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    Cone beam computed tomography vs. microcomputed tomography for trabecular bone healing assessment
    (Urban & Vogel, 2025) Deniz, Yesim; cetin Genc, Cigdem; Orhan, Kaan
    PurposeThis study aimed to compare cone beam computed tomography (CBCT) and microcomputed tomography (mu CT) data to evaluate the micromorphological structure of healing bone in defects created on rabbit mandibles at different stages.MethodsResidual rabbit mandibular alveolar bone tissues from another animal study involving 18 rabbits were utilized. In the prior study, 10 x 4 mm bone cavities were created, left to heal naturally, and the animals were sacrificed after 21, 45, and 90 days. In this study, CBCT and mu CT imaging were performed on the excised defect regions. The micromorphometry parameters including bone-volume fraction (BV/TV), bone-surface density (BS/TV), fractal dimension, connectivity density (Conn. Dn.), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp) were examined by ImageJ (US National Institutes of Health, Bethesda, MD, USA). Paired two-sample t-tests, Wilcoxon test, and Bland-Altman plots were performed.ResultDifferences in the parameters Conn. Dn., fractal dimension, Tb.Th, and Tb.Sp were observed between CBCT and mu CT on day 21. By day 45, no significant differences were noted in BV/TV, BS/TS, Tb.Th, and Tb.Sp. On day 90, all measured parameters showed no statistically significant differences between CBCT and mu CT. Bland-Altman analysis showed an agreement for most parameters (BV/TV, BS/TV, fractal dimension, Tb.Th, and Tb.Sp) after 21, 45, and 90 days, with minimal biases emerging over time, while a more notable divergence in Conn. Dn. was observed.ConclusionCBCT can be used for micromorphological analyses on days 45 and 90 of bone healing as there were no differences between CBCT and mu CT during these periods. ZielIn dieser Studie sollten CBCT- (digitale Volumentomographie) und mu CT(Mikro-Computertomographie)-Daten verglichen werden, um die mikromorphologische Struktur der Knochenheilung in artifiziell erzeugten Defekten an Kaninchenunterkiefern in verschiedenen Stadien zu untersuchen.MethodeVerwendet wurde Restgewebe des Alveolarknochens von Kaninchen aus einer anderen Tierstudie mit 18 Kaninchen. In der vorangegangenen Studie wurden 10 x 4 mm gro ss e Knochendefekte geschaffen, die nat & uuml;rlich ausheilen sollten, und die Tiere wurden nach 21, 45 und 90 Tagen get & ouml;tet. In der vorliegenden Studie wurden CBCT- und mu CT-Aufnahmen der exzidierten Defektregionen durchgef & uuml;hrt. Die mikromorphometrischen Parameter einschlie ss lich Knochenvolumenanteil (BV/TV), Knochenoberfl & auml;chendichte (BS/TV), fraktale Dimension, Konnektivit & auml;tsdichte (Conn. Dn.), Trabekeldicke (Tb.Th) und Trabekelseparation (Tb.Sp) wurden mit ImageJ (US National Institutes of Health, Bethesda, MD, USA) untersucht. Durchgef & uuml;hrt wurden gepaarte Zwei-Stichproben-Tests, der Wilcoxon-Test und Bland-Altman-Diagramme.ErgebnisUnterschiede bei den Parametern Conn. Dn., fraktale Dimension, Tb.Th und Tb.Sp wurden zwischen CBCT und mu CT am 21. Tag festgestellt. Am 45. Tag wurden keine signifikanten Unterschiede bei BV/TV, BS/TS, Tb.Th und Tb.Sp festgestellt. Am 90. Tag zeigten alle gemessenen Parameter keine statistisch signifikanten Unterschiede zwischen CBCT und mu CT. Die Bland-Altman-Analyse zeigte eine & Uuml;bereinstimmung f & uuml;r die meisten Parameter (BV/TV, BS/TV, fraktale Dimension, Tb.Th und Tb.Sp) am 21., 45. und 90. Tag, wobei im Laufe der Zeit nur minimale Abweichungen auftraten, w & auml;hrend eine deutlichere Divergenz bei Conn. Dn. beobachtet wurde.SchlussfolgerungDie CBCT kann f & uuml;r mikromorphologische Analysen am 45. und am 90. Tag der Knochenheilung verwendet werden, da es in diesen Zeitr & auml;umen keine Unterschiede zwischen CBCT und mu CT gab.
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    Influence of Cone-Beam Computed Tomography Voxel Sizes in the Detection of Chemically Induced External Root Resorptions
    (Int Scientific Information, Inc, 2022) Kolsuz, Mehmet Eray; Eren, Hakan; Celikten, Berkan; Evli, Perihan Dalgali; Kocasarac, Husniye Demirturk; Orhan, Kaan
    Background: External root resorption usually does not present a clinical sign or symptom, and, therefore, diagnosis is mainly based on radiographic examination. Many studies confirmed the advantage and accuracy of cone-beam computed tomography (CBCT) in evaluating root resorptions. We aimed to evaluate the diagnostic accuracy of CBCT images of chemically induced external root resorptions on extracted human teeth taken in different vox el sizes. Material/Methods: In this in vitro study, 36 maxillary and 36 mandibular human incisor teeth, extracted owing to periodontal disease, were used. External resorption cavities were created on the buccal and proximal surfaces by using 10% hydrochloric acid with different application periods of 10, 30, and 60 min. Resorption cavities in different depths were induced to simulate different levels of external resorption. CBCT images were taken with Planmeca Promax 3D Max CBCT (Planmeca, Helsinki, Finland) in 4 different voxel sizes: 400, 200, 150, and 100 mu m. Results: There was no statistically significant difference between interobserver and intraobserver reliability. Higher observer agreement was obtained for 100-mu m and 150-mu m voxel sizes. For detection of external root resorption defects, interobserver agreement was highest for the 100-mu m voxel size and when defects were located on the proximal side of the samples. The highest k values were obtained for samples kept in hydrochloric acid for 60 min. Conclusions: Chemically induced resorption cavities should be used for experimental studies to better imitate clinical conditions. CBCT requirement is still ambiguous for detection of external resorptions, and more experimental and clinical studies are needed.
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    Investigation of the effect of indirect pulp capping materials on dentin mineral density
    (Piracicaba Dental School - UNICAMP, 2023) Misilli, Tuğba; Uslu, Gülşah; Orhan, Kaan; Bayrakdar, İbrahim Şevki; Erdönmez, Demet; Özyürek, Taha
    Aim: To evaluate the potential of inducing mineral density changes of indirect pulp capping materials applied to demineralized dentin. Methods: A total of 50 cavities were prepared, 5 in each tooth, in extracted ten molars without caries, impacted or semi-embedded. The cavities were scanned by microcomputed tomography (μ-CT) after creating artificial caries by microcosm method (pre-treatment). Each cavity was subjected to one of 5 different experimental conditions: control (dental wax), conventional glass ionomer cement (Fuji IX GP Extra), resin-modified calcium silicate (TheraCal LC), resin-modified calcium hydroxide (Ultra-Blend Plus), MTA (MM-MTA) and the samples were kept under intrapulpal pressure using simulated body fluid for 45 days. Then, the second (μ-CT) scan was performed (post-treatment), and the change in dentin mineral density was calculated. Afterward, elemental mapping was performed on the dentinal surfaces adjacent to the pulp capping agents of 5 randomly selected samples using energy dispersive X-ray spectroscopy (EDS) apparatus attached to a scanning electron microscope (SEM). The Ca/P ratio by weight was calculated. Friedman test and Wilcoxon Signed Ranks test were used to analyze the data. Results: There was a significant increase in mineral density values of demineralized dentin after treatment for all material groups (p<0.05). Resin-modified calcium silicate had similar efficacy to MTA and conventional glass ionomer cement, but was superior to resin-modified calcium hydroxide in increasing the mineral density values of demineralized dentin. Conclusions: Demineralized dentin tissue that is still repairable can be effectively preserved using materials with remineralization capability.
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    Long-term evaluation of masseter muscle activity, dimensions, and elasticity after orthognathic surgery in skeletal class III patients
    (Springer Science and Business Media Deutschland GmbH, 2023) Müftüoğlu, Özge; Aktürk, Ezgi Sunal; Eren, Hakan; Görürgöz, Cansu; Karasu, Hakan Alpay; Orhan, Kaan; Akat, Bora; Memikoğlu, Tulin Ufuk Toygar
    Objective: To evaluate changes in the masseter muscle after orthognathic surgery using electromyography (EMG), ultrasonography (US), and ultrasound elastography (USE) in individuals with skeletal class III anomaly over long-term follow-up and compare with a control group. Materials and methods: The study group included 29 patients with class III dentofacial deformities scheduled to undergo orthodontic treatment and orthognathic surgery. The control group included 20 individuals with dental class I occlusion. Assessment of the masseter muscles using EMG, US, and USE was performed before orthognathic surgery (T1) and at postoperative 3 months (T2) and 1 year (T3) in the study group, and at a single time point in the control group. All assessments were performed at rest and during maximum clenching. Masseter muscle activity, dimension, and hardness were analyzed. Results: Electromyographic activity of the masseter muscle during maximum clenching was increased at postoperative 1 year but did not reach control group values. On ultrasonography, the masseter muscle showed minimal changes in dimension at postoperative 1 year compared to preoperative values and remained below control group values. The postoperative increase in masseter muscle hardness at rest and during maximum clenching persisted at postoperative 1 year. Conclusion: The results of this study suggest that after orthognathic surgery, additional interventions and much longer follow-up are needed to ensure better muscle adaptation to the new occlusion and skeletal morphology. Clinical relevance: All assessment methods are useful for comprehensively evaluating changes in the masticatory muscles after orthognathic surgery.
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    The evaluation of the relationship between changes in masseter muscle thickness and tooth clenching habits of bruxism patients treated with botulinum toxin A
    (Wolters Kluwer Medknow Publications, 2023) Erdil, Deniz; Bağış, Nilsun; Eren, Hakan; Camgöz, Melike; Orhan, Kaan
    Background: Bruxism is defined as recurrent masticatory muscle activity. Although there is not an agreed treatment method for bruxism, the application of botulinum toxin A (BT-A) has become a reliable lately. This study aimed to evaluate the correlation between the changes in masseter muscle thickness and clenching habits in bruxism patients treated with BT-A. Methods: Twenty-five patients, 23 females and 2 males, diagnosed with possible sleep bruxism were included in the study. The Fonseca Anamnestic Index was applied to the patients to determine their clenching habits and depression levels both before the treatment, and 6 months after it. The masseter muscle thickness was measured using ultrasonography before the treatment and 3 months and 6 months after the treatment. All the patients were injected with a total of 50 U of BT-A, 25 U to each masseter. Results: A statistically significant decrease in masseter muscle thickness was observed in the ultrasonography 3 and 6 months after the BT-A treatment. There was a statistically significant decrease in the Fonseca scores, in which the teeth clenching habits of the patients were evaluated 6 months after the treatment. Although there was a decrease in the depression levels of the patients 6 months after the treatment, this difference was not statistically significant. Conclusion: When the results of this study were evaluated, it was seen that the BT-A injections are an effective, safe, and side effect-free method in the treatment of bruxism and masseter hypertrophy.