İnci Rana Karaca

Experimental Evaluation of the Effectiveness of Demineralized Bone Matrix and Collagenated Heterologous Bone Grafts Used Alone or in Combination with Platelet-Rich Fibrin on Bone Healing in Sinus Floor Augmentation.

PURPOSE The aim of this study was an experimental evaluation of the effectiveness of demineralized bone matrix (DBM) and collagenated heterologous bone graft (CHBG) used alone or in combination with platelet-rich fibrin on bone healing in sinus floor augmentation procedures. MATERIALS AND METHODS In this study, 36 New Zealand rabbits were used. The bilateral sinus elevation was performed, and 72 defects were obtained. The rabbit maxillary sinuses were divided into four groups according to the augmentation biomaterials obtained: demineralized bone matrix (Grafton DBM Putty, Osteotech; DBM group), DBM combined with platelet-rich fibrin (PRF; DBM + PRF group), collagenated heterologous bone graft (CHBG; Apatos Mix, OsteoBiol, Tecnoss; CHBG group), CHBG combined with PRF (CHBG + PRF group). All groups were sacrificed at 2, 4, and 8 weeks after surgery for histologic, histomorphometric, and immunohistochemical analyses. RESULTS The inflammatory reaction was moderate to intense at the second week in all groups and declined from 2 to 8 weeks. New bone formation was started at the second week and increased from 2 to 8 weeks in all groups. There was no significant difference in bone formation between the experimental groups that used PRF mixed graft material and control groups that used only graft material. The percentage of new bone formation showed a significant difference in DBM groups and DBM + PRF groups compared with other groups. There were osteoclasts around all the bone graft materials used, but the percentage of residual graft particles was significantly higher in CHBG groups and CHBG + PRF groups at the eighth week. CONCLUSION There is no beneficial effect of the application of PRF in combination with demineralized bone matrix or collagenated heterologous bone graft on bone formation in sinus floor augmentation. The results of this study showed that both collagenated heterologous bone graft and demineralized bone matrix have osteoconductive properties, but demineralized bone matrix showed more bone formation than collagenated heterologous bone graft.

A 5 year retrospective study of biopsied jaw lesions with the assessment of concordance between clinical and histopathological diagnoses

Introduction: The jaw can be affected by several lesions that manifest in the oral cavity, but little is known about their distribution patterns in various populations. Aims and Objectives: This study presents the frequency and distribution of biopsied jaw lesions recorded in Faculty of Dentistry and gathers the information including provisional and final diagnosis of the lesions. Material and Methods: Biopsy of 1938 lesions (2008–2013) was reviewed and 1473 lesions were included in this study. The provisional diagnosis and histopathological validations of lesions were compared. Data on the location of the lesion, as well as patient demographics, were also evaluated. The lesions were divided into three major groups as 1 - developmental/reactive and inflammatory lesions of the jaw, 2 - cystic lesion and 3 - tumor and tumor-like lesions. Statistical Analysis: The variables were recorded and analysed using descriptive statistics. Results and Observations: Three hundred and ninety-six lesions were in Group 1 and periapical granuloma was the most frequent diagnosis. Seven hundred and eighty-nine lesions were in Group 2 and the radicular cyst was the most frequent diagnosis. Two hundred and eighty-eight lesions were in Group 3 and the keratocystic odontogenic tumor was the most frequent. Two hundred and ninety-one biopsied lesions were in disagreement with respect to the diagnoses on clinical and histopathological examination. Conclusion: Consequently, a provisional diagnosis of some of the malignant lesions was reactive, inflammatory, cystic or benign lesions, therefore the importance of evaluation of the specimen is emphasized.

Effect of Platelet-Rich Plasma on the Outcome of Early Loaded Dental Implants: A 3-Year Follow-up Study

This study evaluated the effect of local application of platelet-rich plasma (PRP) on the outcome of early loaded implants. Two implants were placed in the posterior region or bilaterally symmetric to the median line of the maxilla. Then, PRP was either applied or not applied to the implant sockets. Outcome measures were prosthesis and implant success as well as biological and prosthetic complications. Stability of individual implants was assessed manually and with a resonance frequency analysis device. The implant stability quotient (ISQ) was recorded on the operation day, on postoperative day 4, and at postoperative week 1. At the end of the first postoperative week, implants with ISQ values >60 were early loaded on day 7 with metal-ceramic crowns. Measurements were repeated at postoperative weeks 2, 3, and 4 and at postoperative months 6, 12, 24, and 36. One of the 64 implants was dropped out after 3 months of loading. No prosthesis failed. There were no prosthetic complications. Statistical analysis r...

Experimental evaluation of the effects of Ankaferd Blood Stopper and collagenated heterologous bone graft on bone healing in sinus floor augmentation.

PURPOSE The aim of this study was to evaluate the effect of collagenated heterologous bone graft (CHBG) and Ankaferd Blood Stopper (ABS), a plant extract, on bone healing after sinus floor augmentation. MATERIALS AND METHODS Thirty-six New Zealand rabbits were used. Bilateral sinus augmentation was performed, and 72 bone defects were created. The maxillary sinuses were grafted with four different biomaterials: blood clot (control group), CHBG (Apatos Mix, OsteoBiol, Tecnoss) (graft group), ABS (ABS group), and ABS + CHBG (ABS+graft group). The rabbits were sacrificed at 1, 4, and 8 weeks after surgery. Histochemical and immunohistochemical examinations were performed on all samples. Staining with hematoxylin-eosin and Masson trichrome was performed, and bone marker activity was evaluated. RESULTS Lymphocyte infiltration was high at the first week in all groups and decreased from 1 to 8 weeks. All materials were biocompatible. Osteoclast numbers increased in the control group from 1 to 8 weeks and decreased in the other groups. There was no new bone formation in week 1 in all groups. New bone formation increased in all groups from 1 to 8 weeks, and at the fourth week, new bone formation was greater in the ABS and ABS+graft groups than in the other groups. There were osteoclasts around the bone graft materials, but degeneration of the graft was seen only in the ABS+graft group at week 8. CONCLUSION ABS accelerates bone healing in sinus augmentation procedures and can be used alone or with CHBG. CHBG has osteoconductive properties, and ABS can accelerate bone graft degeneration.

Is low‑level laser therapy and gaseous ozone application effective on osseointegration of immediately loaded implants?

Purpose: The purpose of this study was to investigate the effects of biostimulation lasers and ozone therapy on osseointegration of immediately loaded implants. Materials and Methods: A total number of 100 implants (DTI Implant Systems) were applied to 25 patients evenly. Temporary crowns were applied to each patient on the same session as the surgery. Implants were divided into four treatment groups (Group 1: low-level laser therapy (LLLT) group, Group 2: ozone therapy group, Group 3: different protocol of ozone therapy group, and Group 4: control group) each with 25 implants. The irradiations were performed with a gallium-aluminum-arsenide diode low-level laser (Laser BTL-4000) to Group 1. Ozone therapy was performed using an ozone generator (OzoneDTA) with an intraoral probe to Group 2 and Group 3. Results: In this study, the overall implant survival rate was 92% after a 6-month observation period. The implant stability quotient values were found significantly higher in Group 1 (LLLT group) and Group 3 (different protocol of ozone therapy group) than the other groups (P < 0.05). There was no significant difference in Group 2 (ozone therapy group) and the control group (P > 0.05). Conclusions: Our results suggest that both LLLT and ozone therapy with prolonged application time are promising methods to enhance bone healing around immediately loaded implants and increase implant stability; however, there is a need for more studies on this subject for these methods to become routine applications.

Effects of Inferior Alveolar Nerve Neurosensory Deficits on Quality of Life

Objective: The purpose of this study was to investigate the effect of temporary or persistent neurosensory disturbance of the inferior alveolar nerve (IAN) on the quality of life using Oral Health Impact Profile (OHIP-14) questionnaire. Methods: The patients with the neurosensory deficit of the IAN that was confirmed by subjective and objective neurosensory tests formed the study group. The patients who had dental or oral and maxillofacial surgery procedures in the same unit and did not present neurosensory deficit were matched with the study group according to their gender and age and were presented as the control group. Both groups filled OHIP-14 questionnaire. Results: This study included 200 patients (122 female and 78 male), aged between 18 and 75 years. Kolmogrov–Smirnov, Levene, Mann-Whitney U, and Kruskal Wallis tests were used for statistical analysis. In study group, the average OHIP-14 scores were higher in women than in men in physical pain and handicap subgroups. There were significant differences between study and control groups in functional limitation, psychological discomfort, psychological disability, and handicap subgroups. The OHIP-14 scores were higher in study group compared with the control group. Conclusion: It was concluded that the patients with the neurosensory deficit of the IAN have a poorer quality of life than those without neurosensory deficits.

The effects of ozone therapy as an adjunct to the surgical treatment of peri-implantitis

Purpose The decontamination procedure is a challenging aspect of surgical regenerative therapy (SRT) of peri-implantitis that affects its success. The purpose of the present study was to determine the impact of additional topical gaseous ozone therapy on the decontamination of implant surfaces in SRT of peri-implantitis. Methods A total of 41 patients (22 males, 19 females; mean age, 53.55±8.98 years) with moderate or advanced peri-implantitis were randomly allocated to the test group (ozone group) with the use of sterile saline with additional ozone therapy or the control group with sterile saline alone for decontamination of the implant surfaces in SRT of peri-implantitis. Clinical and radiographic outcomes were evaluated over a period of 12 months. Results At the 12-month follow-up, the plaque and gingival index values were significantly better in the ozone group (P<0.05). Probing depth decreased from 6.27±1.42 mm and 5.73±1.11 mm at baseline to 2.75±0.7 mm and 3.34±0.85 mm at the end of the 12-month observation period in the ozone and control groups, respectively. Similarly, the clinical attachment level values changed from 6.39±1.23 mm and 5.89±1.23 mm at baseline to 3.23±1.24 mm and 3.91±1.36 mm at the 12-month follow-up in the ozone and control groups, respectively. According to the radiographic evidence, the defect fill between baseline and 12 months postoperatively was 2.32±1.28 mm in the ozone group and 1.17±0.77 mm in the control group, which was a statistically significant between-group difference (P<0.05). Conclusions Implant surface decontamination with the additional use of ozone therapy in SRT of peri-implantitis showed clinically and radiographically significant. Trial registry at ClinicalTrials.gov, NCT03018795.

Antibiotic usage - Ectopic Impacted Lower Third Molar.

Dear Editor, The failure of eruption of third molars is very common in our part of the world (Turkey, Ankara) and the removal of third molars is a routine procedure that is carried out in our department. While searching literature for articles about “impacted third molars”, the article ‘Extra-Oral Approach for Removal of Ectopic Impacted Lower Third Molar: A Case Report’ caught our attention. However, there are some points that we would like the authors to clarify. Many years have passed since the first publication about antibiotic usage appeared in the international literature [1]. Although antibiotics have transformed our ability to treat infections, they also pose some problems: As antibiotic resistance increases, these lifesaving drugs do not work as well as they once did and their ability to treat infections decrease [1]. Due to the presence of antimicrobial resistance all over the world, the usage of third generation Cephalosporins, especially Cetaxim, is critical. Because Cefataxim crosses the blood-brain barrier, they are important medical agents for the treatment of infections like meningitis [2]. In the case presented by the authors, we hold the opinion that a microbiological examination could have been carried out to identify the causative microorganisms and to determine their susceptibility to certain antibiotics so that the prescription of potent antibiotics like Cefataxime could have been avoided for that kind of dentoalveolar infection. Like the choice of an appropriate antibiotic, the administration pathway of antibiotics is also a very important issue for infection treatment [3]. With reference to the authors’ case report it has been stated that intravenous antibiotic usage was preferred for the patient. The practice of antibiotic usage is based on certain fundamental principles [3]. Today it is accepted that drug usage should be comfortable for the patient [3]. This is an important point to avoid psychological and physical stress to the patient. Furthermore some antibiotics can be used intravenously as well as orally and both administration pathways share the same absorption parameters [4]. According to the study by Lamp and Freeman, 1gr loading dose of metronidazole have been applied intravenously on seven patients, and it was followed by 500mg every 8 hours either intravenously or orally and same absorption parameters were observed [4]. Several studies [2,5] have shown that Cefataxime cannot be used orally, however there are some other third generation Cefalosporins which can be used for oral applications [5]. If the authors felt the need to use Cefalosporin, would it not be better to use another third generation Cefalosporin orally? Lastly can you clarify us about the day of antibiotic cover that the surgery was realized? Please let us have some explanatory information on the points above.

Regarding “Significantly Decreased Recurrence Rates in Keratocystic Odontogenic Tumor With Simple Enucleation and Curettage Using Carnoy's Versus Modified Carnoy's Solution”

To the Editor:—We recently came across the article by Dashow et al during one of our literature discussion sessions. We read this article with interest and found it intriguing. However, some aspects of the article were rather unclear. We would appreciate enlightenment on these few matters. In another article, Dashow et al stated that Carnoy solution (CS) or modified CS (MC) was applied to the walls of the bony defect in conjunction with enucleation and curettage. However, in the article published in the journal, the application protocol of CS and MC was not mentioned. CS can be used in various ways in the treatment of keratocystic odontogenic tumor (KOT). It can be applied into the cyst cavity before enucleation or to the bone cavity after enucleation. Therefore, we wondered whether all patients were treated with the same protocol and whether CS was used in other ways. If so, then could these differences have affected the recurrence rates? Hellstein et al investigated the penetration values of chloroform and non-chloroform forms of CS in different tissue types to assess the need and effect of chloroform and found that the results were very similar. They concluded that chloroform is an unnecessary constituent of CS. Based on this conclusion, we thought there could be other factors affecting the recurrence rates found by Dashow et al, such as histologic and morphologic features of the lesions and the level of experience of the surgeons. In the literature, the parakeratinized type of KOT is stated to have a more aggressive nature compared with the orthokeratinized type. This could be one of the reasons for recurrences in the study; however, Dashow et al did not mention the histologic characteristics of the lesions. In addition, the multilocular type of KOT has a higher recurrence rate than the unilocular type because it is usually characterized by daughter cysts along its border. They also did not mention the unior multilocular nature of the cysts.

İMPLANT UYGULAMALARI İÇİN KRET KORUMA TEKNİKLERİ

Bone resorption following tooth extraction may lead to inappropriate ridge structure. Ridge preservation is a technique which limits amount of the bone loss after extraction. The purpose of this article is to show changes tooth extraction and evaluate techniques of ridge preservation