Berkay Tolga Suer

The evaluation of the effects of hyperbaric oxygen therapy on new bone formation obtained by distraction osteogenesis in terms of consolidation periods.

ObjectiveThe aim of this study was to evaluate the effect of hyperbaric oxygen therapy on new bone formation obtained by distraction osteogenesis in long- or short-term consolidation periods.Materials and methodsTwenty-four rabbits were used. The animals were divided into two groups of 12 animals each, and vertical mandibular distraction osteogenesis was performed. Hyperbaric oxygen therapy was administered in the first group. Each group was subdivided into two subgroups according to the 30- and 60-day consolidation period. The acquired bone amounts were compared according to their radiographic density and histopathology.ResultsHistopathologically, in the experimental group, callus formation was increased and the new bone was more mineralized. According to the radiographic densitometry analyses, there were no statistically significant differences between the 30-day consolidated subgroups of the experimental group and the 60-day consolidated subgroup of the control group (p = 0.873).ConclusionHyperbaric oxygen therapy can be used to increase the quality and the quantity of bone and to decrease the maturation time which may shorten the consolidation period of vertical distraction osteogenesis.Clinical relevanceThe effect of hyperbaric oxygen therapy on vertical distraction osteogenesis procedure according to consolidation periods has been determined. Hyperbaric oxygen therapy may increase the quality and the quantity of bone and shorten the consolidation period.

Biomechanical evaluation of a new design titanium miniplate for the treatment of mandibular angle fractures

The optimal management of mandibular angle fractures remains controversial. The aim of this experimental study was to test the stability and resistance to mechanical force of a new titanium miniplate design. Thirty fresh sheep hemimandibles, sectioned at the angle region, were used to evaluate two plating techniques. One group received fixation via a new design single non-compression titanium miniplate and the second group via a six-hole straight non-compression titanium miniplate. A custom-made biomechanical test model was used for the samples. Each hemimandible was subjected to compressive and tensile forces using an Instron machine. The biomechanical forces (N) that caused 4-mm displacement or fixation loosening were compared. Comparison between the groups showed that fixation with the new design miniplate had more resistance to lateral compression forces than with a six-hole straight miniplate (P<0.009). Moreover, the new design miniplate fixation displayed more resistance to vertical compression and tensile forces (P>0.46 and P>0.61, respectively). The study demonstrated that mandibular fracture fixation with the new design non-compression titanium miniplate offered greater resistance to lateral displacement forces and may also provide increased resistance to vertical compressive and tensile forces than a conventional six-hole straight miniplate.

Finite-Element Analysis of a New Designed Miniplate which is Used via Intraoral Approach to the Mandible Angle Fracture: Comparison of the Different Fixation Techniques.

AbstractThe mandible is the largest facial bone as well as the most commonly fractured bone in the maxillofacial region. Despite numerous studies conducted to identify optimal treatment modalities and plates configurations for intraoral and transoral approaches, no definitive conclusion has been reached.This study used finite element analysis (FEA) to assess 4 scenarios for treatment of an angle fracture (6-hole noncompression miniplate; 6-hole single plate/Champys technique, 3D strut plate; 2 parallel 4-hole noncompression miniplates). Analysis included segmental displacement and Von Mises Stress evaluations of a 3D reconstruction of a human mandible.Von Mises Stress values for plates did not vary significantly among treatment groups. Moreover, no significant differences were observed in cumulative displacement of segments subjected to vertical and horizontal loads, with all treatment configurations demonstrating clinical acceptability.

Effects of the hyperbaric oxygen on de novo bone formation during periosteal distraction.

Objective The purpose of this study was to investigate the effect of hyperbaric oxygen (HBO) therapy on de novo bone formation during periosteal distraction (PD). Materials and Methods Periosteal distraction was performed in 24 mature male New Zealand rabbits using a custom-designed device placed on the lateral surface of the mandibular corpus. Twelve rabbits (group H) were given adjunctive HBO treatment, whereas 12 rabbits (group N) were kept in a normal environment (normobaric oxygen). After a 7-day latency period, the same distraction protocol was applied to both groups. However, the rabbits in group H were treated with pure oxygen at 2.4 atm absolute for 25 times. Both groups were further divided into 2 subgroups and killed after consolidation periods of 4 and 8 weeks. Photodensitometric and histologic analyses were performed to evaluate the newly formed bone. Results There was no significant difference between the 4-week consolidated HBO group and the 8-week consolidated normobaric oxygen subgroup (P = 0.229). Moreover, there was better bone formation in the 8-week HBO group than in the 8-week control group. Conclusion The results of this study indicate that PD with HBO could be used to increase the quality and the quantity of the bone newly formed by PD.

The use of piezoelectric surgery in oral and maxillofacial surgery

P therapy (PDT) is a modern approach in dentistry where light of an appropriate wavelength is used in the presence of a specific photosensitizer (PS) to eradicate target cells selectively. Although PDT is more widely known for its application in the treatment of neoplasms, PDT shows great potential in the treatment of periodontitis. Treatment of patients with periodontitis of varying extent and severity can be often challenging and difficult. Although scaling and root planing still remains to be the gold standard for the non-surgical treatment of periodontal disease, however, it has been noticed that in some cases, adjuctive treatment modalities are required to suppress periodontal pathogens and augment the effect of conventional mechanical treatment. Therefore, photodynamic therapy (PDT) has been suggested as an alternative treatment modality in managing periodontitis. Various clinical trials have been conducted to evaluate the effects of PDT as an adjunct in the management of chronic and aggressive periodontitis patients. While there is still inconclusive data regarding a definitive benefit for PDT along with SRP in the treatment of periodontitis, its noteworthy that several clinical trials have shown additional clinical, microbiological, immunological and patient-based benefits when PDT and SRP were given in combination to patients with periodontitis. This presentation is an evidence-based approach to summarize the results of the available literature for clinical protocol for application of photodynamic therapy. It is intended to aid the clinicians and academicians in making evidence-based treatment decisions regarding PDT as a nonsurgical treatment modality in management of periodontal diseases.Associate Professor, Department of Pediatric Dentistry, School of Dentistry, Islamic Azad University Isfahan (Khorasgan) Branch, Isfahan, Iran Associate Professor, Department of Restorative Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran Postgraduate Student, Department of Restorative Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran Dentist, Private Office, Isfahan, Iran Dentist, Private Office, Shahrekord, IranP surgery device or ultrasonic surgery device was originally developed for the atraumatic cutting of bone by way of ultrasonic vibrations and as an alternative to the mechanical and electrical instruments that are used in conventional oral surgery. Even though piezoelectric bone surgery is a relatively new alternative for bone-related procedures in oral and maxillofacial surgery, over the past two decades, increasing amount of literature has shown the application of piezosurgery within dental surgery, implantology and maxillofacial surgery. Recent publications have also shown the benefits of their use in craniofacial surgery, plastic and reconstructive surgery, head and neck surgery, neurosurgery, ophthalmology, traumatology, and orthopaedics. Key features of piezosurgery include the selective cutting of bone without damaging the adjacent soft tissue (e.g. vessels, nerves or mucosa), providing a clear visibility in the operating field by the way of pressurized irrigation and cavitation phenomenon, as well as cutting with micron sensitivity without the generation of heat. According the literature large initial costs of this innovative tool could be considered one of the disadvantages. The other main disadvantage would be the increased operation times when compared with conventional techniques in Oral and Maxillofacial procedures. The author of this presentation describe the current status of the application of piezosurgery within oral and maxillofacial surgery facilitated by the use of clinical case examples and argue that piezosurgery should take a place in the surgical armamentarium of a surgeon that deals with bone procedures.T expanding role of endodontics into different phases of dental treatment is illustrated by the awareness of its relationship with orthodontics. Orthodontic treatment is done for gaining esthetic appearance for the patient & for the establishment of proper occlusion. However, there is a paucity of information on the concise relationship between endodontics and orthodontics during treatment planning decisions. This relationship ranges from effects on the pulp and potential for root resorption from orthodontic treatment to the clinical management of teeth requiring integrated endodontic and orthodontic treatment. This paper presentation will address the consequences of tooth movement on the pulp and preventive measures to be taken to maintain its vitality. Other areas such as comparison of various endodontic procedures on teeth movement and effects of teeth movement on apical seal will also be covered. Towards its end, the presentation will cover the treatment planning with combined orthodontic-endodontic therapy, necessary to gain the desired endodontic result and ascertain better prognosis.A a stroke the mouth can become a very unhealthy place and act as a reservoir for opportunistic oral microbiota. The growth and proliferation of opportunistic microbiota can not only result in deteriorating oral health status but lead to systemic upsets with life-threatening consequences and impact for stroke rehabilitation. Maintaining oral hygiene in the initial periods following stroke is problematic as often stroke survivors experience loss of motor function of the limbs required for oral self-care. Patients with stroke are commonly encountered difficulties in swallowing and, therefore, are at a greater risk of aspiration pneumonia from microbiota originating in the oral cavity. Thus good oral hygiene for stroke survivors is of key importance to potential lifesaving effects. Patients require specific information and assistance on the oral care to enable them to maintain good oral hygiene. Hence, empowerment of caregivers is crucial and important. Caregivers may need to be vigilant of this and to assist patients with stroke to maintain oral hygiene so as to prevent not only oral diseases that further compromise their rehabilitation, but also to prevent life threatening events. Improved in oral health knowledge, attitude and behaviors of the caregivers may provide better delivery of oral health care to patients. Hence helps to improve the oral health conditions in patients. This presentation will explore the gap present in implementing oral health care and the importance of caregivers in maintaining good oral hygiene to patients with stroke.

Clinical Evaluation of the Use of Tibial Bone Grafting in Dentoalveolar Reconstructive Surgery.

Objective: The aim of this study was to evaluate the efficacy of tibial autogenous bone grafting in the treatment of patients with alveolar bone defects. Materials and Methods: The study subjects consisted of 12 patients (10 male, 2 female, age: 19-51 years) who underwent reconstructive autogenous bone-grafting procedures. The medial approach to the tibial bone was used to harvest autogenous cancellous bone grafts in all the patients. Clinical parameters (complications at the donor and recipient sites, resorption and volume of the grafts) were evaluated retrospectively. Results: The mean age of the patients was 36.25 ± 0.9 years. Of the 12 patients, 5 (41.7%) received bone grafts for sinus augmentation, 3 (25%) for cyst cavity reconstruction and 4 (33.3%) for alveolar cleft reconstruction procedures. The average follow-up period was 28.4 months (range: 21-40 months). An average of 5.2 cm3 of cancellous bone was harvested for grafting procedures. All the grafting procedures were successful, and there were no surgical complications during the harvesting protocol. In all cases, pain and gait disturbance lasted less than 2 weeks. Conclusion: The results of this study suggest that the use of tibial autogenous bone graft harvested using a medial approach was a safe, simple and effective method for grafting various alveolar bone defects where high amounts of cancellous bone grafts were needed with low morbidity.

Bifosfanat kullanimina bağli çenelerde gelişen osteonekrozlar: Çok merkezli retrospektif çalişma

Bifosfonatlar (BP), metastatik kemik hastaliklari ve osteoporoz tedavisinde kullanilan kemik rezorbsiyonu inhibitorleridir. Bifosfanat kullanimina bagli cenelerde gelisen osteonekroz (BBCO), cenelerinde radyasyon tedavisi gormemis, bifosfanat kullanan ya da kullanmis hastalarda mandibula ya da maksillada 8 haftadan daha uzun suren kemik ekspozu ile karakterize bir durum olarak tanimlanmistir. Bu calismada farkli merkeze yonlendirilen BBCO vakalari retrospektif olarak sunulmustur. 2012 ve 2013 yillarinda GATA Haydarpasa Egitim Hastanesi Dis Hekimligi, Kocaeli Universitesi Dis Hekimligi Fakultesi, ve Kirikkale Universitesi Dis Hekimligi Fakultesi, Agiz, Dis ve Cene Cerrahisi kliniklerine basvuran BBCO tanisi konulmus 18 hastanin demografik ozellikleri, anamnez bulgulari, klinik muayene bulgulari, bifosfanat cesidi ve kullanim bilgileri (sure, uygulama yolu) ve eger varsa ilgili sebep acisindan degerlendirmeleri yapilmistir. Hastalarin 12’ sinde mandibula (% 67), 5’ inde maksilla (%28) ve 1 hastada ise hem mandibula hem maksillada (%5) BBCO izlendi. Hastalarin 2 tanesi osteoporozis (% 11) nedeniyle 16 hasta ise (% 89) onkolojik tedavi nedeniyle bifosfanat grubu ilac kullanmaktaydi. Tip ve dis hekimligini ortak olarak ilgilendiren konu olmasi itibariyle bifosfanat grubu ilac tedavisine baslanacak hasta gruplarinin ortak klinikler tesis edilerek takip edilmeleri ve bilgi paylasimlariyla ortaya cikabilecek olasi komplikasyonlarin azaltilabilecegini dusunmekteyiz.