Buket Aybar

Bilateral Oroantral Fistulas Following Devitalization Of Teeth By Arsenic Trioxide: A Case Report

Although it is well known that prolonged application or leakage of arsenic trioxide can cause severe damage to the periodontal tissues, the substance is still used by some dentists. This paper describes a case of arsenical necrosis of the jaws affecting the right and the left side of the maxilla. As a result of leakage into the tissues of an arsenical paste from the pulp chamber of endodontically treated teeth, bilateral oroantral fistula (OAF) occurred. It is concluded that there is no justification, whatsoever, for the use of arsenic in modern dental practice. In the following case, buccal advancement flap and submucosal palatal island flap techniques were used for to close the OAF. The submucosal palatal island flap technique resulted in successful closure of the OAF.

A technique for atraumatic extraction of teeth before immediate implant placement using implant drills.

Purpose:The purpose of this article is to present a minimally invasive technique using the implant drills to help extract teeth before the insertion of immediate implants. Materials and Methods:Nine patients (7 women and 2 men) aged 24 to 60 years having root fractures and dental caries were included in this study. Inclusion criteria for the study were presence of at least 4 mm of bone beyond the root apex, the absence of acute signs of infection or inflammation in the treatment area, and the absence of systemic pathologies that would contraindicate bone healing around implants. Heavy smokers were not included in the study. Extraction was done after thinning the root walls by the help of the implant drills. After extraction, implant sites were prepared and implants were inserted. In 2 of the cases, the peri-implant bone defect was filled with autogenous bone graft. Results:Healing progressed uneventfully in all 9 cases. The use of implant drills to thin the root walls provided atraumatic tooth extraction protecting the thin buccal bone. At second stage surgery, all implants were asymptomatic, immobile, and osseointegrated. The soft tissue anatomy was clinically acceptable in all patients. Radiographic examination of all 9 implants showed no peri-implant radiolucency at the end of a year. Conclusion:Successful osseointegration and complete bone healing were observed for all patients. The new extraction technique was found to be effective in immediate implant cases in order not to damage the thin plate of buccal bone.

Measurement of the lingual position of the lower third molar roots using cone-beam computed tomography.

PURPOSE The aim of this study was to evaluate the distance between the roots of the impacted third molars and the floor of the mouth to predict the risk of lingual root displacement during surgery. MATERIALS AND METHODS Thirty-one patients (5 men and 26 women) were evaluated for this study using cone-beam computed tomography (CBCT). The teeth were grouped according to their position on the orthopantomogram as vertical, mesioangular, horizontal, and distoangular. The distance between 2 points on the roots and lingual soft tissues was measured. RESULTS The average distance between the apex of the root, which is in the most lingual position, and the lingual cortical plate was 1.03 mm. The average distance between the most lingual point on the apical half of the root, which is in closer proximity, and the lingual cortical plate was 0.65 mm. CONCLUSION The distance between the apices and the lingual plate is very short, which allows displacement of broken roots or teeth, especially when the lingual plate is perforated.

Effects of bone morphogenetic protein on neonatal rat calvarial osteoblast-like cells: An in vitro study

Bone morphogenetic proteins (BMPs) are factors that promote osteoblastic differentiation and osteogenesis. The aim of this study was to examine the behavior of neonatal rat calvarial osteoblast cells cultured on different concentrations of BMP graft materials. Fifty thousand cells per milliliter were seeded and cultured on graft materials for 24 and 48 h. Different concentrations of BMPs (combination of BMPs numbered from 1 to 14) were supplemented to the medium. To evaluate cellular proliferation and differentiation, specimens were examined for DNA synthesis, alkaline phosphatase (ALP) activity, cell numbers, and viability of the cells. Further, transforming growth factor-beta(1) (TGF-beta(1)) and lactate dehydrogenase (LDH) levels were investigated. Morphological appearance of the specimens at 24 and 48 h of incubation was evaluated using scanning electron microcopy. Evaluations of DNA synthesis, cell count, and cell viability data revealed that a significant difference existed at 24 and 48 h (p < 0.05). The TGF-beta(1) and ALP analysis showed only a significant difference between the groups at the end of 24 h (p < 0.05). Regarding the lactate dehydrogenase activity there was not any significant difference at 24 and 48 h (p > 0.05). No morphological differences were observed in cell morphology on BMP graft material and the control group. These results indicate that BMPs have an inductive effect on osteoblast differentiation and a possible inhibitory effect in the early phases of cell proliferation.

Effects of bone morphogenetic proteins on osteoblast cells: vascular endothelial growth factor, calcium, inorganic phosphate, and nitric oxide levels.

Purpose:Bone morphogenetic proteins (BMPs) play an important role in the initiation of bone formation by affecting cell growth and differentiation in a variety of cell types including osteoblasts. Vascular endothelial growth factor (VEGF) is an important regulator of angiogenesis and vasculogenesis, and also, VEGF signaling is important for skeletal development. Nitric oxide (NO), calcium (Ca), and inorganic Phosphate (Pi) are important molecules for cell functions. In this study, the effects of BMP on VEGF, Ca, NO, and Pi levels were investigated in an osteoblast cell culture. Materials:Fifty thousand cells per milliliter were seeded and cultured on graft materials for 24 and 48 hours. Different concentrations of BMPs (combination of BMPs numbered from 1 to 14) were supplemented to the medium. Results:BMP was found to increase VEGF (P = 0.00), Ca (P = 0.02), and Pi (P = 0.00) especially in the first 24 hours. The increase in the NO in the experimental groups were found to be statistically insignificant (P = 0.12). Conclusion:Our data state that further investigation should be performed on the effects of BMPs on osteoblast cell membranes and membrane receptors and cell signaling, together with their known effects on early phases of bone and vascular epithelial tissue formation.

Effects of Hemostatic Agents on Fibroblast Cells

Purpose:Hemostatic agents may be used topically to control hemorrhage, especially in patients with bleeding disorders. The agent used may have a negative effect on the tissue prolonging the healing time. The aim of this study was to compare the effects of 3 different hemostatic agents on fibroblast cells on a rat primary fibroblast cell culture model. Materials and Methods:Ankaferd Blood Stopper (ABD) (Ankaferd Pharmaceuticals Cosmetics Production and Marketing Co.), fibrin glue, and tranexamic acid were the agents to be evaluated for their effects on cell proliferation, cell numbers, cell viability, and cell morphology. Also lactate dehydrogenase, basic fibroblast growth factor, and vascular endothelial growth factor C levels were measured. Results:It was found that all of the agents used in the study have negative effects on fibroblasts, with ABD having the lowest values of cell proliferation, cell number, and cell viability. Conclusion:The results of this study indicate that ABD, fibrin glue, and tranexamic acid may negatively affect tissue healing.

Immediate implant placement without bone grafting: a retrospective study of 110 cases with 5 years of follow-up.

Purpose:Immediate implant placement not only reduces the number of surgeries necessary but also decreases the treatment time and treatment costs. The purpose of the study was to present the clinical results of 110 cases of immediate implant placement without using graft materials at the end of 5 years. Materials and Methods:One hundred and ten implants in 72 patients were included in the study. Inclusion criteria for the patients were presence of at least 2 mm of bone beyond the root apex, the absence of acute signs of infection or inflammation in the treatment area, and the absence of systemic pathologies that would contraindicate bone healing around implants. In cases where bone grafting was necessary, the implant was excluded from the study. Results:Healing progressed uneventfully in 105 cases. Four implants were lost as a result of infection in the first 3 months and 1 implant was lost 1 year after the functional loading of the prosthesis. The soft tissue anatomy was clinically acceptable in all patients. The implants that were placed in the extraction sockets of infectious teeth had also acceptable survival rates and clinical success. Conclusion:With proper patient selection, immediate implant placement without bone grafting has predictable survival rates and clinical success.

Management of a mandibular fracture accompanying a gunshot wound.

Gunshot injuries of the mandible can result in high rates of complications, especially in cases of bone loss. A fractured mandible accompanying a gunshot wound almost always has an external wound; the fracture is always compound and comminuted. Sometimes management of these injuries may require multiple surgical interventions. In this clinical report, treatment of a patient, who had a mandibular fracture due to a gunshot wound, is presented.A 52-year-old man with a mandibular fracture in the right mandibular body accompanying a gunshot wound was operated on. Owing to a nonunion, a second surgery was performed using reconstruction plates after hyperbaric oxygen treatment. Healing was uneventful after the second surgical intervention.

The influence of titanium surfaces in cultures of neonatal rat calvarial osteoblast-like cells: an immunohistochemical study.

Background:The goal of this present study was to evaluate the behavior of neonatal rat calvarial osteoblast-like cells cultured on different implant surfaces. Materials:Sandblasted acid-etched (SLA) surfaces of 2 different companies with different alloy properties were used. These were named as SLA-1 and SLA-2. The osteoblasts behavior were analyzed on sand blasted-acid etched (SLA-1) surface (Straumann, Basel, Switzerland), sand blasted-acid etched (SLA-2) surface (Alpha bio, Petach-tikva, Israel), acid-etched surface (Alpha bio), machined surface (Alpha bio). To analyze the effect of titanium surfaces on cell proliferation, cell numbers, and cell viability cells were cultured on titanium discs for 7 days and measurements were held out at 24 hours and on day 7. Cell proliferation rate was assessed by bromodeoxyuridine (BrdU) immunohistochemical technique. Cell morphologies were evaluated by scanning electron microscopy. Results:The highest number of BrdU labeled cells were seen on SLA-1 group at the end of 24 hours. The number of cells was found to be the highest in the acid-etched group on the 7th day, even though there were no significant differences between the groups at the end of 24 hours. Scanning electron microscopy views showed the morphological differences between the groups. Osteoblasts were able to proliferate on all of the tested surfaces, with differences in cell count and DNA synthesis values between the groups. Conclusion:Implant surface characteristics may modulate the biological response of osteoblast-like cells depending on the manufacturing techniques and cell culturing procedures.

The effects of pulsed electromagnetic field (PEMF) on osteoblast-like cells cultured on titanium and titanium-zirconium surfaces.

Background Commercially pure Ti, together with Ti Ni, Ti-6Al-4V, and Ti-6Al-7Nb alloys, are among the materials currently being used for this purpose. Titanium-zirconium (TiZr) has been developed that allows SLActive surface modification and that has comparable or better mechanical strength and improved biocompatibility compared with existing Ti alloys. Furthermore, approaches have targeted making the implant surface more hydrophilic, as with the Straumann SLActive surface, a modification of the SLA surface. Purpose The aim of this study is to evaluate the effects of pulsed electromagnetic field (PEMF) to the behavior of neonatal rat calvarial osteoblast-like cells cultured on commercially pure titanium (cpTi) and titanium-zirconium alloy (TiZr) discs with hydrophilic surface properties. Materials and Methods Osteoblast cells were cultured on titanium and TiZr discs, and PEMF was applied. Cell proliferation rates, cell numbers, cell viability rates, alkaline phosphatase, and midkine (MK) levels were measured at 24 and 72 hours. Results At 24 hours, the number of cells was significantly higher in the TiZr group. At 72 hours, TiZr had a significantly higher number of cells when compared to SLActive, SLActive + PEMF, and machine surface + PEMF groups. At 24 hours, cell proliferation was significantly higher in the TiZr group than SLActive and TiZr + PEMF group. At 72 hours, TiZr group had higher proliferation rate than machine surface and TiZr + PEMF. Cell proliferation in the machine surface group was lower than both SLActive + PEMF and machine surface + PEMF. MK levels of PEMF-treated groups were lower than untreated groups for 72 hours. Conclusions Our findings conclude that TiZr surfaces are similar to cpTi surfaces in terms of biocompatibility. However, PEMF application has a higher stimulative effect on cells cultured on cpTi surfaces when compared to TiZr.