Ercan Durmus

Effects of preoperative ibuprofen and naproxen sodium on orthodontic pain.

Three experimental groups of 20 patients each, all of whom were to undergo fixed orthodontic treatment, were enrolled in this prospective study. Group 1 was given a placebo, group 2 was given 400 mg ibuprofen, and group 3 was given 550 mg naproxen sodium. All the patients received only one dose that was given one hour before archwire placement. All patients were asked to complete a questionnaire concerning the pain perceived after archwire placement. The questionnaire was in the form of a seven-page booklet that contained 100-mm horizontal Visual Analogue Scale on which the patient marked the degree of discomfort at the indicated time periods. The patients were instructed to make a check on the scale at each time interval to represent the perceived severity of pain during each of four activities, ie, chewing, biting, fitting back teeth together, and fitting front teeth together. Incidence and severity of pain were recorded by the patient at two hours, six hours, nighttime on the day of appointment, 24 hours after the appointment, and two days, three days, and seven days after bonding. The results revealed that patients taking 550 mg naproxen sodium one hour before archwire placement had significantly lower levels of pain at two hours, six hours, and nighttime after adjustment than patients taking placebo or ibuprofen. However, the use of additional postoperative doses was recommended to control orthodontic pain completely.

Management of Alveolar Clefts Using Dento-osseous Transport Distraction Osteogenesis

This article evaluates the usage of distraction osteogenesis (DO) in the treatment of cleft alveoli. The procedure was carried out on eight alveolar clefts of five patients between the ages of 17 and 25 years. Three patients had bilateral alveolar clefts (BAC) and two patients had unilateral alveolar clefts (UAC). DO was carried out bilateral to the palatal segments for the BAC patients and unilateral to the lesser segment for the UAC patients. A custom-made tooth-borne distractor was used. The average amount of distraction was eight mm (range, 5-11.5 mm). The average amount of distal movement of the anchorage teeth was 0.8 mm (range, 0-2 mm). The average amount of inclination changes of the transport segments and anchorage teeth was 7.6 degrees (range, 2-17.5 degrees) and 3.3 degrees (range, 0-9 degrees), respectively. Two important problems were observed attributable to the method. First, the transport segment was docked in a more superior position at the end of distraction process. This undesirable movement also changed the inclination of the teeth in the transport segment and increased tooth tipping. Removing the device in the second week of the consolidation period and retracting the segment to its ideal position orthodontically solved these problems. Second, the bony defect on the nasal side of the alveolar cleft could not be completely closed. This method for repairing small or large alveolar clefts is a simple, cost-effective, and useful treatment option. However, repairing the alveolar cleft without grafts seems to be impossible when using a tooth-borne device.

Paresthesia of the mental nerve stem from periapical infection of mandibular canine tooth: a case report

Sensory disturbances such as paresthesia, anesthesia, hypoesthesia, and hyperesthesia may be present in the oral cavity. Paresthesia is defined as a burning or prickling sensation or partial numbness caused by neural injury. Paresthesia in dentistry can be caused by local or systemic factors. Local factors include traumatic injuries such as mandibular fractures, expanding compressive lesions (benign or malignant neoplasia and cysts), impacted teeth, local infections (osteomyelitis, periapical, and peri-implant infections), iatrogenic lesions after tooth extractions, anesthetic injection, endodontic therapy (overfilling and apical surgery), implantology, orthodontic surgery, and preprosthetic surgery. The main purpose of this case report is to present the treatment and resolution of a mental nerve paresthesia stemming from apical pathosis of a mandibular canine tooth and the follow-up of 3 years.

Evaluation of the Potential Beneficial Effects of Ostrich Eggshell Combined with Eggshell Membranes in Healing of Cranial Defects in Rabbits

Potential beneficial effects of outer and inner ostrich eggshell membranes alone and in combination with the shell powder on bone regeneration in cranial defects of 18 rabbits were investigated using radiological, clinical and histological methods. Three 6 mm wide, half-thickness defects were made in the calvarial bones of each rabbit. One defect remained empty as a control; prepared eggshell membranes were extended across the other two defects; and prepared eggshell powder was inserted inside the membrane in one case. Either alone or in combination with eggshell powder, the outer and inner ostrich eggshell membranes produced little adjunctive effect under the conditions and duration of this experiment.

Desmoplastic ameloblastoma in the mandible.

The desmoplastic variant of ameloblastoma (DA) is characterized by unique histological and radiographic features. It is histologically characterized by an abundance of densely collagenous stroma with small nests and strands of likely compressed odontogenic epithelium. Although radiographic examination of ameloblastomas usually reveals unilocular or multilocular radiolucency, DA may appear as a mixed radiopaque-radiolucent lesion. In this case report, a 68-year-old man who had a complaint of a mass in his right mental region is presented. The patient was unable to wear his prosthesis because of an underlying swelling. An incisional biopsy was performed. Microscopic examination of the surgical specimen revealed large epithelial islands of ameloblast-like cells within increased, dense, collagenous desmoplastic stroma. Histopathologically, it was diagnosed as DA. Under local anesthesia, the lesion was enucleated. There was no recurrence after 32 months of follow-up.

A Method for Quantifying Condylar Motion in Patients With Osteoarthritis Using an Electromagnetic Tracking Device and Computed Tomography Imaging

PURPOSE The purpose of this study was to develop a method to accurately study the kinematic changes of the temporomandibular joint (TMJ) in patients treated with hemijoint implant reconstruction for dysfunction of advanced degenerative osteoarthritis. MATERIALS AND METHODS Mandibular kinematic motion data and patient-specific computed tomography (CT) data were acquired. Patients were fitted with custom dental stents that were embedded with metal markers to link the mandibular kinematics data with the 3-dimensional TMJ CT images. An electromagnetic tracking device was used to collect kinematic motion data during maximal mouth opening and closing. The coordinate systems of the kinematic data and CT data were registered to calculate the motion of the mandibular condyle. RESULTS This technique was successfully used to study patients with motion aberration of the TMJ due to osteoarthritis. A typical case is illustrated in which the motion of both mandibular condyles was simulated preoperatively and postoperatively. CONCLUSIONS The results of this study suggest that it is possible to use the proposed methodology to accurately quantify the motion of the mandibular condyle in 3 dimensions. The developed technique is user-friendly and noninvasive to the patient. The proposed methodology is a potential clinical tool that may be used in the management of patients with TMJ dysfunction.

Kinematic assessment of the temporomandibular joint before and after partial metal fossa eminence replacement surgery: a prospective study.

PURPOSE This study compared the functional kinematic outcome of the temporomandibular joint (TMJ) in patients with end-stage TMJ osteoarthritis before and after TMJ hemijoint replacement surgery. MATERIALS AND METHODS Fourteen patients (15 joints), with a mean age of 46.1 years, undergoing metal fossa eminence hemijoint replacement surgery, participated in this study. Each patients jaw motion was recorded using an electromagnetic tracking device and patient-specific computed tomography images. A visual analog scale patient response questionnaire was used before and after the operation to assess the subjective outcome of the surgery. RESULTS The mean linear distance (LD) traveled by the incisors increased significantly due to the surgical intervention, from 30.4 +/- 6.9 mm preoperatively to 35.5 +/- 5.3 mm postoperatively (P = .02). The LD of the operated condyle decreased from 14.1 +/- 5.7 mm to 11.4 +/- 6.2 mm, but this was not significant. The mean LD for the unoperated condyle remained similar (preoperative, 13.2 +/- 5.9 mm; postoperative, 13.3 +/- 6.5 mm). The total mandibular rotation increased significantly, from 19.3 +/- 4.9 degrees preoperatively to 24.8 +/- 3.9 postoperatively (P < .01). CONCLUSIONS Kinematic data support the functional efficiency of hemijoint replacement surgery, with benefits of increased maximal mouth opening, preservation of operated and unoperated condyle translation motion, and increased mandibular rotation.

Comparison of Depth of Anesthesia in Different Parts of MaxillaWhen Only Buccal Anesthesia Was Done for Maxillary Teeth Extraction

Objective. Recently, some authors reported that maxillary teeth could be extracted without using palatal anesthesia, but they did not clearly specify the extracted teeth. This is important, because apparently the local anesthetic solution infiltrates the maxilla and achieves a sufficient anesthesia in the palatal side. Thus, thickness of the bone may affect the depth of anesthesia. The aim of this study was to compare the depth of anesthesia in different parts of the maxilla when only a buccal infiltration anesthesia was done. Patients and Method. The maxilla was divided into anterior, premolar, and molar regions. In each region, 15 teeth were extracted with a single buccal infiltration. The patient marked the pain level on a numerical rating scale. Results. Anesthesia depth was sufficient and was not significantly different (P > 0.05) among three maxillary regions. Conclusion. Except for surgical interventions, all maxillary teeth can be extracted using only a buccal infiltration anesthesia.

Evaluation of osteoblastic activity around dental implants using bone scintigraphy

OBJECTIVES The aim of this study was to evaluate the osteoblastic activity around delay-loaded intraosseous dental implants using nuclear medicine imaging techniques. MATERIAL AND METHODS Seven totally edentulous patients (two females and five males, between 48 and 57 years of age) were included in the study. Two implants were inserted into mandibular canine regions and removable prostheses were produced after 3 months. Whole-body bone scintigraphies with 20 mCi technetium 99m labelled methylene diphosphonate were taken from the patients before implant insertion, 3 months after implant placement just before the prostheses were made and 1 year after implant placement. Standardized count/pixel (SC/P) rates were calculated for each patient. Preimplantation SC/P values were compared with the 3- and 12-month values. Three-month values were compared with the 12-month values as well. RESULTS SC/P rates in the third month were significantly higher (P<0.05) than preoperative values and the SC/P rates of the 12th month were significantly lower (P<0.05) than 3-month values. The SC/P rates of the 12th month were relatively higher than first scintigraphies but the difference was insignificant (P>0.05). CONCLUSIONS Within the limitations of this study, in which delayed loading was applied, we showed that osteoblastic activity persisted more in delay loaded implants than immediate and early loading. After 1 year, there was no cellular activity around two implants and this implied that two implants were sufficient for a total prosthesis.

Analysis of Chromosomes 8 and 17 Aneuploidies in Laryngeal Squamous Cell Carcinoma by Fluorescence In Situ Hybridization

Objectives/Hypothesis: The objectives were to investigate chromosomes 8 and 17 numerical aberrations by using fluorescence in situ hybridization in laryngeal squamous cell carcinoma and also to determine whether there is any association between chromosomes 8 and 17 aneuploidies and TNM classification and subgroups of laryngeal squamous cell carcinomas.