Hakan Eren

Stability and Marginal Bone Level Changes of SLActive Titanium-Zirconium Implants Placed with Flapless Surgery: A Prospective Pilot Study

BACKGROUND Immediately-loaded, narrow-diameter implants can be a less invasive alternative for the implant-supported fixed rehabilitation of narrow, posterior crests. PURPOSE To determine the stability and marginal bone level (MBL) changes of narrow-diameter, titanium-zirconium (TiZr) implants placed with flapless surgery and loaded immediately in the posterior region. MATERIALS AND METHODS Thirty-eight TiZr implants (3.3 mm diameter, 10 mm length, Roxolid, Straumann AG) were placed in the posterior crests of 14 patients with computer-guided flapless surgery as a support of 3-unit posterior bridges. Eighteen implants were loaded immediately, and 20 implants were loaded conventionally. The implant stability quotients were determined at the 1, 2, 4, and 8. weeks of healing before conventional loading, and at the 3, 6, and 12. months after loading by resonance frequency analysis. The MBL changes were measured by digital radiography. RESULTS The surgical protocols were accomplished without any biological complications. There was no significant difference in the stability changes of TiZr implants between the loading groups (p > .05). The MBL changes were -0.18 ± 0.27 mm and -0.24 ± 0.27 mm at the 12. month of immediate and conventional loading, respectively, which was not statistically significant (p > .05). CONCLUSION The stability and MBL changes of TiZr implants supporting posterior 3-unit bridges were clinically acceptable at the first year of loading.

Burnout and occupational participation among dentists with teaching responsibilities in universities

Abstract The aim of this study was to investigate the levels of burnout and explore the relationships between burnout and occupational participation among dentists with teaching responsibilities. Canadian Occupational Performance Measure (COPM) was used to evaluate occupational participation with questions on demographic information among 155 dentists with teaching responsibilities. Age, gender, years of experience, academic position were the factors affecting level of burnout and occupational participation. Occupational performance score was negatively correlated with emotional exhausment (r = –.731) and depersonalization (r = –.693) while positively correlated with personal accomplishment (r = .611). Occupational satisfaction scores were negatively correlated with emotional exhausment (r = –.631) and depersonalization (r = –.625) while positively correlated with personal accomplishment (r = .614). Occupational participation level can effect burnout among dentists with teaching responsibilities. Further studies with a larger sample are needed to investigate these preliminary results deeply.

Comparison of the burr and chemically induced periodontal defects using different field-of-view sizes and voxel resolutions

OBJECTIVE This study assessed the use of different voxel resolutions in a cone beam computed tomography (CBCT) unit for the detection of artificially induced periodontal bone defects created using burr, burr and chemicals, and only chemicals. STUDY DESIGN Seven dry skulls were used in this study. In total, 65 dehiscence defects, 43 fenestration defects, and 76 control sites with no periodontal defects were examined. Images were obtained from a CBCT unit (3 D Accuitomo; J Morita Mfg. Corp., Kyoto, Japan), using 3 field-of-view (FOV) sizes (4 × 4 cm; 6 × 6 cm; and 8 × 8 cm) and 4 scan modes (standard, high-definition, high-fidelity, and low-dose). RESULTS Overall, κ coefficients for interobserver agreement on burr-induced periodontal defects ranged from 0.336 to 0.795, with the lowest κ value (indicating a fair degree of agreement) obtained for images acquired in standard mode with a voxel size of 0.160 mm3. κ coefficients for the detection of periodontal defects were highest (indicating moderate to high degrees of interobserver agreement) for smaller voxel sizes and high-resolution images. Statistical comparison among groups (burr, burr + chemicals, and chemicals only) was performed using 1-way analysis of variance with post hoc tests. CONCLUSIONS The CBCT scan mode may affect the diagnosis of periodontal defects. The technique used to create periodontal defects also affected diagnosis. For this kind of experiment, burr-induced or burr + chemical-induced defects should be used, rather than those induced solely using a chemical technique.

KIBT İLE TESADÜFEN BULUNAN PARSİYEL EMPTY SELLA TANISI: İKİ VAKA RAPORU

Empty sella syndrome is defined as a herniation of the subarachnoid space within sella, hence, flattening of the pituitary gland. Most of the empty sella cases are found incidentally which this syndrome can be easily missed during maxillofacial radiological examinations. The aim of this paper is to describe two cases of partial empty sella and discuss the differential diagnosis for this condition. Both patients administered to our clinic with pain in the forehead and maxilla. In addition to clinical examination two patients (37 year old male, 70 year old female) were imaged using panoramic radiography, cone beam computed tomography and magnetic resonance imaging. Panoramic radiographies showed no findings in terms of empty sella. However, in CBCT imaging, both patients showed an expansion in the sella turcica and protrusion into sphenoid sinus. These were more precisely located using 3D CT reconstructions. MR imaging showed intermediant signal on T1-weighted images and high signal on T2- weighted images. MRI findings showed the partial anterior prolapsus of pituitary gland with cerebrospinal fluid leak in posterior border of sella turcica. According to MRI findings, definitive diagnosis was partial empty sella syndrome. Maxillofacial radiologists should be aware of this kind of abnormalities while reporting the entire FOV. Keywords: Empty Sella Syndrome, CBCT, MRI, sella turcica, pituitary gland INCIDENTAL DIAGNOSIS OF PARTIAL EMPTY SELLA ON CBCT: TWO CASE REPORTS OZ Empty sella sendromu, subaraknoid bolgenin sella icerisine herniyasyonu bundan dolayi da hipofiz bezinin duzlesmesi olarak tanimlanmistir. Bir cok empty sella vakasi tesadufen tespit edildigi icin bu sendrom maksillofasiyal radyolojik inceleme sirasinda kolaylikla gozden kacabilir. Bu makalenin amaci iki parsiyel empty sella vakasini sunmak ve bu durum ile ilgili ayirici tanilari tartismaktir. Her iki hasta da maksilla ve alin bolgesinde agri ile klinigimize basvurdu. Klinik muayeneye ek olarak her iki hastadan da (37 yas erkek, 70 yas kadin) panoramik radyograf, konik isinli bilgisayarli tomografi ve manyetik rezonans goruntuleme ile goruntuler alindi. Panoramik radyografide empty sellaya iliskin herhangi bir bulguya rastlanmadi. Ancak, KIBT goruntulerinde her iki hastada da sella tursikada ekspansiyon ve sfenoid sinus icerisine protruzyon goruldu. Bu bulgular 3 boyutlu rekonstruksiyon goruntulerinde tam olarak lokalize edildi. Manyetik rezonans goruntulemede T1 agirlikli goruntulerde orta duzeyde sinyal ve T2 agirlikli goruntulerde ise yuksek sinyal alindi. MRG bulgulari sella tursikanin arka sinirinda serebrospinal sivi sizintisi ile birlikte hipofiz bezinin parsiyel anterior prolapsusu oldugunu gosterdi. MRG bulgulari ile parsiyel empty sella kesin tanisi kondu. Maksillofasiyal radyologlar goruntuleme alanina giren tum yapilari rapor ederken bu tip patolojilere de dikkat etmelidirler. Anahtar Kelimeler: Empty sella sendromu, KIBT, MRG, sella tursika, hipofiz bezi

Association between burnout and depressive symptoms among Turkish dentists

Background/purpose Health care professionals including dentists can experience increased professional burnout. The aim of the study was to evaluate the association between depressive symptoms and burnout among Turkish dentists. Materials and methods This study was conducted among a Turkish dentist sample in Ankara (Turkey) between February 2015 and August 2015. From a total of 500 dentists, 337 were included. A self-structured questionnaire, Maslach Burnout Inventory (MBI), and Beck Depression Inventory (BDI) were completed by the participants. The Student t test or analysis of variance was used to compare the variables. Results A total of 337 dentists (162 female dentists; mean age of participants 36 ± 4.45 years) participated in this study. Age, sex, professional status, years in profession, sector, and number of patients seen/d were factors affecting level of burnout (P < 0.05); 29% of the participants showed burnout and 22.2% showed depressive symptoms. Participants showed increase in emotional exhaustion (38%), increase in depersonalization (22%), and decrease in personal accomplishment (12%). The mean score of BDI significantly correlated with those of the MBI subscales (P < 0.05). All items of BDI except weight loss, irritability, and loss of appetite significantly correlated with MBI subscores (P < 0.05). Conclusion Dentists may face burnout and depressive symptoms during their professional life. Increased burnout level can give an idea on depressive symptoms, and may provide an opportunity to identify depression earlier. Creating and raising awareness about burnout are important to avoid and prevent depression among dentists. Further longitudinal studies analyzing the effects of interdisciplinary client-centered self-management programs for dentists on depressive symptoms and burnout must be planned.

Cone beam computed tomography evaluation of mandibular canal anterior loop morphology and volume in a group of Turkish patients

ABSTRACT The aim of the present study was to assess the presence and course of the anterior loop in the mental foramen region according to age and gender, using cone beam computed tomography (CBCT). Both the right and left sides were retrospectively studied in 141 patients (n = 282). Axial, sagittal, cross-sectional and panoramic images were evaluated and three-dimensional images were reconstructed and evaluated as necessary. The morphology, course and length of the anterior loop were measured. The reliability and reproducibility were assessed based on the intraclass correlation coefficient (ICC) and the coefficient of variation. An anterior loop was found in about 86% of the scans. The mean anterior loop proximal edge was 3.15 mm and the mean distance between the buccal border of the anterior loop and buccal alveolar wall was 2.24 mm. The mean volume of the mandibular canal was 1140 mm3 and the mean volume of the anterior loop was 90 mm3. Statistically significant difference was found in male patients in terms of the canal and anterior loop volume (p < 0.05). A high prevalence of anterior loop was detected by CBCT imaging, with predominance in female patients. Clinicians should be careful during implant or bone surgery procedures to avoid possible complications, with special emphasis on patient age, using this imaging modality that involves use of less radiation.

A diagnostic dilemma: Vertical fracture case

A vertical root fracture (VRF) in an endodontically treated tooth is one of the most frustrating complications of dental therapy. VRFs are a particularly significant clinical problem because they are associated with a poor prognosis for the affected tooth and often lead to tooth extraction. This report presents a case of a VRF in a nonendodontically treated mandibular second premolar, for which the displaced fractured fragment appeared to be that of a mandibular molar in the radiograph.