İbrahim Damlar

Effects of smoking on periimplant health status and IL-1β, TNF-α, and PGE2 levels in periimplant crevicular fluid: a cross-sectional study on well-maintained implant recall patients.

Purpose:The aim of this cross-sectional study was to evaluate the effects of smoking on periimplant health status and inflammatory cytokines interleukin-1&bgr;, tumor necrosis factor-&agr;, and prostaglandin E2 levels in periimplant crevicular fluid (PICF) and to determine their correlation with clinical parameters in well-maintained implant recall patients. Material and Methods:A total of 60 dental implants placed in 60 patients (27 patients were smoker and 33 were nonsmoker) were included in the study. Plaque index, gingival index, probing depth, periimplant bone loss, PICF volume, and biochemical cytokine levels in PICF were determined and analyzed statistically. The correlation between PICF cytokine levels and clinical parameters were also analyzed. Results:All clinical parameters with the exception of plaque scores were significantly higher in the smoker group. Significantly increased levels of cytokines were observed in the smoker group. The correlation between the cytokine levels and clinical parameters were more marked in smokers. Conclusions:Although the implants of the smoker patients seem to be clinically healthy, the results demonstrate that the implants are relatively at risk even if in a well-maintained population.

Demonstration of ethyl glucuronide in dental tissue samples by liquid chromatography/electro-spray tandem mass spectrometry.

INTRODUCTION Ethyl glucuronide (EtG) has been studied in various tissues and body fluid for determination of alcohol intake. However, no study, dealing with EtG analysis in dental tissue, was performed so far. In this study, we aimed to demonstrate EtG levels in dental tissue. MATERIALS AND METHODS Michigan Alcohol Screening Test (MAST) was performed to 29 participants. Following the test, cases were divided into three groups as non-hazardous alcohol users, alcohol abusers and 6 controls who verbally declared that they were abstainers. A total of 29 tooth specimens, obtained from participants, was included in the study. These specimens were analyzed using LC/MS/MS. RESULTS All of the participants included in the study were male. According to the MAST outcomes 14 of the participants were non-hazardous alcohol users, and 9 were alcohol abusers, while 6 patients verbally declared that they were abstainers. Dental tissue analyses revealed EtG levels ranging between EtG<LOD and 23.39 pg/mg. EtG levels were observed to be <LOD in dental specimens of 6 abstainer cases. A significant correlation was found between EtG levels measured in the dental tissues and MAST outcomes on the statistical analyses (r=0.914). CONCLUSION The findings of the present study demonstrated that dental tissue can be used for detection of alcohol intake, using LC/MS/MS.

Effects of glucosamine-chondroitin combination on synovial fluid IL-1β, IL-6, TNF-α and PGE2 levels in internal derangements of temporomandibular joint.

Background The aim of the present study was to evaluate the effects of glucosamine-chondroitin sulphate combination on internal derangements of temporomandibular joint in clinical and biochemical manners. Material and Methods This randomized clinical study included 31 cases reporting joint tenderness, in which disc displacement was detected on MR imaging. In all patients, synovial fluid sampling was performed under local anesthesia. In the study group, the patients were prescribed a combination of 1500 mg glucosamine and 1200 mg chondroitin sulphate, while patients in the control group were only prescribed 50 mg tramadol HCl (twice daily) for pain control. After 8 weeks, synovial fluid sampling was repeated in the same manner. The levels of pain, maximum mouth opening (MMO), synovial fluid IL-1ß, IL-6, TNF-α and PGE2 measured before and after pharmacological intervention were compared. Results The reduction in pain levels was significant in both groups. There was no significant difference between two groups in terms of pain reduction. The improvement in MMO was significant in the study group but it was not in the control group. The MMO improvement was significantly higher in the study group compared to the control group. In the study group, significant decrease was observed in PGE2 level, while the decreases in IL-1β, IL-6 and TNF-α levels were not significant. In the control group, no significant decrease was observed in any of the inflammatory cytokines after 8 weeks, moreover IL-1ß and IL-6 levels were increased. Alterations of IL-1ß and IL-6 levels were significant in study group while TNF-α and PGE2 levels were not, compared to control group. Conclusions In conclusion, these results might suggest that glucosamine-chondroitin combination significantly increases the MMO and decreases the synovial fluid IL1β and IL6 levels in internal derangements of TMJ compared to tramadol. The modifications of synovial fluid TNF-α and PGE2 levels do not reach statistical significance. This combination also provides efficient pain relief in similar level with tramadol, a narcotic analgesic. Key words: Chondroitin sulphate, glucosamine, internal derangement, TMJ, tramadol.

Comparison of osteoconductive properties of three different β-tricalcium phosphate graft materials: a pilot histomorphometric study in a pig model.

AIMS The aim of this study was to compare the de novo bone formation ability and osteoconductive effects of three different β-tricalcium phosphate (β-TCP) graft materials. The micro-architectural parameters of the newly formed bone tissues were also compared among the different graft materials. MATERIAL AND METHODS Eight male Swiss domestic pigs were used in the study. Five bony defects were made with a trephine bur. Three of the defects were filled with Cerasorb®, Kasios® and Poresorb®. The fourth defect was filled with an autogenous bone graft. The last defect remained empty. All subjects were sacrificed after 8 weeks. RESULTS When compared to a negative control group, significant healing was observed in all the groups except the Cerasorb group. The osteoconductivity of the Poresorb group was better than that of the other groups (p < 0.05). The difference in the osteoconductivity of the Kasios and Cerasorb groups was statistically significant (p < 0.05). Comparison of the micro-architectural properties of newly formed bone tissues retrieved from the defects showed that those filled with Poresorb were the best. CONCLUSION β-TCP materials show different results in terms of the volume and characteristics of new bone formation, although they have a similar chemical structure.

Diagnostic Concordance Characteristics of Oral Cavity Lesions

Purpose. The objective of this study was to evaluate the diagnostic concordance characteristics of oral cavity lesions by comparing the clinical diagnosis of the lesions with the histopathologic diagnosis. Material and Method. A retrospective analysis was conducted on the patients, who were admitted with oral cavity pathology and underwent biopsy procedure between 2007 and 2011. The oral cavity lesions were classified into 6 different groups as odontogenic cysts, nonodontogenic cysts, odontogenic tumors, nonodontogenic tumors, malignant tumors, and precancerous lesions in accordance with the 2005 WHO classification. The diagnoses were also recategorized into 3 groups expressing prognostic implications as benign, precancerous, and malignant. The initial clinical diagnoses were compared with the histopathologic diagnoses. Data were analyzed statistically. Results. A total of 2718 cases were included. Histopathologic diagnosis did not match the clinical diagnosis in 6.7% of the cases. Nonodontogenic tumors and malignant tumors had the highest misdiagnosis rates (11.5% and 9%, resp.), followed by odontogenic tumors (7.7%), precancerous lesions (6.9%), and odontogenic cysts (4.4%). Clinicians were excelled in diagnosis of benign and precancerous lesions in clinical setting. Conclusion. The detailed discordance characteristics for each specific lesion should be considered during oral pathology practice to provide early detection without delay.

Treatment of displaced mandibular condylar fracture with botulinum toxin A

The aim of this case report is to discuss the effect on condylar reduction of botulinum toxin A treatment used in a child with displaced fracture at condylar neck of mandible. A 3-years old boy was admitted to our clinic for incomplete fracture of mandibular symphysis and displaced condylar fracture at the left side. An asymmetrical occlusal splint with intermaxillary fixation was used instead of open reduction and internal fixation because of incomplete fracture of symphysis and possible complications of condyle surgery. However, it was observed that condylar angulation persisted despite this procedure. Thus, botulinum toxin A was administered to masseter, temporalis and pterygoideus medialis muscles. At the end of first month, it was seen that mandibular condyle was almost completely recovered and that fusion was achieved. In conclusion, Botulinum A toxin injection aiming the suppression of masticatory muscle strength facilitates the reduction in the conservative management of displaced condyle in pediatric patients.

Angioleiomyoma of the gingiva: a report of two cases

Leiomyoma is a type of benign smooth muscle neoplasm that is a common neoplasm of the uterus and gastrointestinal tract but rarely affects the head and neck region and is especially unlikely to affect the oral cavity. The diagnosis of leiomyoma is mainly determined by histopathological studies due to variation in its clinical appearance and symptoms. In the present paper we report two rare cases of gingival angioleiomyoma in the posterior maxilla and mandible. After total excision, hematoxylin-eosin and smooth muscle actin staining confirmed the diagnosis of angioleimyoma.

Management of obstructive sleep apnea in a Treacher Collins syndrome patient using distraction osteogenesis of the mandible

In this study, we present the surgical treatment of obstructive sleep apnea in a child with Treacher Collins syndrome. A 10-year-old girl with a past history of Treacher Collins syndrome presented to our clinic with her parents for respiratory distress and insomnia. The patient was referred to a sleep laboratory where she was diagnosed with obstructive sleep apnea, which was a consequence of her Treacher Collins syndrome. The patient underwent mandibular distraction osteogenesis under general anesthesia. The mandible was expanded by 15 mm using internal bilateral distractors. After distraction osteogenesis, the patient’s respiratory problems resolved, and she was able to sleep comfortably. Distraction osteogenesis was an effective method of advancing the mandible, increasing the upper airway space and ultimately preventing obstructive sleep apnea syndrome in patients with Treacher Collins syndrome.

Disappearance of a dental implant after migration into the maxillary sinus: an unusual case.

Migration of dental implants into the maxillary sinus is uncommon. However, poor bone quality and quantity in the posterior maxilla can increase the potential for this complication to arise during implant placement procedures. The aim of this report is to present a dental implant that migrated into the maxillary sinus and disappeared. A 53-year-old male patient was referred to us by his dentist after a dental implant migrated into his maxillary sinus. The displaced implant was discovered on a panoramic radiograph taken five days before his referral. Using computed tomography, we determined that the displaced dental implant was not in the antrum. There was also no sign of oroantral fistula. Because of the small size of the displaced implant, we think that the implant may have left the maxillary sinus via the ostium.

To what extent does hyaluronic acid affect healing of xenografts? A histomorphometric study in a rabbit model

ABSTRACT Among the many graft materials that have been used for the treatment of bone defects in oral and maxillofacial regions is xenograft. To improve osteoconductive effects of xenografts, they have been combined with various biocompatible materials, such as hyaluronic acid and bone morphogenetic protein. Objective To determine bone-healing capacity of high molecular weight hyaluronic acid (HA) combined with xenograft in rabbit calvarial bone defects. Material and methods Ten adult male New Zealand rabbits (mean weight 3 kg) were included in the study. Three 6-mm-diameter bicortical cranial defects were created on calvarial bone of all rabbits. These defects were filled as follows: a) xenograft; b) HA+xenograft; c) autograft. One month after the first operation, rabbits were sacrificed. Specimens were evaluated histomorphometrically. Results Considering multiple comparisons, differences regarding new bone were statistically significant between all groups (p<0.05). The volume of residual graft was significantly decreased in HA group compared to xenograft group (p=0.035). Marrow space, trabecular thickness (TbTh), trabecular width (TbWi), trabecular separation (TbSp), and number of node: number of terminus (NNd:NTm) in the autograft group were significantly better than xenograft and HA groups (p<0.05). However, regarding marrow space, TbTh, TbWi, TbSp, and NNd:NTm values, xenograft and HA groups showed similar results and the difference were not significant (p>0.05). Conclusion These results support that high molecular weight hyaluronic acid could contribute to the healing of xenograft by improving the percentage of new bone formation and reducing the percentage of residual graft. However, HA did not significantly affect the quality of newly formed bone assessed by microarchitectural parameters.