Erol Cansiz

Closure of oroantral fistula using auricular cartilage: a new method to repair an oroantral fistula.

r f p b T any of surgical techniques have been described for the losure of oroantral fistulaes and most of them rely on mobiizing the soft tissue and advancing the resultant flap into he defect. For this reason, conventional techniques such as; imple vestibular mucosal flaps, rotational pedicled palatinal r buccal flaps or palatinal island flaps are used. In addition o these conventional techniques, some others are developed n time such as; otogenous bone grafting techniques, metal laque techniques, using fibrin adhesives, etc. Also, nasal septal cartilage is used for the closure of roantral fistulas and using an auricular cartilage graft can be n alternative. Auricular cartilage is biocompatible, resistant o infection, nonresorbable, easily manipulated, structurally ound, noncarcinogenic, easy to obtain and cost-effective. uricular cartilage do not require vascularisation for the interation of the graft to the recipient site and this characteristic ecreases the failure incidence of the graft. Also, after the haresting of an auricular cartilage, scar or defect formation do ot occur on the donor site. In addition, an auricular cartilage raft treat like a separator barrier between the sinus memrane and the oral mucosa which allows successful healing. ecause of these properties, auricular cartilage is a valuable lternative for the nasal cartilage. Using a cartilage in between

Evaluation of Volumetric Changes of Augmented Maxillary Sinus With Different Bone Grafting Biomaterials.

AbstractExtensive alveolar bone resorption because of pneumatized maxillary sinus is a common problem that limits dental implant placement. Maxillary sinus floor augmentation (MSFA) is an accepted treatment protocol that provides sufficient bone volume. The aim of this study was to evaluate the percentage of graft volume reduction following MSFA using cone beam computed tomography. In this retrospective study, cone beam computed tomography scans of MSFA were measured to evaluate the volume of the grafted sinus with deproteinized bovine bone (DBB), mineralized allograft (MA), or a mixture of MA and demineralized allograft as a composite. The volumetric changes in sinus augmentation between 2 weeks (T-I) and 6 months (T-II) after operation were analyzed. Thirty-nine patients were included in this study. The average percent volume reduction was 8.14 ± 3.76%, 19.38 ± 9.22%, and 24.66 ± 4.68% for DBB, MA, and composite graft, respectively. A significant graft volume reduction was found between T-I and T-II for all groups (P < 0.01). The DBB group showed the least volume reduction (P < 0.01). Biomaterials can influence the bone graft volume change before implant placement. Deproteinized bovine bone may offer greater volume stability during healing than mineralized and composite allografts.

Complications associated with surgically assisted rapid palatal expansion without pterygomaxillary separation

INTRODUCTION The purpose of this retrospective clinical study was to evaluate the surgical complications associated with the surgically assisted rapid palatal expansion (SARPE) which does not involve pterygomaxillary separation (PMS). PATIENTS AND METHODS A total of 40 (25 females, 15 males) skeletally mature patients, who had the diagnosis of maxillary transverse maxillary deficiency (TMD), were treated surgically under local or general anesthesia. The mean follow-up time was 6 months. RESULTS Recorded perioperative and postoperative complications were discussed within the current literature. No serious complications were observed intraoperatively. Eight patients (20%) showed postoperative complications including neurosensory deficits, maxillary sinus infection, epistaxis, fistula formation and incisional dehiscence. DISCUSSION Neurosensory deficits were the most common findings. The present findings suggest that minor complications were observed associated with SARPE without PMS. The technique may be performed safely also under local anesthesia.

Aspergillosis associated with surgically assisted rapid maxillary expansion

Surgically assisted rapid palatal expansion (SARPE) is one of the most common orthognathic surgery operations for the treatment of maxillary transverse deficiencies. Although this operation is considered technically simple and has low complication rate, predisposing factors can complicate the postoperative period. In this case report, fistula formation and aspergillosis after SARPE operation were presented.

COMPARATIVE EVALUATION OF THE MECHANICAL PROPERTIES OF RESORBABLE AND TITANIUM MINIPLATES USED FOR FIXATION OF MANDIBULAR CONDYLE FRACTURES

In this paper, comparative evaluation of the mechanical properties of resorbable and titanium miniplates, which are used for the fixation of the mandibular condyle fractures, was carried out using finite element analysis (FEA). To do so, first two-dimensional (2D) computed tomography (CT) images of mandibles recorded from 10 adult patients were converted into three-dimensional (3D) solid body models. Then these models were transferred to the finite element software. In the finite element stage of the study, a condyle fracture was created onto the mandible and double-titanium and double-resorbable miniplates were separately fixed to the mandible surface such that the fractured sites to be firmly attached. Stress distribution over the plates and interfragmentary displacements between adjacent surfaces, which stem from the clenching force applying to the mandible, were calculated using FEA. It was observed from the results that maximum tensile stresses occurred in the titanium miniplates were significantly higher than those obtained from resorbable miniplates (p < 0.01). Higher maximum displacements between fractured surfaces were observed in the case of resorbable plate systems (p < 0.01). Maximum stress and displacement values obtained from both titanium and resorbable plate systems were under clinically acceptable limits. According to results, resorbable plates showed a similar reliability with titanium miniplates in terms of withstanding various stress and strain deformations.

The use of reconstruction plates to treat benign mandibular pathological lesions: A retrospective clinical study

INTRODUCTION The purpose of this retrospective clinical study was to evaluate the indications for and the utility of reconstruction plates in the management of benign mandibular pathological lesions. The complications associated with plate use were also assessed. PATIENTS AND METHODS The clinical and radiological data of 23 patients (16 males, 7 females) with large, benign mandibular pathologies were evaluated. During operations, reconstruction plates were used to prevent mandibular fracture or to allow for bone reconstruction after segmental or disarticulation resection. The mean follow-up time was 11.2months. RESULTS Condylar sag was observed in one patient who had undergone disarticulation resection. A reconstruction plate was removed from one patient because of pain. A plate became exposed in one patient who had undergone a disarticulation resection. Two patients reported slight paraesthesia. Screw-loosening was observed in one patient who had received a non-locking plate. CONCLUSION Reconstruction plates can be safely used to manage benign mandibular lesions. Preoperative bending of the plates on individualised models is useful for reducing the time required for plate adaptation during operation. Locking reconstruction plates are preferable for preventing screw-loosening. All complications can be managed with careful follow up.

A REVIEW OF FINITE ELEMENT APPLICATIONS IN ORAL AND MAXILLOFACIAL BIOMECHANICS

Finite element method (FEM) is preferred to carry out mechanical analyses for many complex biomechanical structures. For most of the biomechanical models such as oral and maxillofacial structures o...

DOES INTRAVENOUS TRANEXAMIC ACID REDUCE BLOOD LOSS DURING SURGICALLY ASSISTED RAPID PALATAL EXPANSION

Purpose: The purpose of this study was to evaluate the efficacy of tranexamic acid (TXA) in reducing blood loss during surgically assisted rapid palatal expansion (SARPE) procedure. Subjects and Methods: A total of 34 patients (12 male, 22 female) who had been treated surgically under general anesthesia with SARPE including pterygoid disjunction for transverse maxillary deficiency (TMD) were included in this study. The study group (n=17) received intravenous (IV) TXA 10 mg/kg as a preoperative bolus; the control group (n=17) received normal saline solution. Preoperative and postoperative haemoglobin and haematocrit values, intraoperative blood loss, and any blood product transfusion were recorded. Results: Blood loss during SARPE was statistically significantly less in the study group than the control group (p=0.0001). Conclusion: Preoperative IV administration of TXA can effectively control blood loss during when SARPE with pterygoid disjunction is performed.

RECONSTRUCTION OF ATROPHIC MAXILLA BY ANTERIOR ILIAC CREST BONE GRAFTING VIA NEUROAXIAL BLOCKADE TECHNIQUE: A CASE REPORT

Anterior iliac crest bone grafting is a well-established modality in the treatment of alveolar bone deficiencies. However, this procedure may also have considerable postoperative morbidity which is mostly related to general anesthesia. Postoperative pain-related complications can be managed by neuroaxial blockade techniques which provide adequate surgical analgesia and reduce postoperative pain. This clinical report describes the reconstruction of a severely atrophic maxilla with anterior iliac crest bone grafting using combined spinal epidural anesthesia. Neuroaxial blockade techniques may be a useful alternative to eliminate general anesthesia related challenges of anterior iliac crest bone grafting procedures.

Treatment of Oral Fistulas

The term “fistula” can be defined as an improper connection between different body compartments. It can occur in different parts of the body. Although, fistulae mostly develop due to untreated chronic infections, traumatic injuries and congenital deformities, specific infections or diseases, and post-surgical healing abnormalities can also cause fistula formation. Although, there is a general classification system made by the World Health Organization to identify fistulae, specifically, in this chapter oral fistulae are divided into four different categories, namely dentoalveolar, oroantral, oronasal and orocutaneous fistulae. The diagnosis and the treatment protocols for oral fistulas are described using this specific classification and with additional new techniques introduced for the correction of the lesions. Conventional surgical meth‐ ods also are summarized. The importance of the radiological examination is empha‐ sized and the practitioners are informed of possible complications.