Kemal Murat Okçu

Premaxillary Distraction Osteogenesis with an Individual Tooth-Borne Appliance

Distraction osteogenesis defines a technique of bone generation and osteosynthesis by the distraction of native preexisting bone. The technique offers a promising treatment alternative for patients with maxillary hypoplasia and a retrognathic mandible. In this case report, the steps in the treatment of an 18.2-year-old girl with premaxillary hypoplasia and anterior crossbite are described. The patient was treated with a distraction osteogenesis technique, and premaxillary advancement was performed using an individual tooth-borne distraction device. The surgical operation consisted of a classical segmental maxillary osteotomy carefully respecting the palatal periosteum. The distractor was cemented in the mouth after the surgical procedures. The patient was observed during a seven-day latency period, after which the device was activated 0.5 mm every 12 hours. The anterior crossbite was eliminated in one week, and the treatment was finished with fixed orthodontic appliances.

Use of zygomatic anchors during rapid canine distalization: a preliminary case report.

Rapid canine distalization is a technique involving periodontal ligament distraction. The primary aim of this technique is to distalize the canines without anchorage loss and to shorten the duration of orthodontic treatment. After the rapid canine distalization, the healing process of the periodontal ligament is similar to rapid palatal expansion and requires a consolidation period. The long consolidation period of the technique conflicts with the second aim. Skeletal anchorage systems seem to compensate for this conflict because they can be also used for retraction of incisors during consolidation period. This case report presents the orthodontic treatment of a 16-year-old female, who had a bimaxillary retrusion and a dental Class II division I malocclusion. Upper first premolars were extracted and, while the canines were being distalized rapidly by periodontal ligament distraction, the incisors were retracted using a zygomatic anchorage system. The treatment of the patient was completed in five months without any anchorage loss.

Anatomical and functional aspects of ligaments between the malleus and the temporomandibular joint

The aim of this paper is to investigate the anatomical topography and the relationship between the ligaments, malleus and temporomandibular joint (TMJ) and to determine the role of these ligaments on the movement of the malleus. The malleus, incus, petrotympanic fissure (PTF), chorda tympani, anterior malleolar ligament (AML), discomallear ligament (DML), malleomandibular ligament, sphenomandibular ligament and articular disc were explored in 15 skulls. Traction and tension tests were carried out to clarify their role in malleolar movement. In 12 of the cases, two separate ligaments were connected to the anterior of the malleus, whereas a single ligament from the anterior of the malleus to the PTF was observed in 3 cases. In 12 cases, the DML united the retrodiscal tissues. In the other 3 cases, the medial and the lateral parts of the ligament were connected to the retrodiscal tissue after passing through the PTF. The thickness of the ligaments differed among specimens. When tension was applied to the DML no malleolar movement occurred, but when the AML was overstretched, significant movement was observed in 5 cadavers; little movement in 6 cadavers, and no movement in 4 cadavers. This study suggests that extreme stretching of the condyle in conjunction with the ligaments between the ossicles of the inner ear and the TMJ could be the reason for unexplained otological problems.

Evaluation of the Dental Health of the Young Adult Male Population in Turkey

This study aimed to determine the prevalence of dental caries in military recruits and to assess the relation of dental caries with socioeconomic and demographic factors, and sugar consumption behavior, and to generalize the findings for the young adult male population to draw a picture of dental health status of this population segment in Turkey. In this cross-sectional study conducted between August and October 2000 in a military basic training center in Turkey, 2,766 male recruits of the age of 20 were examined by dental specialists to determine their mean number of decayed, missing, or filled teeth (DMFT) scores and were administered a questionnaire for capturing their demographic characteristics and sugar consumption behavior. The mean DMFT score for the 20-year-old male population in Turkey was found to be 5.97. DMFT scores were weakly correlated with income level and urbanization. Sugar consumption was strongly correlated with DMFT scores. The mean number of teeth with fillings component was strongly correlated with income level, moderately with the subjects education, and weakly with the mothers education, fathers education, and urbanization. DMFT scores for the young adult male population in Turkey were strongly associated with sugar consumption behavior, whereas they were weakly or not at all associated with demographic factors such as education level, income level, and urbanization.

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.

Evaluation of oral or rectal midazolam as conscious sedation for pediatric patients in oral surgery.

This study was undertaken with a view to determine the acceptance and treatment possibilities of midazolam, depending upon its oral and rectal application for pediatric patients requiring an oral surgery procedure (tooth extraction) and having a pretreatment behavioral score of 1 or 2 according to the Frankl Scale. Oral (0.5 mg/kg) and rectal (0.35 mg/kg) midazolam was compared in view of acceptance of the mode of treatment and local anesthesia, level of amnesia, and adverse effects. Although oral or rectal midazolam application has similar characteristics in respect to ease of working, the oral midazolam application should generally be preferred because it is more easily accepted by pediatric patients.

Mandibular Distraction with MD-DOS Device

Distraction osteogenesis is an alternative treatment method for the correction of mandibular hypoplasia. In this case report, mandibular distraction with a dynamic osteosynthesis system (MD-DOS) was performed to gradually lengthen the mandible of a patient who had a severe hypoplastic mandible. The patient underwent intraoral bilateral mandibular distraction osteogenesis. The latency period after the operation was seven days. The distraction was performed three times daily for 14 days at the rate of 0.33 mm each time. Subsequent retention was nine weeks. The patients mandible was elongated successfully and a satisfactory profile and occlusion was achieved.

Rectangular body ostectomy for the treatment of severe mandibular prognathism.

Objective The aim of this article was to present the surgical technique and the outcomes of rectangular body ostectomy in the treatment of severe mandibular prognathism. Methods Mandibular setback by bilateral rectangular body ostectomies combined with Le Fort I level maxillary advancement was performed. The deep bony concavity of paranasal area was grafted with bone blocks harvested from the ostectomized segments of the mandible. Results Satisfactory functional and aesthetic outcomes were obtained by rectangular body ostectomy combined with Le Fort I level maxillary advancement and an acceptable profile was provided for the patient. Conclusions The mandibular rectangular ostectomy remains a safe and versatile procedure with predictable results in well-selected cases.