Hasan Ayberk Altug

Histomorphometric analysis of different latency periods effect on new bone obtained by periosteal distraction: an experimental study in the rabbit model

OBJECTIVES The aim of this study was to evaluate the effects of latency period on the bone formation after periosteal distraction. For this purpose, a rabbit model was developed and histologic and histomorphometric analyses were conducted. STUDY DESIGN Periosteal distractors were custom designed and built from stainless steel. Rabbits were divided into 2 groups of 18 each according to the duration of latency period. In group 1, the latency period was 7 days, and in group 2 it was 1 day. Distraction was performed by activating the distractor 0.25 mm twice per day. A periosteal distraction of 7.0 mm was achieved after a distraction period of 10 days. Both groups were divided to 3 subgroups according to the rabbits being killed on the 15th, 30th, or 60th day of the consolidation period. Histologic and histomorphometric analyses were performed to evaluate the bone formation. RESULTS In the histologic evaluation, new bone formation was observed on the lateral side of the mandible of all the rabbits. Histomorphometric measurements revealed that the mean area of newly formed bone formation was 2.62 cm(2) in group 1 and 3.26 cm(2) in group 2. CONCLUSIONS Periosteal distraction osteogenesis is a viable method in acquired and congenital alveolar ridge defects, resulting in new bone formation. Newly formed bone can be obtained by periosteal distraction osteogenesis applying different latency periods.

Evaluation of Articular Eminence Morphology and Inclination in TMJ Internal Derangement Patients with MRI

La morfologia e inclinacion de la eminencia articular son reportados como dos factores predisponentes para el trastorno interno (TI). El proposito de este estudio fue investigar la relacion entre la inclinacion y la morfologia de la eminencia articular y el TI. El estudio incluyo a 70 articulaciones temporomandibulares, con TI en 35 pacientes: 51 articulaciones con desplazamiento discal con reduccion (DDCR) y 19 de las articulaciones tuvieron desplazamiento discal sin reduccion (DDSR). Todos los sujetos fueron sometidos a imagenes de resonancia magnetica bilaterales de alta resolucion que se realizaron en los planos sagital y coronal con la boca cerrada y abierta. La morfologia articular la eminencia se caracterizo como una caja, sigmoide, aplanada, o deforme. La inclinacion de la eminencia articular se midio en tres posiciones: empinada (de 60 ° a 90 °), moderada (entre 30 ° a 60 °) y poco profunda (entre 15 ° y 30 °). Las imagenes fueron divididos en dos; DDCR y DDSOR, y estos criterios fueron comparados. Al comparar las imagenes de ambos grupos, la forma aplanada se observo con mayor incidencia en el grupo de DDSR, la forma sigmoide fue la mas frecuente en el grupo de DDCR y la inclinacion de la eminencia articular se encontro mas pronunciada que en el grupo DDSR. La inclinacion de la eminencia articular puede no tener un efecto predisponente en el desarrollo de los desplazamientos de disco.

Early Detection of Alterations in the Resonance Frequency Assessment of Oral Implant Stability on Various Bone Types: A Clinical Study

This study was undertaken to evaluate the relation between bone quality and alterations of implant stability quotient values measured during the initial phase of healing. Nineteen patients treated with 106 implants were included in the current study. The mean bone density of the implant recipient area was measured using Simplant 11 software incorporated in the computerized tomography (CT) machine. Mean bone density measurements were recorded in Hounsfield units. The implant recipient sites were subdivided into 5 groups according to bone quality. The numbers of the structures on the recipient site belonging to D1 and D5 types showed no statistical significance and were excluded. Standard 2-stage surgical technique was utilized to prepare the surgical sites. The implant stability quotient (ISQ) value at implant placement was recorded and did not influence the treatment procedure. The ISQ was measured by an Osstell instrument. The ISQ was further registered on the 21st and 60th days. SPSS statistical software was used for the statistical analysis. In comparison with the time of insertion, the mean values of the ISQ were decreasing for the first 21 days. However, on subsequent days, the ISQ values of all bone types have increased and on the 60th day reached the values recorded at the time of insertion. Analysis of the relation between changes in stability and bone type does not reveal statistical significance. With knowledge of the current clinical study, it can be concluded that bone quality in the recipient bone site does not effect changes in implant stability at the early stages of the osseointegration process.

Synchronous ossifying fibromas of the jaws: a review

According to the World Health Organization, it is proposed that benign fibro-osseous lesions be divided into 3 categories, including fibrous dysplasia, ossifying fibroma (OF), and osseous dysplasia. OF arises from the periodontal ligament, which contains multipotential cells. These benign tumors may become large and aggressive. Slow growth and lack of symptoms are the cardinal features. OF tends to occur in the second and third decades of life, with predilection for women and for the mandibular premolar-molar area. The method of treatment used for large or rapidly expanding lesions is surgical removal (enucleation). Rarely, OFs occur multifocally. We report a 20-year-old man with synchronous OFs of his maxilla and mandible and review other synchronous cases reported. Such lesions can be properly diagnosed and treated by correlating radiographic, clinical, surgical, and histopathologic findings.

Extraction of upper first molar resulting in fracture of maxillary tuberosity

Fracture of the maxillary tuberosity sometimes can happen when pneumatization of the maxillary sinus extends between the roots of upper molars. Some factors may lead to this complication including prominent or curved roots, chronic periapical infection, hypercementosis, root ankylosis and tooth fusion. This paper reports a case with fracture of the maxillary tuberosity following extraction of an upper first molar in general dental practice. Prevention from any complication during extractions of maxillary molars with large antral enlargement is possible with careful preoperative examination and accurate surgical planning. The general dentist should be prepared to refer such cases to an oral surgeon when facing difficulties like the presented case.

The Efficacy of Mylohyoid Nerve Anesthesia in Dental Implant Placement at the Edentulous Posterior Mandibular Ridge

The aim of this study is to evaluate the anesthetic efficacy of mylohyoid and buccal nerve anesthesia at the posterior edentulous mandible versus regional anesthetic block to the inferior alveolar nerve in dental implant surgery. The study was composed of 2 groups. In the first group (group A), 14 voluntary adults (7 female and 7 male) received local infiltrations of 1 mL articaine HCl 4% with epinephrine 1/200,000 to the ipsilateral mylohyoid and buccal nerves. In the second group (group B, control; 9 female and 5 male adults), the inferior alveolar and the buccal nerve blocks were performed. Visual analog scales were obtained from patients to determine the level of pain during incision, drilling, implant placement, and suturing stages of implant surgery. A combination of buccal and mylohyoid nerve block offered an acceptable level of anesthesia. Two patients from group A stopped the ongoing surgery and had extraregional anesthesia by inferior alveolar nerve block. In group B, patients were operated on successfully. Local anesthetic infiltrations of the mylohyoid and the buccal nerve may be considered alternative methods of providing a convenient anesthetic state of the posterior mandibular ridge.

Clinico-Radiographic Examination of Odontogenic Myxoma with Displacement of Unerupted Upper Third Molar: Review of the Literature

El mixoma odontogenico es un tumor benigno que se presenta en el 3% a 6% de todos los tumores odontogenicos. De acuerdo a la clasificacion de la OMS, las caracteristicas radiologicas de esta patologia presentan multiples areas radiolucidas de tamano variable, separadas por tabiques oseos rectos o curvos, con margenes mal definidos. Presentamos un caso de mixoma odontogenico maxilar en un hombre de 21 anos. La caracteristica radiologica es interesante, debido al tamano de la lesion y al desplazamiento severo del tercer molar superior.

The effect of cigarette smoking on the healing of extraction sockets: an immunohistochemical study.

Abstract The aim of this study was to investigate immunohistochemically the influence of cigarette smoking on the socket healing after tooth extraction in rats. Eighty-four male rats were divided into 3 groups; 2 groups were considered as experimental and the other as control. The animals in test 1 were exposed to smoking regimen before the surgery and after the surgery, but the animals in test 2 were exposed to the smoking regimen only before surgery. All animals’ maxillary right central incisors were extracted and killed at the 3rd, 7th, 15th, and 28th day. The samples taken on third day after tooth extraction were stained immunohistochemically with fibronectin antibody and the other with type I collagen antibody. On the third day after tooth extraction, samples in the control group were intense stained (3) (+++); in the test 1 they were slight positive (1) (+) and in the test 2 they were moderate positive (2) (+ +). As a result of scoring type I collagen antibody, there was no statistically significant difference between the groups at seventh day, but there were statistically significant differences between the groups at the 15th and 28th day (P = 0.000 and P = 0.001, respectively). Comparison of the paired intense scores of type I collagen antibody staining according to days within each groups were not statistically significant. As a result, we have found out that the healing process of the tooth extraction socket is negatively affected by cigarette smoke.

Radiologic assessment of the relationship between the maxillary artery and the lateral pterygoid muscle.

Objective The course of the second part of the maxillary can vary among different races. The aim of this study was to evaluate the relation between the maxillary artery and the lateral pterygoid muscle in a white population sample on computed tomographic (CT) angiograms. Materials and Methods We retrospectively reviewed multidetector CT angiograms of 209 patients (134 men and 75 women). The images were taken using a 64-row multidetector CT scanner. The imaging parameters were 0.5 × 64-mm slice thickness, 0.5- or 0.3-mm increment, 120 kV, 250 mA s, 0.5-second rotation time, 0.641 pitch, and 512 matrix. The relationship between the pterygoid portion of the maxillary artery and the lateral pterygoid muscle was assessed on axial, sagittal, and coronal multiplanar reformatted images with the Vitrea 2 software program. Results A total of 572 maxillary arteries in 286 patients were assessed. Of these maxillary arteries, 418 (68.42%) had a superficial course to the pterygoid muscle and 132 (31.58%) had a deep course. In 165 (78.94%) of 286 patients, there was a cross-lateral symmetry of the course of the artery; that is, both vessels were superficial or deep. In 44 (21.1%) of 209 patients, an asymmetric course was observed. Conclusions Because of the incidence of the asymmetric presentations, generalization regarding such a controversial topic should not be based on findings of cadaveric studies and each hemi head should be considered as a single entity. Therefore, advanced imaging systems are useful tools in preoperative planning and play a key role in the avoidance of hemorrhagic complications.

Management of obstructive sleep apnea by maxillomandibular advancement surgery in an edentulous patient.

Background Maxillomandibular advancement (MMA) surgery is a surgical treatment option for treating the patients with obstructive sleep apnea (OSA). Surgical treatment of OSA by MMA surgery is a problem when it is encountered with an edentulous patient because of the intermaxillary fixation problem of the jaws. A paucity of information is available concerning MMA surgery for edentulous patients. Materials and Methods In this case report, we present the preoperative planning, orthognathic surgery, and postoperative phases of a 49-year-old edentulous severe OSA (apnea hypopnea index, 81.9 event/hr) patient who underwent MMA surgery. Results Polysomnographic examination 9 months after surgery revealed normalization of the somnographic evaluations (apnea hypopnea index, 1.3). Conclusions The results reported in the present case showed that the surgical treatment of OSA by MMA surgery in edentulous patients could be successfully done. Further critical evaluations of this approach for the surgical treatment of edentulous OSA patients are needed.