Aim To evaluate the effect of various parameters of periapical lesion(s) on the amount and type of mucosal thickening using cone beam CT images. Methodology CBCT scans of 1000 patients were evaluated retrospectively for the presence of apical lesions in maxillary posterior teeth associated with sinus mucosal thickening. The number of cases with pathological mucosal thickening was recorded and classified according to the amount and type of mucosal thickening. The parameters evaluated as the cause of mucosal thickening were the type and number of posterior teeth, number of root(s), diameter of the periapical lesion and distance between maxillary sinus and lesion. Descriptive statistics and multiple logistic regression was used for data analyses. Spearman's correlation coefficient was used for pair‐wise comparisons. Intrarater reliability was tested by Cohen’s kappa. Results Mucosal thickening associated with periapical lesions was determined in 48% of 202 cases. The most frequently detected extent of mucosal thickening was type 3 (42%), whereas flat type thickening (59%) was the most frequent type. The tooth most frequently associated with mucosal thickening was the maxillary first molar (44%). Parameters significantly affecting the extent of mucosal thickening were gender, number of roots, number of teeth with periapical lesions and diameter of periapical lesions (P < 0.05). The single parameter with an association with the type of mucosal thickening was the number of roots with an apical lesion (P < 0.05). Conclusion Mucosal thickening associated with periapical lesions was observed in almost 50% of all mucosal thickening cases. Therefore, collaboration amongst endodontists and otolaryngologists is mandatory to provide successful treatment and prevent recurrence of maxillary sinusitis.
Objective: To qualitatively investigate whether a prototype brush composed of metal bristles collects oral epithelial cells effectively for cytological evaluation of oral mucosal lesions. Material and Methods: Twenty patients with suspicious oral mucosal lesions were enrolled. Patients were asked to gargle with saline and to deposit the oral rinse into specimen cup. Then, oral mucosal cell samples were collected using a metal oral brush, via sweeping motion. Punch biopsy was performed for histological examination. All samples were evaluated with liquid based cytology (LBC) according to the cellularity, the depth of the epithelial layer, cellular integrity by an oral pathologist. Results: Oral rinse provided samples with 100% cellular integrity and cellularity, mostly from the intermediary layers. With metal brush, both inadequate cellularity and cellular integrity was observed in 25% of the cases. Cellular integrity was adequate in 65%, cellularity was adequate in 45% of the lesions. Samples were dominantly from the intermediary layers, but in one case, metal brush collected cells from the parabasal layer. Conclusion: The narrow spiral pitch and width of metal bristles may have resisted to release the cellular samples collected. With adjustment of the spiral pitch and diameter of metal brush bristles, its' efficacy could be enhanced.
Amaç: Bu çalışmanın amacı; radyolojik konsültasyon amacıyla yönlendirilen hastaların başlıca yönlendirilme sebeplerini araştırarak, tıp ve diş hekimliği fakültesi arasındaki genel radyolojik konsültasyon profilinin belirlenmesidir. Yöntem: 2017-2018 tarihleri arasında, EÜ Diş Hekimliği Fakültesi Ağız, Diş ve Çene Radyolojisi AD ve E.Ü Tıp Fakültesi Radyoloji AD birimine radyolojik konsültasyon amacıyla sevk edilen tüm olguların kayıtları incelendi. Olgular; yaş, cinsiyet, konsültasyon nedeni ve mevcut patoloji lokalizasyonuna yönelik sınıflandırıldı. Elde edilen veriler tanımlayıcı istatistiksel yöntemler kullanılarak değerlendirildi. Bulgular: Toplam 80 adet radyolojik konsültasyon olgusu incelendiğinde, 65 tanesinin diş hekimliği fakültesinden tıp fakültesine; 15 olgunun ise tıp fakültesinden diş hekimliği fakültesine yönlendirildiği belirlendi. Olguların yaş ortalamasının 49 olarak belirlendiği çalışmamızda katılımcıların 44 tanesi erkek (%55) iken, 36 tanesinin kadın (%45) olduğu saptandı. Diş hekimliği fakültesinden tıp fakültesine radyolojik konsültasyon amacıyla yönlendirilen hastaların başlıca yönlendirilme sebepleri arasında malign lezyon şüphesi olan olgularda ileri tetkik gerekliliği (%39) ve cihazın görüntüleme hacmini (FOV) (Field of view) aşan geniş kemik içi lezyon varlığı (%35) yer almaktaydı. Mevcut patolojilerin en sık yerleşim bölgesi mandibula (%25) olarak belirlenirken, en sık talep edilen ileri radyografik tetkik bilgisayarlı tomografi ile görüntüleme (%48.7) idi. Tıp fakültesinden diş hekimliği fakültesine en sıklıkla yönlendirilen olguların başında ise travma olguları yer alırken (%54), bunu odontojenik kist cerrahisi sonrası kontrol (%33) ve dentofasiyal anomali olguları (%13) izledi. En sık talep edilen radyografik tetkik ise panoramik radyografi ile görüntüleme (%100) idi. Sonuç: Diş hekimliği fakültesi ve tıp fakültesinden radyolojik konsültasyon amacıyla yönlendirilen hastaların başlıca yönlendirilme sebepleri birbirinden farklılık göstermektedir. Radyolojik konsültasyon, hastanın durumunun belirlenmesi ve en uygun tedavinin planlanmasında önemli katkı sağlayacaktır.
Topikal, sistemik, inhalasyonel, rektal ve intraartiküler ajanlar olarak kullanılabilen glikokortikoidler genellikle enflamatuvar, alerjik, otoimmün ve neoplastik hastalıkların tedavisinde tercih edilirler. Özellikle bu ajanlardan topikal formda olanlar oral mukozal hastalıklarla ilişkili ağız lezyonlarının tedavisinde kullanılmaktadırlar. Bu nedenle oral mukozal hastalıklarda etkili bir tedavi sağlamak ve aynı zamanda hastaları potansiyel yan etkilerden korumak için diş hekimleri topikal steroidlerin (TS) endikasyonlarını, yan etkilerini ve klinik uygulama şekillerini bilmelidirler. Doğru şekilde kullanıldığında birçok oral mukozal hastalıkta tatmin edici klinik sonuçlar sağlayan TS'nin, hatalı uygulamalar sonucunda iyatrojenik Cushing sendromu, adrenal yetmezlik gibi ciddi komplikasyonlara neden olabileceğine dair birçok çalışma bulunmaktadır. Literatürde, TS'nin hangi dozdan ve uygulama sıklığından sonra sistemik kan dolaşımına katıldığına ilişkin bir görüş birliğine varılamamıştır. Sunulan bu derlemede, son yıllarda diş hekimleri tarafından sıklıkla reçete edilmeye başlayan TS'nin endikasyon ve kontrendikasyonları ile avantaj ve dezavantajlarının yanı sıra, güncel literatür bilgileri ışığında doğru kullanım önerilerinin paylaşılması amaçlanmıştır. Anahtar kelimeler: Diş hekimliği, topikal steroid, yan etki. SUMMARY Glucocorticoids, which are used as topical, systemic, inhalational, rectal and intraarticular agents, are often preferred for treatment of inflammatory, allergic, autoimmune and neoplastic diseases. Especially, topical forms of these agents are used to treat oral lesions associated with oral mucosal diseases. Therefore, dentists must know indications, side effects and application forms of topical steroids (TS) in order to treat oral mucosal diseases effectively, and to protect the patients from potential side effects. There are many studies, suggesting that when TS are used properly, they provide satisfactory clinical results in many oral mucosal diseases; whereas it may lead to serious complications, such as iatrogenic Cushing syndrome and adrenal insufficiency, as a result of inaccurate applications. In the literature, there is no consensus about the posology of TS, which results in the absorption of the TS into systemic circulation. The aims of this review are to offer indications, contraindications, advantages, and disadvantages of TS, which have been frequently prescribed by dentists in recent years, as well as to share suggestions for proper usage of these drugs in accordance with the current information in the literature.
Styloid process of temporal bone is a pointed projection from the petrous part of temporal bone which ranges with an average of 25 mm in length, and any process longer than 30 mm is defined as the "Elongated Styloid Process". In asymptomatic cases, diagnosis is usually made with routine radiological examination, but morphological aspects of styloid process can be evaluated with different imaging modalities. Although digital panoramic radiographs are sufficiently accurate for the diagnosis of elongated styloid process, multislice computed tomography scan with 3D reconstruction can further assist in determining the actual length and correct relationship with the surrounding adjacent anatomical structures. The aim of this case report is to investigate the morphological characteristics of an unilateral elongated styloid process using both conventional and multidetector computed tomography (MDCT) on a 55 year old asymptomatic male patient and to review the literature.
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