Araştırmacılar(2)

• Akyuz, Mehmet
• Ocak, Ali

• ArticleAçık Erişim2026/r/ebyu/10846
  CBCT-based submandibular fossa depth classification and panoramic fractal dimension analysis in the posterior mandible

  Ocak, Ali; Akyüz, Mehmet

  Deep concavities of the submandibular fossa (SF) in the posterior mandible substantially increase the risk of lingual cortical plate perforation during implant placement. Although cone-beam computed tomography (CBCT) enables accurate three-dimensional assessment of SF morphology, panoramic radiography remains the most commonly used initial imaging modality. We investigated whether trabecular bone texture on panoramic radiographs, quantified using fractal dimension (FD), is associated with CBCT-measured SF depth. In this retrospective cross-sectional study, 133 patients with CBCT and panoramic radiographs obtained within 3 months were included. SF depth was classified as Type I (≤ 2 mm), Type II (2–3 mm), or Type III (> 3 mm). On the matching panoramic level, a 20 × 20-pixel cancellous region of interest was analyzed in ImageJ using box-counting FD. Group comparisons were performed using the Kruskal–Wallis and Mann–Whitney U tests with Bonferroni correction; correlations were assessed using Spearman’s rank correlation coefficient (p < 0.05). A total of 229 hemimandible measurements were evaluated. Mean age was 41.96 ± 15.59 years; 57.1% were female. Mean SF depth was 1.845 ± 0.750 mm and mean FD was 1.0964 ± 0.0667. Median FD was 1.0747, 1.1324, and 1.1340 in Types I, II, and III, respectively (Kruskal–Wallis p = 4.45 × 10⁻⁵). FD was significantly higher in Types II and III versus Type I (p = 0.000514 and p = 0.00633), with no difference between Types II and III (p = 1.00). SF depth positively correlated with FD (Spearman rho = 0.4138, p = 6.95 × 10⁻¹¹). Panoramic FD values reflected CBCT-defined SF depth categories, with deeper concavities showing consistently higher trabecular texture complexity. These results suggest that SF anatomical variation is a previously unrecognized source of regional FD heterogeneity in the posterior mandible and should be considered when interpreting panoramic FD in this region. FD is not proposed as a substitute for CBCT, but as a complementary quantitative descriptor with implications for both surgical risk awareness and radiographic research methodology.

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• ArticleAçık Erişim2026/r/ebyu/10446
  Evaluation of trabecular architecture and bone density in periradicular bone of dilacerated mandibular third molars: a cone beam computed tomography study

  Ocak, Ali; Akyüz, Mehmet

  Background: This study aimed to evaluate and compare the periradicular trabecular bone density (BD) and microarchitecture of dilacerated and non-dilacerated mandibular third molars using gray values (GVs) and fractal dimension (FD) derived from cone-beam computed tomography (CBCT) images. Methods: This retrospective cross-sectional study included CBCT scans of 54 patients with dilacerated mandibular third molars and 60 controls without dilaceration. Root dilaceration was defined as deviation > 20° from the long axis. The dilaceration group was further divided into subgroups based on severity (angle of dilaceration > 60° vs. ≤60°). Standardized regions of interest were selected adjacent to the curvature of the roots, excluding cortical bones. GVs were automatically measured by Romexis 6.2.1 (R®software, Planmeca, Helsinki, Finland), and FD was calculated via ImageJ using the box-counting method. Appropriate statistical analyses were performed, with significance set at p < 0.05. Results: No significant differences were found between dilacerated and non-dilacerated groups in GV (437.12 ± 184.83 vs. 439.25 ± 148.90, p = 0.645) or FD (1.07 ± 0.15 vs. 1.04 ± 0.17, p = 0.204). However, when dilacerated teeth were stratified by severity, roots with > 60° curvature exhibited significantly higher FD values than those ≤ 60° (p = 0.040), whereas GV values did not differ between curvature groups (p > 0.05). Spearman’s correlation revealed no significant association between dilaceration angle and GV or FD (p > 0.05). Conclusion: Within the limitations of this study, fractal analysis was used as a quantitative method to assess periradicular trabecular bone changes adjacent to dilacerated root apices. Although overall GV- and FD-based metrics did not differ between dilacerated and non-dilacerated teeth, the higher FD observed in severely dilacerated roots (> 60°) suggests increased trabecular complexity in the apical region, reflecting a potential biological bone response associated with pronounced root curvature.

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• ArticleAçık Erişim2026/r/ebyu/10273
  Association of mandibular third molar positions, ramus height, and gonial angle on panoramic radiographs: a retrospective cross-sectional study

  Altındağ, Ali; Akyüz, Mehmet; Uzun, Sultan; Yüksel, İbrahim Burak; Mağat, Güldane

  Background: The aim of this study was to investigate the relationship between the positions of impacted mandibular third molars and the gonial angle and ramus height, as measured on panoramic radiographs, according to the Pell and Gregory/Winter classifications. Methods: This retrospective study included panoramic radiographs of 700 patients (350 males and 350 females) aged 18–62 years, who presented with bilaterally impacted mandibular third molars. The gonial angle and ramus height were measured, and the position of the impacted third molars was categorized based on the Pell and Gregory/Winter classification systems. Results: The most common third molar impaction position observed was vertical, followed by mesioangular and horizontal positions. The study found that a high gonial angle was more frequently observed in males, while a low gonial angle was more common in females. No significant association was identified between the type of mandibular third molar impaction and the gonial angle or ramus height. Additionally, individuals with high gonial angles had lower ramus heights. Individuals with impacted teeth in the “other” position had statistically higher gonial angles (p < 0.05). Conclusion: The study concludes that there is no significant correlation between the gonial angle, ramus height, and the type of mandibular third molar impaction. However, individuals with impacted teeth in the “other” position were found to have higher gonial angles, which may increase the risk of mandibular fractures. These findings show that although certain impaction types are more prevalent, mandibular anatomical parameters such as gonial angle and ramus height do not appear to significantly influence impaction patterns when assessed on panoramic radiographs.

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• ArticleAçık Erişim2026/r/ebyu/10067
  Radiographic root pulp visibility of the mandibular left second molar as an indicator of legal adulthood (≥ 18 Years): a panoramic study

  Akyuz, Mehmet; Magat, Guldane

  This study aimed to evaluate the diagnostic performance of mandibular left second molar root pulp visibility (RPV) for legal age classification (≥ 18 years) using panoramic radiographs. A total of 983 orthopantomograms (492 males, 491 females) were retrospectively analyzed. Root pulp visibility was classified according to the staging system described by Olze et al. Diagnostic performance measures, logistic regression analysis, and receiver operating characteristic (ROC) analysis were performed. A p-value < 0.05 was considered statistically significant. A statistically significant association was observed between pulp stage and legal age classification (p < 0.001). Logistic regression analysis demonstrated a stage-dependent increase in the odds of being classified as ≥ 18 years, with Stage 2 and Stage 3 showing strong predictive effects (OR = 6.04 and OR = 19.13, respectively). Diagnostic performance analysis indicated that Stage ≥ 2 demonstrated high specificity (0.94). ROC analysis revealed moderate discriminatory performance (AUC = 0.676; 95% CI: 0.647–0.705). Mandibular second molar root pulp visibility may serve as a useful radiographic marker for legal age threshold assessment, particularly at higher pulp stages.

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• ArticleYayıncıda açık erişim2025/r/ebyu/12059
  Cone beam computed tomography assessment of the anatomical variations in mandibular lingual foramen: A strobe retrospective cross-sectional study

  Ocak, Ali

  The anterior mandible is a region that may frequently receive insufficient attention in surgical interventions; however, is crucial to recognize that this area associated with significant complications due to the presence of lingual foramina and the vascular structures passing through it. Notably, these foramina may exhibit variations in both different numbers and locations, necessitating diligent during surgical planning. The objective of this study is to evaluate the location, distribution, and prevalence of the median lingual foramen and lateral lingual foramen (LLF) as identified through cone-beam computed tomography (CBCT) in a sample drawn from the Turkish population. Measurements were taken concerning the frequency, distribution, location, and diameter (Df) of both the median lingual foramen and LLF. Additionally, the vertical distance to the inferior border of the mandible (Hinf) for each foramen, the horizontal distance (Hhor) from the deepest point of the median lingual canal and lateral lingual canal to the buccal cortical plate, as well as the lengths of the canals (Lc) were systematically recorded. The analysis revealed no statistically significant differences in the prevalence of lingual foramina or in the measurements of Df, Hinf, Hhor, and Lc when comparing male and female patients. It was observed that all CBCT scans exhibited the presence of at least 1 lingual foramen in the mandible. Notably, a significantly greater occurrence of LLFs was identified in the mandibular premolar region compared to other anatomical regions. The findings indicate a higher prevalence of mandibular lingual foramina within the Turkish population compared to previous studies. Specifically, the variations in the anatomy of mandibular lingual foramina and canals warrant careful consideration through CBCT imaging prior to surgical interventions in proximity to the inner surface and basis of the mandible, particularly in the anterior and premolar regions, to mitigate the risk of potential complications.

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• ArticleAçık Erişim2024/r/ebyu/19726
  Sinus Maxillaris Morphometric Measurements and Comparative Anatomy Between Genders

  Sunar, Mukadder; Kolak, Merve; Ocak, Ali

  Objective: This study aimed to investigate the usability of the maxillary sinus as a criterion in gender determination by comparing the dimensions of the maxillary sinuses in adult males and females using cone-beam computed tomography (CBCT). Methods: Our study was designed to measure individuals’ bilateral maxillary sinus height, width, and depth with CBCT. A total of 100 patients, 50 women and 50 men between the ages of 18 and 70, were included in the study. The height (H), width (W), and depth (D) of the sinus were measured in the coronal and axial planes, and their statistical significance was evaluated. Results: In our results, the confidence interval was determined as 95% and P < .05, was considered significant. Right height (P < .001), right width (P = .045), and left height (P = .015) parameters were statistically higher in males than in females. In the discriminant analysis, the parameter that gave the best discrimination was the right height with 63%. Conclusion: In our study, it was observed that the sinus maxillaris dimensions were larger in male individuals than in female individuals, but it was concluded that it is not a definitive criterion on its own and can be used as a supporting one.

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