Haluk Öztunç

Comparison of bovine-derived hydroxyapatite and autogenous bone for secondary alveolar bone grafting in patients with alveolar clefts.

PURPOSE The aim of this retrospective study was to compare the long-term outcomes of secondary alveolar bone grafting (SABG) using bovine-derived hydroxyapatite versus autogenous bone. PATIENTS AND METHODS The subjects in this study were 23 patients with unilateral cleft lip and palate (13 male, 10 female) who underwent SABG from 2004 through 2009. The patients were recalled and examined to evaluate the success of the long-term outcomes of SABG. In group 1, there were 12 patients (7 male, 5 female) who underwent grafting with anterior iliac crest bone; in group 2, 11 patients (6 male, 5 female) underwent grafting with bovine-derived hydroxyapatite. RESULTS The mean ages at grafting were 13 ± 3.76 years in group 1 and 10.82 ± 2.6 years in group 2 (P = .134). The mean lengths of follow-up were 47.33 ± 13.79 months in group 1 and 67.82 ± 10.36 months in group 2 (P = .002). Pocket depth, periodontal index, and gingival index scores were similar and indicated acceptable periodontal status in the 2 groups. The results for patient satisfaction were not statistically different (P > .05). There was no statistically significant difference between the 2 groups when results of the Chelsea scale were analyzed (P > .05). The radiologic results showed an 83.4% success rate in group 1 and a 100% success rate in group 2 (P = .478). When the densitometric values for cleft sites were analyzed, the difference between the 2 groups was not statistically significant (P = .190). CONCLUSIONS Bovine-derived hydroxyapatite is as successful as the iliac graft for the SABG procedure.

Evaluation of relationship between preoperative bone density values derived from cone beam computed tomography and implant stability parameters: a clinical study

OBJECTIVES The aim of this study was to explore the efficacy of bone density value derived from cone beam computed tomography (CBCT) by evaluating its correlation with implant stability parameters including insertion torque value (ITV) and radiofrequency analysis in relation to different clinical variables including location, gender, age, bone quality, and implant diameter. MATERIAL AND METHODS A total of 65 implants were placed in 17 patients. The bone densities of implant recipient sites were preoperatively recorded using CBCT. Bone quality was subjectively assessed, which depends on the stiffness of the jawbone according to the Lekholm and Zarb index during drilling procedure. The maximum ITV of each implant was recorded using a digital torque meter during implant placement. Resonance frequency measurements were taken using an Osstell Mentor immediately after implant placement. Data were analyzed statistically. RESULTS The mean bone density, insertion torque, and implant stability quotient values of all implants were 556 ± 80, 37.4 ± 3.3 Ncm, and 73.8 ± 7.2, respectively. Statistically significant correlations were found between bone density values from CBCT and implant stability parameters in relation to all variables. CONCLUSION Bone density assessment using CBCT is an efficient method and significantly correlated with implant stability parameters and Lekholm and Zarb index. Thus, it is possible to predict initial implant stability and possibility of immediate or early loading using CBCT scans prior to implant placement.

Outcomes of periradicular surgery of maxillary first molars using a vestibular approach: a prospective, clinical study with one year of follow-up.

PURPOSE The aim of the present prospective, randomized, controlled, clinical study was to compare the outcomes of periradicular surgery of the maxillary first molar tooth using the vestibular approach between 2 preoperative radiologic evaluation methods: cone beam computed tomography (CBCT) and conventional radiography. PATIENTS AND METHODS Periradicular surgery was applied to the maxillary first molar tooth in 40 patients. The patients were divided into 2 groups. The patients in group 1 underwent examination and preoperative planning with CBCT, and the patients in group 2 underwent examination and preoperative planning with conventional radiography. The outcomes of the treatment were evaluated radiographically and clinically, and the data were analyzed statistically. RESULTS The mean operative time was significantly shorter in group 1 than in group 2. According to the radiographic and clinical healing criteria used in the present study, the healing of patients in group 1 was rated as a success in 35%, an improvement in 40%, and a failure in 25%. In the group 2 patients, healing was rated as a success in 42.1%, an improvement in 31.6%, and a failure in 26.3%. Sinus membrane elevation was performed in 92.3% of all patients. Sinus membrane perforation occurred in 20% of the patients in group 1 and 36.8% of the patients in group 2. CONCLUSIONS Periradicular surgery of maxillary first molars using a vestibular approach is a viable treatment method with a low complication rate. Preoperative CBCT examination demonstrated positive contributions to the treatment outcomes.

Cone-beam computed tomographic evaluation of styloid process: a retrospective study of 208 patients with orofacial pain

IntroductionThe purpose of this study was to assess the structural characteristics of styloid process (SP) by cone-beam computed tomography (CBCT) examination in a patient population suffering from orofacial pain. The second aim was to assess the prevalence of elongated SP and its relation to gender, site and subjective symptoms in the study population.MethodsClinical and radiographic records of 208 patients were evaluated retrospectively. Radiological examinations including measurements of the structure, length, and medial angulations of SP were performed on CBCT images.ResultsOut of 208 patients, 96 (46%) had not-elongated SP, 28 (13%) had left side, 16 (8%) had right side, and 68 (33%) had bilateral elongation of SP. The patients with elongated SP had significantly decreased angle values. There were no statistically significant differences in length values of SP between males and females in both groups. Significantly increased prevalence of symptoms except headache was observed in patients with elongated SP.ConclusionsThis study presents the CBCT as an alternative method to CT or panoramic radiographs for the measurement and the assessment of the styloid process. Patients suffering from orofacial pain, who also had elongated SP, had increased rate of corresponding neurological complaints compared with non-elongated ones.

A unique case of Turner syndrome accompanying prolactinoma and unexpected elongated styloid process: Clinical and cone-beam computed tomographic features

Turner syndrome (TS) is one of the most common chromosomal abnormalities, with an estimated frequency among female live births of 1/2,000-3,000. The syndrome is characterized by the partial or complete absence of one X chromosome (45,X karyotype). We reported a unique case of a 40-year-old woman with TS accompanying unexpected elongated styloid process specific to Eagle syndrome (ES) and followed up-prolactinoma. The present article is the first report to define the cone-beam computed tomographic (CBCT) features of TS accompanying ES. Patients with TS carry various risks that make treatment more complicated; thus advanced imaging techniques for proper treatment and follow-up are extremely important. In the light of CBCT examination, craniofacial abnormalities specific to TS and accompanying syndromes such as the crowding of teeth especially in the maxillary anterior region caused by maxillary narrowness, micrognatic maxilla and mandible, relative mandibular retrusion, malocclusion, open-bite, and an elongated styloid process (length of 32.7 mm) on the right side were illustrated in detail.

Dijital radyografi ve diş hekimliğinde ileri görüntüleme yöntemleri

Since the discovery of x-rays in 1895, film has been the primary medium for capturing, displaying and storing radiographic images. Digital or filmless radiography is slowly being adopted by the dental profession. Digital radiography offers a number of capabilities compared with conventional radiography, such as postprocessing, electronic archiving, concurrent access to images, and improved data distribution. Computer based applications which are used for quantitative measurements and evaluations on digital images for better user interpretation. New diagnostic imaging processes are improved connected with the technological progress of computer systems. Since the first clinical use of computed tomography (CT) scans in 1972, technological development has been rapid. Dental volumetric tomography (DVT), uniquely used for dentomaxillofacial imaging came to the market owing to recent rapid developments in digital radiology technology and is becoming more popular in dental applications. Low radiation dose cone beam computed tomography (CBCT) units that are commercially available at a lower cost than CT units, has performed valuable diagnostic information for dentists.