Cem Üngör

Comparative Evaluation of Antimicrobial Effects of Er:YAG, Diode, and CO2 Lasers on Titanium Discs: An Experimental Study

PURPOSE This study examined carbon dioxide (CO(2); 10,600 nm), diode (808 nm), and erbium (Er):yttrium-aluminum-garnet (YAG; 2,940 nm) laser applications on Staphylococcus aureus contaminated, sandblasted, large-grit, acid-etched surface titanium discs and performed a comparative evaluation of the obtained bactericidal effects and the applicability of these effects in clinical practice. MATERIALS AND METHODS This study was carried out in 5 main groups: Er:YAG laser in very short pulse (VSP) emission mode, Er:YAG laser in short pulse (SP) emission mode, diode laser with a 320-nm fiber optic diode laser with an R24-B handpiece, and CO(2) laser. After laser irradiation, dilutions were spread on sheep blood agar plates and, after an incubation period of 24 hours, colony-forming units were counted and compared with the control group, and the bactericidal activity was assessed in relation to the colony counts. RESULTS The CO(2) laser eliminated 100% of the bacteria at 6 W, 20 Hz, and a 10-ms exposure time/pulse with a 10-second application period (0.8-mm spot size). The continuous-wave diode laser eliminated 97% of the bacteria at 1 W using a 10-second application with a 320-μm optic fiber, 100% of the bacteria were killed with a 1-W, 10-second continuous-wave application with an R14-B handpiece. The Er:YAG laser eliminated 100% of the bacteria at 90 mJ and 10 Hz using a 10-second application in a superpulse mode (300-ms exposure time/pulse). The Er:YAG laser also eliminated 99% to 100% of the bacteria in VSP mode at 90 mJ and 10 Hz with a 10-second application. CONCLUSIONS The results of this study show that a complete, or near complete, elimination of surface bacteria on titanium surfaces can be accomplished in vitro using a CO(2), diode, or Er:YAG laser as long as appropriate parameters are used.

Does an alkaline environment prevent the development of bisphosphonate-related osteonecrosis of the jaw? An experimental study in rats

OBJECTIVE To investigate the preventive effect of locally applied sodium bicarbonate on bisphosphonate-related osteonecrosis of the jaw (BRONJ). STUDY DESIGN Thirty-six Sprague-Dawley rats were divided into 4 groups. Animals in group I received 0.1 mg/kg sterile saline 3 times per week for 8 weeks. Groups II, III, and IV received intraperitoneal zoledronate injection in the same manner with the same frequency and duration. The right first molar tooth was extracted in groups III and IV. One mL 8.4% sodium bicarbonate (SB) was applied to the extraction socket at the time of extraction in group IV. The effect of locally applied SB as an alkalizing agent was evaluated by histomorphometric analysis. RESULTS BRONJ was observed in none of the animals in the control groups, 67% of the animals in the tooth extraction group, and none of the animals in the local SB application group (P < .01). CONCLUSIONS Administration of locally applied SB had positive effects on the prevention of BRONJ in animals, but further studies are required to verify the effectiveness of this form of treatment before its use in humans.

The effects of adjunctive parathyroid hormone injection on bisphosphonate-related osteonecrosis of the jaws: an animal study

Bisphosphonate (BP)-related osteonecrosis of the jaw (BRONJ) is a serious and challenging complication of chronic BP uptake in patients with osteoporosis who require management of skeletal-related events. The efficiency of adjunctive parathyroid hormone (PTH) injection was evaluated after chronic BP administration that was followed by tooth extraction. BRONJ was not observed in any of the subjects in the control groups, while BRONJ was observed in 66% and 22% of the subjects in the tooth extraction group and the tooth extraction with PTH injection group, respectively. In addition the presence and severity of inflammation was lower in the PTH injected group than in the tooth extraction group, but the difference was not statistically significant (P>0.01). In conclusion, the administration of 30μg/kg/day PTH during a period of 8 weeks had positive effects on the resolution of BRONJ, but further studies are required to verify the effectiveness of PTH in the treatment of BRONJ.

Short-term results of prolotherapy in the management of temporomandibular joint dislocation.

ObjectiveProlotherapy, the rehabilitation of ligaments or tendons by induced proliferation of cells by using dextrose, is a noninvasive and effective method for the treatment of temporomandibular joint (TMJ) dislocation. The aim of this study was to evaluate the efficacy of prolotherapy method for the management of acute or chronic dislocation of TMJ. Materials and MethodsIn this study, 10 patients with TMJ dislocation (2 acute, 8 chronic) were examined retrospectively. All patients consisted of female patients, with a mean age of 28.4, who were treated with prolotherapy procedure. Differences of visual analog scale scores in quality of life, pain on function, and chewing function efficacy between sessions were investigated using the Wilcoxon t test and median values of sessions were evaluated using the Kruskal-Wallis H test. The amount of change at the maximum mouth opening occurring between the preoperative and postoperative values and the frequency of locking episodes were calculated, with results considered statistically significant at P < 0.05. ResultsPain on function scores were significantly decreased in all patients, and TMJ locking were not observed during the follow-up period. Maximum mouth opening exhibited a tendency to decrease, but it was not statistically significant. Also, clicking sound on function presented no significant change (P > 0.05). On the other hand, the visual analog scale scores for quality of life showed significant improvement in all patients (P < 0.05). ConclusionsThe results of this study show that prolotherapy can be used as an efficient, simple, and conservative method to treat TMJ dislocation.

Evaluation of sedation in oral and maxillofacial surgery in ambulatory patients: failure and complications

OBJECTIVES This study evaluated the failure and complication rates of sedation in ambulatory patients undergoing oral and maxillofacial surgery. MATERIALS AND METHODS This retrospective cohort study was carried out among 619 patients who had undergone maxillofacial surgical procedures under intravenous sedation with midazolam and fentanyl. Each patients age, American Society of Anesthesiologists (ASA) classification, systemic condition, surgical procedure, complications, and failures were recorded for evaluation. RESULTS A total of 400 patients with ASA I, 199 with ASA II, and 20 with ASA III between the ages of 9 months and 84 years were included in the study. The most common systemic disorders in our patients were mental retardation (35%), hypertension (19%), and epilepsy (15%). Evaluation of the cases revealed 9 complications (1.4%) and 9 sedation failures (1.4%). The complications were bradycardia, postoperative agitation and hallucination, drug reaction, vomiting and nausea, desaturation, and hypotension. CONCLUSIONS Our results in the oral and maxillofacial surgery clinic revealed low complication and failure rates.

An acoustical analysis of the effects of maxillary sinus augmentation on voice quality.

OBJECTIVE Increased experience in sinus lifting procedures has led to a number of literature reports, but the potential effects of sinus lifting on voice quality is not clearly addressed in clinical studies. The aim of this study was to objectively investigate the effects of sinus lifting on alterations in voice quality and, in particular, on vocal resonance. STUDY DESIGN A total of 17 patients who were in need of bilateral sinus augmentation were recruited. Acoustic analyses were performed before and after surgery. Volume changes in the sinuses were recorded before and after surgery using dental volumetric tomography. The Friedman test with Bonferroni correction was used to analyze the data. RESULTS Changes in the perturbation parameters of acoustic sound analysis were found to be statistically significant. CONCLUSIONS We recommend that all patients (especially voice professionals) be informed about the possible effects of sinus lifts on speech and voice alterations.

Long-Term Outcome of Arthrocentesis Plus Hyaluronic Acid Injection in Patients With Wilkes Stage II and III Temporomandibular Joint Internal Derangement.

Objective:Arthrocentesis is a minimally invasive procedure used to manage temporomandibular joint (TMJ) internal derangement (ID). This study evaluated the outcome of arthrocentesis in patients with Wilkes stage II and III TMJ ID. Patients and Methods:This retrospective study enrolled 50 patients who underwent arthrocentesis in 2011 and 2012 at the Karadeniz Technical University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Turkey. In total, 43 patients underwent unilateral arthrocentesis, whereas 7 patients had bilateral arthrocentesis. The clinical parameters recorded were pain (visual analogue scale [VAS] 0–100 mm during movement), chewing function efficacy (VAS 0–100), clicking sounds, and mandibular movements, including maximum interincisal opening (MIO), lateral excursion, and protrusion. All the parameters were recorded preoperatively, and 1, 3, 6, and 24 months after treatment. Results:The MIO, lateral excursion, and protrusion were significantly greater than preoperatively in all the patients. Pain declined significantly postoperatively. The patients in Wilkes III group had greater improvement in mandibular movement and pain than the patients in Wilkes II group. Conclusion: Arthrocentesis was reliable for treating both Wilkes II and III TMJ ID, and the treatment results were better in Wilkes III patients.

MANDİBULADA GÖRÜLEN BİLATERAL TRAVMATİK KEMİK KİSTİ: İKİ OLGU SUNUMU

Traumatic bone cyst (TBC) is a radiolucent pseudocyst with no epithelial lining. TBC can be seen as an empty cavity that might contain some fluid and/or small amounts of soft tissue. The lesion is generally asymptomatic and detected as incidental findings on radiographic examination. Curettage of the bone walls is the most widely accepted approach for the treatment of the lesion. Most TBCspresent as solitary lesions. In these cases we presented 2 unusual presentation of bilaterally traumatic bone cyst of mandible