Özet Gardner sendromu otozomal dominant kalıtımlı nadir görülen bir sendromdur. Gastrointestinal poliplerin dışında ekstraintestinal bulgu olarak çenelerde osteomlar, gömülü/süpernumere dişler, epidermoid kistler, desmoid tümörler, retinal lezyonlar görülebilir. Rutin diş hekimi muayenesi esnasında panoramik radyografi ile çenelerde ekstraintestinal bulgular tespit edilebilir ve bu durum da diş hekimlerini daha ileri klinik araştırmalar yapmaya yönlendirebilecek önemli bir gösterge olabilir. Bu çalışmanın amacı kliniğimize başvurmuş ve daha önceden bu durumun farkında olmayan Gardner Sendromlu üç olguyu bildirmek ve sendromun çenelerde gözükebilecek ekstraintestinal bulguları sebebiyle diş hekimlerin dikkatini bu konuya çekmektir.

Objectives: The aim of this study was to estimate the legal age using the parameters obtained from radiomic analysis of the mandibular condyle in cone beam computed tomography (CBCT) images. Material and Methods: The study group consisted of 300 mandibular condyles, which were categorized into six groups based on the age of the patients: 8-11 years, 12-14 years, 15-17 years, 18-20 years, 21-23 years, and over 24 years. Each patient's condyle was segmented individually using the 3D Slicer program. Radiomic features were extracted from the segmented images using the SlicerRadiomics plugin. Subsequently, three distinct models were developed with reference to three specific subgroups of the 12-14 age group, 15-17 age group, 18-20 age group and the efficacy of radiomic features in predicting the age of the patient was evaluated. Results: The ROC analysis of the three radiomics scores (RS) yielded AUC values of 0.927, 0.860, and 0.769 for RS 12-14 , RS 15-17 , and RS 18-20 , respectively. The RS 12-14 model exhibited the highest sensitivity and specificity values among the models, with 88% and 84.4%, respectively. Conclusion: Among the radiomic features extracted from the mandibular condyle in CBCT images, the most significant features, identified based on developed models and their respective coefficients, can be applied to estimate patients' ages. Future studies hold substantial potential for advancing this method, particularly in automating both the segmentation process and the derivation of formulae for age estimation. The use of radiomic features for age prediction presents a promising alternative method for developing fully automated systems in clinical practice.

This study's objective is to investigate the incidence and anatomical structure of the retromolar canal (RMC), an anatomical variation that can be seen in the posterior region of the mandible in the Northwestern Turkish adult population, and to emphasize its importance for surgical procedures in the retromolar region. The cone-beam computed tomography (CBCT) images of 2176 patients aged 18–57 years were analyzed retrospectively. The presence of an RMC (if any), the type and width of the RMC, the height of the RMC, and its distance from the mandibular second molar were examined. The distribution of the detected RMCs according to gender, age, and canal type was statistically determined. Thirty-one RMCs were detected in 28 (10.7

This study aimed to evaluate the repeatability of radiomic features extracted from cone-beam computed tomography (CBCT) images and to identify specific radiomic features suitable for use in CBCT studies. In this study, radiomic analysis was conducted using the 3D Slicer program on two CBCT scans obtained at different time points from each of 33 individuals, using the same CBCT device. A total of 107 radiomics features were extracted from the segmented C2 (Axis) data in all cases. The results of the radiomic analysis were evaluated using the Intraclass Correlation Coefficient (ICC) in the SPSS program to assess repeatability. As a result of the analysis, 25 out of 107 radiomic features demonstrated excellent repeatability (ICC > 0.90). These included nine of the 14 shape-based features, four of the 18 first-order features, two of the 24 GLCM features, three each from the 14 GLDM, 14 GLRLM, and 16 GLSZM features, and one of the five NGTDM features. The grey-value dependent second-order radiomic features obtained from CBCT images have been found to exhibit lower repeatability compared to shape and first-order features. The poor repeatability of grayscale parameters should be taken into account when performing radiomics analysis of CBCT volumes.

Amaç: Oral kavitede görülen malign tümörlerin %85-95’i, oral mukozayı döşeyen skuamöz epitelden köken almaktadır. Oral skuamöz hücreli karsinom (OSHK) genellikle ileri evrelerde teşhis edildiği için çeşitli komplikasyonlara ve yüksek mortalite oranına sahip olan bir kanser türüdür. TNM evrelendirmesi malign tümörlerin prognozunu değerlendirmek amacıyla en sık kullanılan sistemlerden biridir. Bu çalışmada histopatolojik olarak OSHK tanısı konulmuş olguların TNM evrelenmesi için gerekli bulgular retrospektif olarak değerlendirilmiştir. Gereç ve Yöntemler: 2018-2023 yılları arasında Kocaeli Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalında incelenmiş ve OSHK tanısı almış olgular retrospektif olarak değerlendirilmiştir. OSHK olgularının TNM evrelenmesi için lezyon boyutu, tümör invazyon derinliği, metastaz varlığı, lenf nodu tutulumu ve boyutu değerlendirilmiştir. Ayrıca hastaların demografik bilgileri, tümör lokalizasyonu ve diferansiyasyon derecesinin TNM evrelenmesiyle ilişkisi değerlendirilmiştir. Bulgular: Bu çalışmada 15 erkek ve 18 kadın olmak üzere 33 OSHK olgusu retrospektif olarak değerlendirilmiştir. İyi diferansiyasyon gözlenen 16 olguda tümör boyutu ortalama 2,4 cm, orta derece diferansiyasyon gözlenen 17 olguda ise 3,3 cm olarak bulunmuştur. İyi diferansiye olgular en sık dil tutulumu gösterirken, orta derece diferansiye olgularda dil dışında gingiva, retromolar bölge ve bukkal mukozada da tutulum saptanmıştır. Orta derece diferansiye 4 olguda lenf nodu tutulumu mevcuttur. Hiçbir olguda metastaz saptanmamıştır. Sonuçlar: Oral kavitedeki tümörlerin boyutu 2 cm’den küçük olduğunda (T1) BT veya MR gibi görüntüleme yöntemleriyle tespit edilemez. Boyutu 2 cm’den büyük olduğunda (T2 ve üstü) çevre dokulara invazyon ve metastaz yapma olasılığı artar. Bu yüzden diş hekimleri prekanseröz lezyonları tanımalı ve özellikle ileri yaşlardaki hastalarda ülsere/eroziv lezyonlara dikkat etmelidir. Anahtar Kelimeler: Skuamöz hücreli karsinom, Tümör evrelemesi, TNM

Malign neoplazmlar arasında oral sküamoz hücreli karsinom (OSHK) mortalite ve morbiditeye sebep olan en önemli nedenler arasında yer almaktadır. Bu sebeple OSHK olgularında erken tanı büyük bir önem kazanmaktadır. OSHK olgularının ilk belirtilerinin asemptomatik ülser ya da ağrısız şişlik olması nedeniyle, tanı sürecinde hem hasta hem de hekim kaynaklı faktörler sebebiyle gecikme yaşanabileceği bilinmektedir. Bu olgu sunumunda 6 aydır iyileşmeyen intraoral ülserasyon şikayetiyle kliniğimize başvuran 71 yaşındaki kadın hastadan alınan anamnezde, altı ay önce mandibular sol bölgede ağrı ve hassasiyet şikayeti sebebiyle diş çekim işlemi yapıldığı ancak şikayetlerinin devam ettiği öğrenilmiştir. Yapılan intraoral muayenede sol mandibular krette kanamaya meyilli, sınırları düzensiz ağrılı ülsere lezyon saptanmıştır. Alveolar kret mukozası ve altındaki nekrotik kemikten alınan insizyonel biyopsi sonrasında yapılan histopatolojik değerlendirme sonucunda iyi diferansiye OSHK tanısı konmuştur. Anahtar Kelimeler: Etiyoloji; Gecikmeli Tanı; Oral Ülser; Yassı Hücreli Kanser

INTRODUCTION The aim of this study was to evaluate radiomorphometric differences of mandibular foramen (MF), lingula (Li), and anti-lingula (AL) between prognathic and non-prognathic patients, using cone-beam computed tomography (CBCT). METHODS A total of 228 3D CBCT images of 57 prognathic and 57 non-prognathic patients were retrospectively evaluated. The distances between MF or Li to occlusal plane (OP), anterior border of ramus (AR), posterior border of ramus (PR), sigmoid notch (SN), gonion (Go) and distances Li to MF were measured. The presence of AL, and the distances to Li were also assessed in both groups. RESULTS In prognathic patients the mean distances of MF-AR and Li-PR were lesser, and Li-OP was greater (p < 0.05). However, distances from MF or Li to the other ramal landmarks were similar in both groups (p > 0.05). Presence of AL was found at 53 sides in prognathic and 20 sides in non-prognathic groups (p < 0.05). The horizontal distance of Li-MF was greater in prognathic patients (p < 0.05). On the other hand, there was no difference between groups regarding the horizontal distance of Li-Al, and the vertical distances of Li-MF and Li-AL (p > 0.05). CONCLUSION The present study provided valuable data regarding morphological differences of MF-AR, Li-MF and Li-OP, which should be considered in the preoperative assessment of patients with mandibular prognathism. Presence of AL was more common in prognathic patients and mainly located above Li. 3D CBCT applications facilitated assessment of AL and its relationship with Li.

Objective: The aim of this study is to investigate the potential of Demirjian method in estimation of age groups with limits of 12, 15, and 18 years, according to ages of legal responsibilities. Methods: The panoramic radiographs of the study population aged between 6 to 22 were assessed for third molar (3M) mineralization with Demirjian method with four subgroups. Group 1 consisted of individuals aged between 6 to and 12 years of age, Group 2 were aged between 12 to 15 (Group 2, ≥12,

Purpose: Aging is accompanied by the gradual loss of teeth, which can cause several orofacial changes. This study aimed to compare panoramic radiomorphometric indices between dentate and totally edentulous patients. Materials and Methods: One hundred panoramic radiographs were analyzed to measure six indices using Clinview 9.3 software: the gonial angle (GA), antegonial angle (AGA), condylar height (CH), ramus height (RH), mental index (MI), and mandibular cortical index (MCI). An independent sample t-test and Chi-square was used to compare the means of the measured data between dentate and edentate subjects and genders. Results: In both genders, dentate people had greater left CH (p=0.05) and left GA (p=0.03). Men had greater RH in the dentate and edentate groups (p<0.001). No correlation was found between groups and genders in MCI scores. Conclusion: CH index assessment as the function of the masticatory muscles and GA as residual ridge resorption were decreased in edentulous people. The findings highlight the importance of oral hygiene education and prosthetic rehabilitation of the edentulous.

Purpose: Langerhans cell histiocytosis (LCH) of the jaws is a rare disease and is often diagnosed at an advanced stage. This study aims to assess the trabecular pattern of jaws via fractal analysis (FA) on initial panoramic radiographs (OPG) of the patients with LCH to facilitate interpretation of the radiographic changes. Methods: A case-control study investigated LCH cases with jaw involvement retrieved from the databases of Istanbul and Kocaeli Universities between 2010 and 2021. Initial OPGs of LCH cases and OPGs of healthy sex- and age-matched controls were investigated with FA. All images were assessed using Image) software. On each OPG, a total of 6 regions of interest (ROIs) located on the mandible were investigated bilaterally. The independent variables were the trabecular patterns of jaws of LCH cases and their control matches. The outcome variables were the fractal dimension (FD) values obtained from the ROIs on OPGs. Data were analyzed using the Mann-Whitney U test and Student's t test. Results: Fifteen LCH-control pairs were investigated. In one ROI located in the supracortical area above the left mandibular angle, FD values of LCH cases (1.273 +/- 112.8) were significantly lower than controls (1.308 +/- 85.3; P < .05). Lower FD values were also calculated for some of the remaining ROIs, but there was no significant difference between groups (P > .05). Conclusions: Regarding our results, FA was not a useful parameter to discern radiographical trabecular changes between LCH cases and controls. Multicenter studies with larger populations are needed to investigate the potential of FA in the identification of this rare disease. (C) 2022 American Association of Oral and Maxillofacial Surgeons

OBJECTIVES:The aim of this study was to assess the reliability of panoramic radiography (OPG) using age estimation method using cone beam computed tomography (CBCT) verification in the evaluation of radiographic visibility of root pulp (RPV) of mandibular third molars for age estimation.METHODS:CBCT and OPG images of 429 mandibular third molars from 290 patients were evaluated. RPV of fully mineralized mandibular third molars was evaluated as stages 0, 1, 2, and 3 for both imaging methods. Descriptive statistics were performed separately for stages by age for both genders. The consistency of these scores with chronological age was evaluated for both imaging methods. The reliability of OPG evaluation was also analyzed with CBCT scores.Results Spearman's rho correlation demonstrated a positive correlation between RPV and chronological age for both genders and for OPG and CBCT evaluation. Considering the minimum ages of both imaging methods, all stages were above the age of 18 except for the female group of Stage 2 and all Stage 0. For the comparison of OPG and CBCT RPV Staging scores, the κ score was found to be 0.312 (p < 0.001), indicating a fair agreement.CONCLUSION:In conclusion, the absence of Stage 3 at age of 18 and under might have a forensic value for RPV age estimation method. Considering the fair agreement in the verification of OPG scores, it is not possible to determine the exact age with the RPV detected in OPG images, the use of CBCT for the RPV evaluation is recommended to available cases.

Purpose: Benign fibro-osseous lesions (BFOLs) are heterogeneous intraosseous disease processes sharing overlapping histopathologic features and demonstrate a wide range of biological behavior. The aim of this study is to highlight the importance of clinical and radiological findings for the definitive histopathologic diagnosis of benign fibro-osseous lesions of the jaws. Materials and Methods: This is a cross-sectional retrospective study evaluating the three main groups of BFOLs: Cemento-osseous dysplasia, ossifying fibromas, and fibrous dysplasia. Previously diagnosed BFOL cases were searched for thoroughly from the archives of Istanbul University, Institute of Oncology, Department of Tumor Pathology in between 2005 and 2015. Clinical and radiological data of these cases were identified and recorded. The histopathologic features were reevaluated from the H&E-stained slides. Results: A total of 276 BFOL cases were identified and reevaluated for the study. The most common BFOL type was cemento-osseous dysplasia (n = 135), followed by cemento-ossifying fibroma (n = 77), fibrous dysplasia (n = 53) and juvenile ossifying fibroma (n = 11). The female male ratio was 3.4:1 with a strong predilection for the 4th decade (n = 102). The mandible (n = 209) was the predominantly affected jaw. Prominent osteoblastic rimming around the bony lesion was commonly observed for cemento-ossifying fibroma (n = 60/77), followed by cemento-osseous dysplasia (n = 23/135). Predominant ossification patterns showed some differences among the groups. The most common radiological feature was the mixed radiolucent/radiopaque internal structure. Conclusion: Our results document various clinical, radiological and histopathologic findings of BFOLs. Even some histopathologic differences are observed, clinical and radiographic correlation is mandatory prior to the definitive histopathologic diagnosis of BFOLs for the prevention of possible misdiagnoses or inappropriate treatments. (C) 2021 Elsevier Masson SAS. All rights reserved.

Amaç: Bu çalışmanın amacı, ameloblastoma (AB) ve odontojenik keratokist (OKK) olgularının konik ışınlı bilgisayarlı tomografi eşliğinde radyolojik özelliklerini

Purpose: The aim of this retrospective study was to investigate the characteristics of cemento-osseous dysplasia (COD) lesions for devising a clinical algorithm to help management decisions, specifically discussing the need for a possible surgical intervention versus solely follow-up. Materials and methods: One hundred thirty-five subjects were thus identified having previously diagnosed and treated for COD from the archives of the pathology in between 2005-2015. These were then re-evaluated. Demographic features, radiographic and histopathologic findings were assessed. Results: The most frequent variant was the focal type (n = 83), and the mandible (n = 131) was predominantly affected jaw bone. Female predilection was evident for all subtypes. Almost half of the lesions (n = 72) presented with mixed radiolucent and radiopaque appearances in radiography at the time of the biopsy. Cementicles/psammoma body-like calcifications and trabecular pattern were the most common hard tissue appearances. Conclusion: COD lesions are non-neoplastic fibro-osseous lesions which can exhibit similar histopathologic and radiologic features with other bone lesions. Ideally, these lesions should be clinically identified and followed-up. Considering the possible complications, a thorough knowledge of these lesions and their differentials is essential in order to avoid unnecessary surgical interventions. (C) 2020 Elsevier Masson SAS. All rights reserved.

Traumatic neuroma is a non-neoplastic proliferative disorder of the nerve sheath in response to injury or surgery. Traumatic neuroma most frequently occurs in soft tissues and intraosseous involvement is uncommon. In this paper, we present a rare case of intraosseous traumatic neuroma of the inferior alveolar nerve leading to pain and paresthesia of the lower lip on the left side.

Oral lokoplaki, oral mukozadaki prekanseroz lezyonlarin basinda gelmektedir. Bu retrospektif calismanin amaci oral lokoplaki olgularinin etyolojik faktorleri esliginde degerlendirilmesidir. 2014-2016 yillari arasinda Kocaeli Universitesi Dis Hekimligi Fakultesi Agiz, Disi ve Cene Radyolojisi Anabilim Dali Oral Diagnoz kliniginde oral lokoplaki olarak teshis konulmus hastalarin klinik anamnezleri ve aliskanliklari, hastada mevcut lezyonun klinik ozellikleri etyolojik faktorler acisindan retrospektif olarak incelenmis, histopatolojik tanilari ile beraber degerlendirilmistir. Bu calismada incelenen yaslari 30 ile 67 arasinda degisen 12 hastanin, 8’i kadin, 4’u erkektir. 9 olguda yanak mukozasinda, 3 olguda sert damakta, 2 olguda dil lateralinde tespit edilen beyaz lezyonlara yapilan klinik degerlendirme sonucu oral lokoplaki tanisi konmustur. Hastalardan 10 tanesi sigara kullanmakta 2 tanesi ise kullanmamaktadir. Hasta anamnezlerinde hipertansiyon, diabetes mellitus tip II, ve kronik obstruktif akciger hastaligi tespit edilmistir. Histopatolojik olarak 1 hastada yassi epitel hucreli karsinoma, 1 adet hafif ve 1 adet orta derecede epitel displazisi, diger olgularda ise 9 adet hiperkeratoz tespit edilmistir. Bu calisma grubunda sigara kullanimi ve oral lokoplaki arasinda yuzdesel olarak iliski bulunmustur (%83). Oral lokoplaki lezyonuna sahip sigara kullanan hastalarin yuksek oranda olmasi bu iliskinin etyolojik faktorler icerisinde ilk sirada yer almasini saglamaktadir. Dis hekimleri bu lezyonlarin degerlendirilmesinde dikkatli olmali ve hastalari sigarayi birakma konusunda yonlendirmelidir. Ote yandan mevcut literatur degerlendirildiginde ve bu calismada sigara kullanmayan olgular oldugu dikkate alindiginda Human Papilloma Virus, alkol kullaniminin sinerjistik etkisi, atrofik epitel, Candida turleri, hormonal durum, diyet gibi diger risk faktorlerini arastiran calismalar devam etmelidir.

Amaç: Bu retrospektif çalışmanın amacı, belirli bir zaman aralığında yapılan oral mukoza lezyonlarının biyopsi sonuçlarını değerlendirmektir.Gereç ve Yöntemler: 2016-2018 yılları arasında Altınbaş Üniversitesi ve Kocaeli Üniversitesi Diş Hekimliği Fakülteleri Oral Diagnoz Kliniklerinde yapılan oral mukoza lezyonlarının biyopsi sonuçları retrospektif olarak incelenmiştir. Bu çalışmada, hastaların demografik bilgileri, kullanılan biyopsi tekniği, lezyonların lokalizasyonu ve histopatolojik tanıları değerlendirilmiştir.Bulgular: Çalışmamıza katılan yaşları 16 ile 73 arasında değişen 36 hastanın 21'i kadın, 15'i erkektir. En fazla biyopsisi yapılmış oral mukoza lezyonları 5 olguda irritasyon fibromu ve 5 olguda papillomdur. Yapılan biyopsi yöntemine göre sınıflama yaptığımızda 25 olguda eksizyonel, 6 olguda insizyonel, 4 olguda punch, 1 olguda smear biyopsisi yapılmıştır. Biyopsilerin alındığı bölge olarak biyopsilerin en sık 13 olguda yanak mukozasından, 6 olguda alt dudaktan, 5 olguda dilden, 4 olguda sert damaktan alındığı görülmektedir.Sonuç: Oral Diagnoz uzmanlarının ağız içinde görülen selim, premalign ve malign lezyonların erken teşhisinde önemli sorumlulukları mevcuttur. Bu lezyonların doğru tanısında histopatolojik ve sitolojik muayene gibi tanıya yardımcı metotlar gerekli olabilmektedir.ANAHTAR KELİMELER Oral Biyopsi, Oral Mukoza Lezyonları, Oral Diagnoz

Objective This study aimed to evaluate the radiomorphometric indexes and fractal dimension (FD) on dental panoramic radiography (DPR) of Thalassemia Major (TM) patients. Methods In 59 TM patients and in 59 healthy control subjects, mandibular cortical index (MCI), mandibular cortical width (MCW), panoramic mandibular index (PMI), and FD of four different regions (FD1-4) were evaluated and compared using DPRs. Results The distribution of MCI in TM patients was similar to control subjects (p > 0.05). The mean MCW was significantly lower in TM patients (p = 0.001). There was no significant difference in PMI between TM patients and control subjects. The mean of FD measured in the supracortical area above the angle of mandible (FD2), in the anterior to the mental foramen (FD4) and mean FD of four different regions was significantly lower in TM patients (p = 0.003, p = 0.001, and p = 0.014, respectively). Conclusions The radiomorphometric indices and fractal dimensions evaluated in the panoramic radiograph are capable of identifying thalassemia patients' jaw bone, and the results of DPR scanning can be used to refer these patients to appropriate medical investigation.

OBJECTIVES: The aim of this study was to assess the visibility of discomallear ligament and anterior mallear ligament together with anatomical morphometric measurements of petrotympanic fissure, and to determine whether the mallear ligaments correlate with the bone compartment changes of temporomandibular joint. METHODS: Cone beam CT images of 275 patients were evaluated retrospectively. The visibility of discomallear and anterior mallear ligaments were evaluated by two observers. The petrotympanic fissure was classified into four groups. Morphologic features of petrotympanic fissure and mandibular fossa were also measured in sagittal, axial and three-dimensional cone beam CT reconstructed images. Pearson's χ2 test and Student's t-test were performed for statistical analysis of differences voxel sizes, age, gender, localization, temporomandibular joint and measurements (p < 0.05). Intra- and interobserver reliability was also performed. RESULTS: Type 3 petrotympanic fissure was more frequent in male, whereas females showed Type 1 and Type 2 petrotympanic fissure structures (p < 0.05). Anterior mallear ligament visibility on cone beam CT images was statistically higher in bone compartment changes of temporomandibular joint. In cone beam CT images, petrotympanic fissure tunnel types 1, 2, 3 and 4 were seen in 11.5, 35.63, 51.34 and 1.53% of patients, respectively. CONCLUSIONS: Knowledge of the anatomy may help in identifying temporomandibular joint pain and auditory symptoms due to temporomandibular disorder. Further cross-sectional studies with larger populations are needed to investigate the physiopathological relation of both disorders.