Alper Alkan

Effects of surgically assisted rapid palatal expansion with and without pterygomaxillary disjunction on dental and skeletal structures: a retrospective review.

OBJECTIVEnThe aim of this study was to evaluate and compare dental and skeletal changes in surgically assisted rapid palatal expansion (SARPE) patients with (+PP) and without (-PP) pterygomaxillary disjunction.nnnSTUDY DESIGNnThe study casts of 18 maxillary constriction patients indicated for SARPE formed the sample of this retrospective review. The sample was divided into 2 groups. Twenty linear and 2 angular measurements were performed on the study models.nnnRESULTSnAll transversal measurements increased after expansion in both the +PP and -PP groups. The -PP group showed greater expansion at the midpalatal and gingival levels, while the +PP group exhibited a greater increase of 0.78 mm at the apical base level and 11.25° less tipping in the molar teeth. A greater expansion of nearly 0.7 mm was measured in the premolar region of the +PP group.nnnCONCLUSIONSnBoth SARPE techniques resulted in significant maxillary expansion.

Effect of platelet-rich plasma on fibrocartilage, cartilage, and bone repair in temporomandibular joint.

PURPOSEnThe purpose of the present study was to explore the potential use of platelet-rich-plasma (PRP) in the treatment of temporomandibular joint osteoarthritis (TMJ-OA).nnnMATERIALS AND METHODSnSurgical defects were created bilaterally on the condylar fibrocartilage, hyaline cartilage, and bone to induce an osteoarthritic TMJ in rabbits. PRP was applied to the right joints of the rabbits (PRP group), and the left joints received physiologic saline (control group). After 4 weeks, the rabbits were sacrificed for histologic and scanning electron microscopy (SEM) examinations. The data were analyzed statistically.nnnRESULTSnThe new bone regeneration was significantly greater in the PRP group (P < .011). Although the regeneration of the fibrocartilage and hyaline cartilage was greater in the PRP group, no statistically significant difference was found between the 2 groups. SEM showed better ultrastructural architecture of the collagen fibrils in the PRP group.nnnCONCLUSIONSnPRP might enhance the regeneration of bone in TMJ-OA.

A new anatomical landmark to simplify temporomandibular joint arthrocentesis

rthrocentesis of the temporomandibular joint (TMJ) was rst described by Nitzan et al.1 and is an accepted treatment or various disorders of the TMJ. Their technique includes nsertion of two needles along the canthal-tragal line, the first f which is placed into the upper joint compartment of the MJ, and the second anterior to the first to allow effective avage of the joint (Fig. 1). However, in some cases it is diffiult to insert the second needle, which means that lavage fails, he operation takes longer, the patient is uncomfortable, and here may be increased postoperative morbidity and possible amage to the facial nerve.2 For this reason single needle rthrocentesis has been proposed, in which inflow and outow go through the same cannula.2 The joint is lavaged with a ingle needle used for injection and ejection resulting 40 ml f irrigation. However, with a single needle the amount of uid may be inadequate and the pressure too low. Previously, we have used a single cannula with two ports nd two lumens that allow irrigation and lavage of the joint ith the same device and permit sufficient irrigation under the esired pressure.3 Rehman and Hall4 used a similar device alled a Shepard cannula that holds two needles together. evertheless the device that keeps two needles together eems to be relatively thick, which has the potential to damge the nerve. Repetitive use of the device may cause the tips f the needles to blunt, and increase the risk of infection. We propose a new technique, by which the patients are sked to open and close the mouth several times so that the

A new approach to arthrocentesis of the temporomandibular joint.

We describe a new temporomandibular joint (TMJ) arthrocentesis technique using the irrigation pump from a surgical and dental implant motor, providing the highest hydraulic pressure reported in the literature for TMJ lavage.

Efficacy of platelet rich fibrin in the reduction of the pain and swelling after impacted third molar surgery: randomized multicenter split-mouth clinical trial.

BackgroundImpacted third molar removal is a routine procedure in oral and maxillofacial surgery. Platelet-rich fibrin (PRF) is a second generation platelet concentration which is produced by simplified protocol. The aim of this study was to assess the effectiveness of PRF in the healing process by evaluating the changes in pain and swelling after third molar surgery.MethodsFifty-six patients (23 male, 33 female) who provide the inclusion criteria were selected to participate in this study. The evaluation of the facial swelling was performed by using a horizontal and vertical guide. The pain was evaluated in the postoperative period using a visual analog scale (VAS) of 100xa0mm.ResultsHorizontal and vertical measurements showed more swelling at the control side (without PRF) in 3th day postoperatively (pu2009<u20090.05). There were no statistically significant differences regarding pain among the groups.ConclusionAs a conclusion, PRF seems to be effectiveness on postoperative horizontal swelling after third molar surgery. PRF could be used on a routine basis after third molar extraction surgery.

Anterior Mandibular Zone Safe for Implants

AbstractDuring implantology procedures, one of the most serious complications is damage of the inferior alveolar nerve (IAN). The mandibular incisive nerve is described as a terminal branch of the IAN and provides innervation to the lower anterior teeth and canines. The incisive nerve and canal are located in the interforaminal area. Although numerous studies report IAN damage during implant placement, few reports in the literature describes sensory disturbances, such as neuropathic pain, related to mandibular incisive nerve damage.The purpose of this retrospective clinical study was to evaluate the risk of neuropathic pain caused by implant placement in the interforaminal region of the mandible.Panaromic radiographs of patients who were treated with dental implants in the Department of Maxillofacial Surgery, Faculty of Dentistry at Erciyes University, between 2007 and 2012, were examined. Fifty-five patients with suspected relationship between mandibular incisive canal and dental implant were included into this study. Computed tomography scans were obtained from 10 patients who have postoperative neuropathic pain. Relationship between dental implant and mandibular incisive nerve was evaluated using a three-dimensional software program. Mandibular incisive nerve perforation by at least 1 implant was observed in all 10 patients. Descriptive analyses were also provided.Neuropathic pain may occur after implant placement in the interforaminal region due to the perforation of the incisive canal and nerve. According to the results of this retrospective study, the incisive canal and nerve perforation should be considered as a complication of implant surgery in the mandibular anterior area.

Osteochondroma of the mandibular coronoid process: a rare cause of limited mouth opening

c e nlargement of the coronoid process of the mandible was rst described by Langenbeck in 1899,1 but Jacob reported he pseudojoint between an enlarged mushroom-shaped andibular coronoid process and the zygoma, now known s Jacob disease.2 The hyperplastic structure of the corooid process in this disease is rare, and the development of n encapsulated osteochondroma and formation of a joint is nique.3 The symptoms of painless restricted mouth openng and an elongated coronoid process of the mandible seen n panoramic radiographs can be confused with those of emporomandibular dysfunction, ankylosis of the temporoandibular joint, and myofascial pain. Three-dimensional omputed tomography (CT) is the gold standard for accurate iagnosis.4

Determination of lingual vascular canals in the interforaminal region before implant surgery to prevent life-threatening bleeding complications

OBJECTIVESnProfuse hemorrhage and airway obstruction may occur during or after the implant surgery in the interforaminal region. The prevention from this complication requires identifying the location of the mandibular lingual vascular canals (MLVCs). The purpose of this study was to evaluate the anatomical variations of MLVCs and to determine the safety margins for implant placement in interforaminal region.nnnMATERIALS AND METHODSnComputer tomography (CT) images of 200 consecutive patients were reexamined retrospectively by a radiologist and a maxillofacial surgeon to evaluate the presence of the MLVCs entering the mandible. The diameter and the number of the canals, the distance between the entrance of the canal and mandibular midline, and the height of the entrances of the canals from the inferior mandibular margin were measured.nnnRESULTSnTwo hundred and thirty-six median lingual canals (MLCs) and 159 lateral lingual canals (LLCs) were found in 200 patients. Significant differences were found between the number of lingual canals in the midline and canine regions (P < 0.001).nnnCONCLUSIONnThere is a potential risk of complications due to the injuries of the vessels entering the lingual cortical bone through a number of bone canals during implant placement in the interforaminal region.

Oral mucosal involvement in Langerhans' cell histiocytosis: long-term follow-up of a rare case.

Langerhans cell histiocytosis (LCH) is a rare disease where different organs and systems may be affected. Oral involvement generally consists of mucosal ulceration associated with lesions of the underlying bone. Many reports exist about the misdiagnosis of this disease. Various symptoms may lead the clinician to an incorrect diagnosis, especially with multiple organ involvement. Oral manifestations are common, and dentists should be aware of this disease and evaluate intraoral findings accordingly. This study presents an LCH case characterized by oral mucosal ulcerations with no involvement of the underlying bone. A definitive diagnosis was made by open biopsy from the oral mucosa.

Alternative method to reposition the dislocated transport segment during vertical alveolar distraction.

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