radiography or LSP images with lower radiation dose can be used instead of CBCT in the diagnosis of vertical condylar fractures. The second aim of the study was to compare observers' capabilities in diagnosing these fractures. Materials and Methods: A sample consisting of 15 fresh cadaver mandibles with 30 condyles frozen within 24 hours post-mortem was randomly selected. Vertical fractures from the lateral 2/3 of the condyle head with 0.5 (10 condyles) and 1mm (10 condyles) thickness were created using a fret saw. After creating condyle fractures, digital panoramic, LSP, and CBCT images were acquired. Two dentomaxillofacial radiologists with 15 years of experience, two dentomaxillofacial radiologists with five and seven years of experience, and two newly graduated dentists have evaluated the images. The success of the observers in diagnosing the vertical condyle fracture in each imaging method, intra-observer and inter-observer agreement was evaluated. Results: The success of all dentists in determining the condyle fractures using LSP images was higher than the success they achieved using panoramic images, but it was not sufficient. Using different imaging options with CBCT, all diagnoses made by new graduates and dentomaxillofacial radiologists with five and 15 years’ experience were 100% compatible with the gold standard (AC1: 1 (1–1)). Conclusions: For the diagnosis of vertical condyle fractures, conventional techniques (panoramic and lateral jaw imaging methods) were found to be insufficient

Benign fibroosseous lesions

Benign fibroosseous lesions represent a group of lesions that share the same basic evolutive mechanism and are characterized by replacement of normal bone with a fibrous connective tissue that gradually undergoes mineralization. These lesions are presented by a variety of diseases including developmental, reactive-dysplastic processes and neoplasms. Depending on the nature and amount of calcified tissue, they can be observed as radiolucent, mixed or radiopaque. Their radiographic features could be well-defined or indistinguishable from the surrounding bone tissue. They can be asymptomatic as in osseous dysplasias and can be detected incidentally on radiographs, or they can lead to expansion in the affected bone as in ossifying fibroma. All fibroosseous lesions seen in the jaws and face are variations of the same histological pattern. Therefore, detailed clinical and radiographic evaluation in differential diagnosis is important. In this review, fibroosseous benign lesions are classified as osseous dysplasia, fibrous dysplasia and fibroosseous tumors; and radiographic features and differential diagnosis of these lesions are reviewed taking into account this classification

Soft tissue calcifications and ossifications: review

Deposition of the minerals in soft tissue which normally accumulates in bone is known as calcification/ossification. These calcifications are generally asymptomatic and are seen mostly at elder ages. Typically, they are detected as incidental findings during radiographic evaluation. When these calcifications/ossifications are seen, primary purpose is to identify and specify whether treatment is necessary. For differential diagnosis, criteria such as localization, number and shape should be considered, and a thorough knowledge of soft tissue anatomy is essential. Additionally, it is beneficial to detail the anamnesis and the clinical examination, and if necessary, take additional radiographs from different angles or using different techniques. The purpose of this review was to discuss the current literature regarding soft tissue calcifications and ossifications