Celal Tümer

In-patient comparison of immediate and conventional loaded implants in mandibular molar sites within 12 months.

OBJECTIVES The aim of this prospective clinical study was to evaluate the clinical outcomes of dental implants placed in the mandibular molar sites and immediately functionally restored compared with conventionally loaded controls in an in-patient study. MATERIAL AND METHODS Twenty-four dental implants were placed in 12 patients who had first molar loss bilaterally in the mandibular area. One site of the patient was determined as immediately loaded (IL) and the other side was conventionally loaded (CL). Resonance frequency analyses for implant stability measurements, radiographic examinations for marginal bone levels and peri-implant evaluations were performed during the clinical follow-up appointments within 12 months. RESULTS During the 12-month follow-up period, only one implant was lost in the IL group. The mean implant stability quotient values were 74.18+/-5.72 and 75.18+/-3.51 for Groups IL and CL at surgery, respectively, and the corresponding values were 75.36+/-5.88 and 75.64+/-4.84 at 1-year recall, respectively. The difference was not statistically significant between the two groups during the 12-month study period (P>0.05). When peri-implant parameters were evaluated, excellent peri-implant health was demonstrated during the 1-year observation period and all implants showed less than 1 mm of marginal bone resorption during the first year. CONCLUSIONS In the present study, immediate functionally loading did not negatively affect implant stability, marginal bone levels and peri-implant health when compared with conventional loading of single-tooth implants.

Seven-Year Follow-Up Results of TiUnite Implants Supporting Mandibular Overdentures: Early versus Delayed Loading

BACKGROUND AND PURPOSE Implant-supported mandibular overdentures have recently become a popular treatment alternative for edentulous patients desiring increased retention of complete dentures. The goal of this study was to evaluate and present treatment outcomes of mandibular overdentures retained by two unsplinted, early-loaded implants and compare these results with those for delayed-loaded implants. MATERIAL AND METHODS Twenty-six edentulous patients had two interforaminal implants placed with a one-stage protocol. The patients were each treated with a mandibular overdenture supported by ball abutments. In the test group, the overdenture was loaded 1 week after surgery and in the control group, the overdenture was loaded 3 months after surgery. Standardized clinical and radiographic parameters were recorded at surgery, and after 3, 6, 12, and 18 months, and 2, 3, 4, 5, and 7 years. RESULTS Because two patients did not make the 7-year recall, only 24 patients (48 implants) were evaluated in this study. No implants were lost, and 1.31 ± 0.2 mm marginal bone resorption was noted for all implants after 7 years. Implant stability measurements, clinical peri-implant parameters and marginal bone levels exhibited no statistically significant differences between the two groups over 7 years. CONCLUSION The results of this clinical trial show that there is no significant difference in the clinical and radiographic outcomes of patients treated with mandibular overdentures supported by TiUnite implants that are either early or delayed loaded.

Early versus Delayed Loading of Mandibular Implant‐Supported Overdentures: 5‐Year Results

BACKGROUND AND PURPOSE Because of poor retention of complete removable dentures for edentulous patients, implant-supported mandibular overdentures have lately become a popular alternative for them. The aims of this prospective study were to evaluate treatment outcomes of mandibular overdentures supported by two unsplinted early-loaded implants and compare these results with those for delayed-loaded implants. MATERIALS AND METHODS A total of 26 edentulous patients were treated with two unsplinted implants supporting a mandibular overdenture. All implants were placed in the canine regions of each mandible according to the one-stage surgical protocol. There were two groups: test group, in which the overdenture was connected 1 week after surgery, and control group, in which the overdenture was connected 3 months after surgery. Standardized clinical and radiographic parameters were recorded at surgery, and after 3, 6, 12, and 18 months, and 2, 3, 4, and 5 years. RESULTS No implants were lost, and 0.93 +/- 0.3 mm marginal bone resorption was noted for all implants after 5 years. Clinical implant stability measurements, clinical peri-implant parameters, and marginal bone resorptions showed no statistically significant differences between the two groups over 5 years. CONCLUSION The results of this prospective clinical study suggest that there is no significant difference in the clinical and radiographic state of patients treated with implant supported mandibular overdentures loaded either 1 week or 3 months after surgery.

Neuroradiological findings in a mother and daughter with Gorlin syndrome

A mother and daughter with Gorlin syndrome with similar neuroradiological findings are reported. These include calcification of the falx cerebri and tentorium cerebelli and dysgenesis of the corpus callosum and vermis. Vermian dysgenesis was detected in both mother and daughter suggesting a previously unrecognized finding associated with Gorlin syndrome.

Possible impact of inflammatory status on C‐telopeptide pyridinoline cross‐links of Type I collagen and osteocalcin levels around oral implants with peri‐implantitis: a controlled clinical trial

Detection of progression level of peri-implantitis may help in the prevention of oral implant failure. C-telopeptide pyridinoline crosslinks of Type I collagen (ICTP) and osteocalcin (OC) are specific markers of bone turnover and bone degradation. Determination of the ICTP and OC levels in the peri-implant sulcus fluid (PISF) may predict the metabolic and/or inflammatory changes in the peri-implant bone. The aim of this clinical study was to evaluate ICTP and OC levels in the PISF for oral implants with and without peri-implant bone destruction and correlate these levels with the traditional clinical peri-implant parameters (probing depth, plaque index, gingival index and gingival bleeding time index) and radiographic bone level measurements. Fifteen patients with 30 peri-implant sites with bone destruction (radiographic bone loss) and health were included. Clinical parameters were measured and PISF was collected from the sites. Peri-implant sulcus fluid ICTP and OC levels were detected by radioimmunoassay technique from PISF samples. All clinical parameters demonstrated a significant increase in peri-implantitis sites compared with healthy sites. The PISF volume of the peri-implantitis sites was also significantly higher than of the healthy peri-implant sites. Although not statistically significant, a trend of increase was demonstrated in ICTP PISF samples sampled from peri-implantitis sites compared with healthy sites. A significant increase was noticed for OC PISF level in peri-implantitis sites compared with healthy ones. As well as peri-implant clinical measurements, volumetric changes at PISF may be counted as an important clinical parameter to distinguish the bone destruction sites from healthy sites around oral implants.

A 12-month evaluation of nitrite oxide metabolism around immediate and conventionally loaded dental implants.

Background:During bone remodeling, alignment of bone is affected by loading direction. Considerable amount of data also suggest nitric oxide (NO) to be involved in bone metabolism. This study was conducted to evaluate the potential changes in NO metabolism in relation to the loading style of dental implants by analyzing the nitrite content of peri-implant sulcus fluid. Methods:Dental implants were placed in 12 patients who had first molar loss bilaterally in the mandibular area. One site of the patient determined as immediately loaded and the other side were conventionally loaded. Clinical parameters were recorded and peri-implant sulcus fluid samples were obtained. Peri-implant sulcus fluid nitrite levels were spectrophoto-metrically determined. Clinical measurements and nitrite analysis were repeated at 1, 3, 6, 9, and 12 months. Results:In both groups, there was a reduction between baseline and 12 months in all clinical parameters, except probing depth. Although, steady decrease was noticed in total nitrite levels during the whole experimental period in immediately loaded implants, more fluctuations were observed in conventionally loaded ones. Conclusions:The findings of this 12-month follow-up study support the association of NO in the bone metabolism around dental implants and further suggest the impact of different loading regimens on NO metabolism.

Familial ring (18) mosaicism in a 23-year-old young adult with 46,XY,r(18) (::p11→q21::)/46,XY karyotype, intellectual disability, motor retardation and single maxillary incisor and in his phenotypically normal mother, karyotype 47,XX,+r(18)(::p11→q21::)/46,XX.

We report on a 23‐year‐old man with craniofacial findings of the holoprosencephaly spectrum disorder (microcephaly, hypotelorism, depressed nasal bridge, single median maxillary central incisor), fusion of C2–C3 vertebrae, intellectual disability, and severe sleep apnea. Chromosome analysis of blood lymphocytes showed 75% ring (18) cells and 25% normal cells, karyotype mos 46,XY,r(18)(::p11→q21::)[75]/46,XY[25]. His mother was phenotypically normal except for a double ureter and bifid renal pelvis as in his son. She had a supernumerary ring (18) in 10% of blood lymphocytes, karyotype mos 47,XX,+r(18)(::p11→q21::)[10]/46,XX[90]. Familial ring (18) is a rare cytogenetic abnormality. This is the first report of a mother with a supernumerary ring (18) and a son with ring (18) mosaicism. Interestingly, the son showed a true mosaicism (mixoploidy) of ring (18) and normal cells. The mothers 46,XX cells could be easily explained by mitotic instability and ring loss during cell division. However, the coexistence of ring (18) and normal cells in the son is unusual. Possibly, during early postzygotic divisions of a 47,XY,+r(18) zygote, two (possibly subsequent) genetic events could have occurred, one when one normal chromosome 18 was lost (resulting in a cell line with ring 18), and one when the ring 18 was lost (resulting in a cell line without ring, “escape to normal”). Alternatively, the zygote of the son could have been 46,XY,r(18), and postzygotic loss of the ring 18 could have resulted in monosomy 18 cells followed by duplication of chromosome 18 in these cells (a rare mechanism for cell survival previously described as “compensatory” isodisomy).

INVERTED POZİSYONDA GÖMÜLÜ ÜST SANTRAL KESİCİ DİŞİN TRANSPLANTASYONU

OZET: Genellikle komsu dis veya patoloji nedeniyle surmesi geciken veya duran dislere ‘gomulu dis’ adi verilir. Klinik olarak antagonist disin surmus olmasi gomukluk suphesi uyandirirken, karsi taraf simetrik disin agiz icindeki varligi, gomuklugu hemen hemen kesinlestirir. Supernumere disler genellikle maksiller anterior bolgede konumlanip, iki santral dis arasinda bulundugunda ‘mesiodens’ olarak adlandirilirlar ve birden cok sayida bulunabilirler. Inverted pozisyonda, mesiodens dislerle birlikte gorulen gomulu santral kesici dis ise cok enderdir. Bu olgu raporunda 13 yasinda bir erkek cocukta gerceklestirilmis inverted pozisyondaki santral kesici disin transplantasyonunun preoperatif, operatif ve postporetaif bulgulari sunulmaktadir.

YAYGİN ORAL LEUKOPLAKİNİN TEDAVİSİNDE ND-YAG LASER (BİR OLGU RAPORU) TREATMENT OF WIDESPREAD ORAJ LEUKOPLAKIA WITH ND-YAG LASEB (A CASE REPORT)

Ozet Oral leukoplaki, oral mukozada gorulen en yaygin (% 85) prekanseroz lezyondur ve malign transformasyonun % 4-5 oldugu belirtilmektedir, Lezyon oral kavite-nin her yerinde ve siklikla bukkal mukoza ve kommis-surlarda lokalize olmaktadir. Bunu gorulme sikligi sirasiyla; alveoler mukoza, dil, dudak, sert ve yumusak damak, agiz tabani ve gingiva izlemektedir. Oral leukoplaki lezyonlari oldukca farkli boyut, lokalIzasyon ve klinik goruntu vermektedir. Lezyon erkeklerde kadinlardan daha sik ve ozellikle 40 yas uzerinde gorulmektedir. Leukoplakinin etyolojisi cok degiskendir. Lezyonlarin olusmasi sadece (disaridan gelen) lokal faktorlere bagli olmayip ayni zamanda (Iceriden gelen) predispozan faktorlerede bagli olabilir. Tutun, alkol kullanimi, oral sepsis, lokal irritasyon, vitamin eksikligi, hormonal bozukluklar ve galvanik akim gibi faktorler siklikla sorumlu olmaktadir. Lokal faktorlerin elimine edilmesi yeterli olmakta ancak israrli lez-yonlarda konservatif cerrahi eksizyon, elektrokoter ve laser cerrahisi uygulanmaktadir. Sunulan olguda, 46 yasinda erkek hasta maksiller ve mandIbuler kretlcr uzerinde israrli ve yaygin lezyonlardan yakinarak klinigimize basvurdu. Klinik ve histopatolojik inceleme sonrasi lezyonlar basarih bir sekilde laser cerrahisi ile tedavi edildi. Anahtar sozcukler: Leukoplaki, laser tedavisi. Abstract Oral leukoplakia is the most common (% 85) premalig-nant lesion which is seen in oral mucosa and it has been reported that malignant transformation rate is 4-5 percent. Although lesion may be found anywhere in the oral cavity, the buccal mucosa and commissures were most frequently involved, followed in descending order by alveolar mucosa, tongue, lip, hard and soft palates, floor of the mouth and gingiva. The lesions of oral leukoplakia show considerable variation in size, location and clinical appearance. This lesion is more common in men man in women and that it is seen chiefly over the age of 40. The etiology of leukoplakia to be a varied one. Tlie initiation of the condition may depend not only upon exhinsic local factors, but also upon intrinsic predisposing factors. Factors most frequently blamed have been tobacco, alcohol, oralsepsis, local irritation, syphilis, vitamin deficiency, endocrine disturbances and galvanism. Elimination of local factors have been sufficient in the treatment of oral leukoplakia but conservative surgical excision, electro-coagidation and laser surgery have been used in persisted lesions. In our presented case, a 46 year old men referred to our clinic with the complaint of persistent and widespread lesions in his maxillary and mandibulary crest. After the clinical and histopathological examination the lesions were successfully treated with the laser surgery. Key words: Leukoplakia, laser therapy.