Fatih Taskesen

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.

Six-Year Survival of a Mini Dental Implant-Retained Overdenture in a Child with Ectodermal Dysplasia

Patients with ectodermal dysplasia (ED) experience several problems caused by abnormal development and functioning of the head and neck region. In addition to developmental nasal cartilage abnormalities and absence of sweat glands, hair, and eyebrows, edentulism or developmental disorders of teeth (cone-shaped teeth) are commonly observed in these types of patients. ED is also characterized by underdeveloped alveolar ridges, a decreased occlusal vertical dimension, reduced salivary secretion, and dry oral mucosa, which make prosthetic rehabilitation difficult. Few studies of intraosseous dental implant-retained prostheses have described adverse effects on craniofacial growth and esthetic and functional disadvantages, while some researchers have described the advantages of this treatment option as an alternative option in these cases. Due to the associated alveolar bone deficiency, dental mini-implant therapy may be a treatment option for these patients; however, there are isolated cases in the literature regarding the rehabilitation of ED patients with mini-implant-supported overdentures. This clinical report describes the rehabilitation of a 6-year-old child with ED using a maxillary removable partial prosthesis and a mini-implant-retained mandibular overdenture. The clinical and radiographic findings of this prosthetic rehabilitation during the 6-year follow-up are also presented.

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.

Clinicoradiological evaluation of dermis-fat grafts after temporomandibular joint discectomy: A retrospective study

Purpose: The aim of this study was to compare the preoperative and 1-year postoperative clinical and radiological findings of the patients after unilateral temporomandibular joint (TMJ) discectomy with inter-positional abdominal dermis-fat graft. Materials and Methods: Fourteen patients underwent unilateral discectomy and dermis-fat grafting between 2008 and 2010. Preoperative and 1-year postoperative clinical parameters such as maximum mouth openings (MMO) and lateral movements (LM) of the mandible were recorded. Additionally, preoperative and postoperative magnetic resonance imagingwas obtained to determine the duration of operated TMJs. Results: All of the 14 patients showed the improvement in mandibular mobility and function. There was a significant increase in the MMO and LM during the follow-up period. Pain levels at follow-up were significantly lower than the preoperative levels. Radiologically, the dermis-fat graft was detected within the joint or surrounding the condyle in all 14 operated joints. The graft material that was found within the joint space was mainly grey in four joints. Ten joints showed heterogeneous material composed of fat interspersed with grey tissue. Conclusion: Discectomy and dermis-fat grafting appears to be a successful surgical option regarding to the clinical parameters. However, summed degenerative changes depending on surgical operation should be retained.

Evaluation of discectomy and dermis-fat grafting on the contralateral side.

Purpose We investigated the effects of unilateral discectomy with an abdominal dermis–fat graft of the temporomandibular joint (TMJ) on the contralateral side. Patients and Methods A total of 14 patients who underwent unilateral TMJ discectomy and dermis–fat grafting for severe internal derangement in 2009 and 2010 were included. Clinical parameters, such as maximum mouth opening and lateral movements of the mandible, were recorded preoperatively and at 1 year postoperatively. Preoperative and 1-year postoperative magnetic resonance imaging was conducted to determine the duration of the operated and unoperated TMJs. Results and Conclusions All 14 patients showed improvement in the mandibular mobility and function. However, postsurgical disc displacement without reduction was observed on the unoperated TMJ in 1 patient. Another patient complained of crepitus on the operated TMJ. Primary occlusal contact on the operated side of occlusion was observed in 2 other patients. Maximum mouth opening and measured lateral movements had increased in all patients at 1 year after the operation.

Novel Retromandibular Subparotideomasseteric Fascial Approach for Placement of a Temporomandibular Joint Prosthesis

For placement of a temporomandibular joint prosthesis, preauricular and retromandibular approaches are used. The main complication of the retromandibular approach is marginal mandibular nerve damage. In this technical study, the retromandibular subparotideomasseteric fascial approach is introduced as an alternative to avoid the complications of the conventional retromandibular approach.