Kemal Şençift

Comparison of Conventional Surgery and CO2 Laser on Intraoral Soft Tissue Pathologies and Evaluation of the Collateral Thermal Damage

OBJECTIVE The aim of the study was to compare conventional surgery with carbon dioxide (CO(2)) laser applied on oral soft tissue pathologies and to evaluate the effect of collateral thermal damage on histopathological diagnosis. Anesthesia need, postoperative pain, and intraoperative and postoperative complications were examined as part of the comparison. METHODS Forty-three patients (32 female and 11 male) with a mean age of 54 (54 +/- 7.0) requiring soft tissue surgeries were randomly assigned to receive treatment either with conventional surgery using a scalpel or with a CO(2) laser technique. Anesthesia method and need, postoperative pain, systemic pain medications if needed, and intra- and postoperative complications were recorded. Excised tissues were evaluated histopathologically for the effect of thermal damage. RESULTS All patients were anesthetized with local anesthesia in the conventional group whereas only 10 (42%) patients needed local anesthesia after topical anesthetic application in the laser group. In the conventional group, 18 (90%) patients need analgesics after the operation, compared with seven (29%) patients in the laser group. No intra- or postoperative complications were seen for either procedure. Histological examination of 39 specimens showed that collateral thermal damage on the incision line did not affect the histopathological diagnosis. CONCLUSIONS CO(2) laser is an effective instrument for soft tissue excisional biopsies with minimal intraoperative and postoperative complications and good pain control. CO(2) laser applications are suggested as an alternative method to conventional surgery on oral soft tissues.

Determination of Potential Cellular Proliferation in the Odontogenic Epithelia of the Dental Follicle of the Asymptomatic Impacted Third Molars

PURPOSE The aim of this study is to determine the proliferative potentials of dental follicles (DF) of radiographically asymptomatic impacted third molar teeth by using Ki-67 and mini-chromosome maintenance protein 2 (MCM-2) proliferation markers, and to discuss whether there is any necessity for the removal of all impacted third molars by detecting the potential of the developing cysts and tumors of its DF. MATERIALS AND METHODS This study involved 59 DF of 54 patients referred for clinically and radiographically asymptomatic lower impacted third molars. Thirteen healthy gingiva tissues obtained during the impacted third molar operation in 13 patients served as a control group. DF widths on periapical radiographs below 2.5 mm were included in the study. The epithelial and mesenchymal components of DF were examined histologically. All specimens were stained with periodic acid Schiff, Alcian blue, and mucin for the evaluation of mucous cell prosoplasia. Epithelial cell proliferation was determined by using immunohistochemical labeling. RESULTS The histologic examinations showed 11.9% mucous cell prosoplasia, 55.9% squamous metaplasia, 15.3% glandular epithelium, and 33.9% inflammation. Ki-67 expression was found to have higher values than MCM-2 expression in controls 6.15 (3.18) and 10.53 (5.77) and in DF 4.46 (1.39) and 5.89 (2.89), respectively. The expression of both proliferation markers in the basal epithelial cells, mucous, and squamous epithelium and inflammatory cells were statistically significant (P < .01). CONCLUSION The results of this study indicate that the odontogenic epithelium in DF of asymptomatic impacted third molars might be actively proliferating and may be an indicator for the differentiation potential of DF. It would also seem that the inflammation observed in the mesenchymal components of DF up-regulate the cell turnover of odontogenic epithelium and lead to proliferation. Based on these observations, we support prophylactic removal of impacted third molars.

Conservative Management of Keratocystic Odontogenic Tumors of Jaws

Purpose. The aim of this study was to evaluate different surgical treatment methods for keratocystic odontogenic tumors (KCOTs) and the outcome of those treatments over a 9-year period. Patients and Methods. A retrospective review was performed on 43 KCOTs in 39 patients. In radiographic evaluations for diagnosis, follow ups and before and after treatment, panoramic, 3D CT and MR images were used. The three groups of different surgical treatment were (1) enucleation for small unilocular lesions without certainty of histology; (2) enucleation with Carnoys solution, for small unilocular lesions after previous histological confirmation of KOCT; (3) marsupialization followed by enucleation with Carnoys solution implemented for large often multilocular KCOTs with intact or destruction of cortical bone without infiltration of neighbouring tissue. Results. 43 KCOT cases were mostly localized in mandible (76.7%), radiologically unilocular (72%), and parakeratocysts (88.4%). Inflammation and satellite cysts (daughter cysts) were detected histopathologically in 14 (32.5%) and 7 (16.3%), respectively. Among the 43 cysts, 20 (46.5%) were associated with the impacted third molar and of 21 (48.8%) was in tooth bearing area, and 5 (11, 6%) located on edentulous areas. It was located mostly in the anterior region of maxilla (90%) and in mandibular molar and ramus (62.8%). The treatments of KCOTs were 18 (41.9%) for group 1, and 10 (23.3%) group 2, and 15 (34.8%) group 3. A statistically significant relationship was found between the radiographic appearance and treatment methods (P = 0.00). No recurrence was found on 40.54 ± 23.02 months follow up. Conclusion. We concluded that successful treatment methods were enucleation and Carnoys solution in small lesions and marsupialization in lesions that have reached a very large size, but because KCOT was observed in second decade mostly, long-term follows up are suggested.

The Effect of Bovine Bone Graft With or Without Platelet-Rich Plasma on Maxillary Sinus Floor Augmentation

PURPOSE The purpose of this study was to compare Unilab Surgibone (USB) (Mississauga, Ontario, Canada), a bone xenograft (bovine), with platelet-rich plasma (PRP) and USB without PRP to augment the human maxillary sinus in preparation to receive dental implants. PATIENTS AND METHODS Patients who had bilateral pneumatized maxillary sinuses were included. Sinuses on one side were augmented with the USB-PRP combination and formed the study group, whereas the opposite-side sinuses were augmented with USB alone and served as controls. Bone biopsy specimens were taken during implant placement at 6.8 ± 0.9 months after maxillary sinus floor augmentation. Resonance frequency analysis measurements were performed at implant placement (first control) and before the prosthetic stage (second control), at 6.5 ± 0.7 months after implant surgery. RESULTS There were 10 patients (7 men and 3 women; mean age, 53.7 ± 0.8 years). Integration between new bone and residual grafts was histologically observed in all samples. The volumes of soft tissue were 59.9% ± 7.5% and 57.8% ± 4.4% in the control and study groups, respectively; residual graft, 21.9% ± 6.6% and 23.6% ± 5.9%, respectively; new bone, 15.8% ± 4.8% and 16.0% ± 3.8%, respectively; and trabecular bone, 64.7% ± 22.5% and 69.1% ± 18.6%, respectively. A positive correlation was found between new bone volume and trabecular bone volume (P = .0001). The mean Implant Stability Quotient (ISQ) values were 71.7 ± 4.9 and 70.3 ± 5.7 in the control and study groups, respectively, at first control and 75.4 ± 6.4 and 74.4 ± 6.4, respectively, at second control. The mean ISQ values at second control in both groups were significantly higher than at first control (P = .043 and P = .028, respectively). No statistically significant differences were observed between groups (P > .05). CONCLUSION The combination of USB and PRP does not have any effect on new bone formation and implant stabilization.

Yeditepe Üniversitesi Diş Hekimliği Fakültesi öğrencilerinin, kan ve vücut sıvılarıyla bulaşan enfeksiyonlar, enfeksiyon kontrolü ve hepatit B enfeksiyonu ile ilgili bilgi düzeylerinin, tutumlarının ve hepatit B aşılanma ve serolojik durumlarının değerlen

Amac: Bu calismanin amaci Yeditepe Universitesi Dis Hekimligi Fakultesi ogrencilerinin kan ve vucut sivilariyla bulasan enfeksiyonlar, enfeksiyon kontrol yontemleri ve hepatit B virusu (HBV) enfeksiyonu ile ilgili bilgi duzeylerini ve tutumlarini degerlendirmek, ve HBV asilanma ve serolojik durumlarini incelemektir. Gerec ve Yontem : Yeditepe Universitesi Dis Hekimligi Fakultesi’nde, 2010-2011 yilinda egitim goren 261 ogrenciye, HBV bilgi duzeyleri, asilanma durumlari ve enfeksiyon kontrolu konusundaki 52 sorudan olusan anket formlari dagitildi. Sonuclar, tanimlayici istatistiksel metodlar, Student t testi, Ki-Kare testi ve Fisher’s Exact Ki-Kare testi kullanilarak degerlendirildi. Veriler p<0,05 anlamlilik duzeyinde degerlendirildi. Bulgular: Yas ortalamasi 21,29 olan ogrencilerin 123’u (%47,1) kendilerini HBV acisindan risk grubunda gormekteydi. Ogrencilerin 207’sinin (%79,3) HBV asisi yaptirdigi, 142’sinin (%54,4) HBV serolojilerini kontrol ettirdikleri saptandi. 7 (%2,7) ogrenci HBV tasiyicisi oldugunu bildirdi. Kiz ogrencilerin HBV serolojilerini kontrol etme, asi dozlarini tamamlamis olma ve koruyucu yanit gelisme oranlarinin erkek ogrencilerden anlamli sekilde yuksek oldugu belirlendi (p<0,01). Sinif yukseldikce ogrencilerin kendilerini risk grubunda gorme, asi dozlarini tamamlamis olma, titre olcturme islemi yapmis olma ve koruyucu yanit gelisme oranlarinin anlamli sekilde arttigi gozlendi (p<0,01). Kan ve vucut sivilari ile bulasan enfeksiyonlar ile ilgili genel bilgi duzeyleri incelendiginde preklinik ve klinik siniflar arasinda anlamli bir fark bulunurken, riskli islemler ve koruyucu onlemler ile ilgili bilgi duzeyleri incelendiginde preklinik ve klinik ogrenciler arasinda anlamli bir fark bulunmadi. Sonuc: Dis hekimligi ogrencilerinin HBV’ye karsi 1.siniftan itibaren asilanmasi zorunlu hale getirilmeli, kan ve vucut sivilariyla bulasan enfeksiyonlar ve HBV ile ilgili bilgi duzeyleri duzenli olarak olculmeli, yururlukte olan sterilizasyon ve dezenfeksiyon islemlerini uygulatmaya yonelik egitimler arttirilmalidir. Aim: The aim of this study was to evaluate the dental students knowledge and attitude about infections transmitted by blood and body fluids, infection control measures, hepatit B virus infection and their serological and hepatitis B vaccination status. Material and Method: A questionnaire prepared to measure the knowldge levels about infections transmitted by blood and body fluids, infection control measures, hepatit B virus infection , serological and hepatitis B vaccination status of 261 students, educating at University of Yeditepe, Faculty of Dentistry in 2010-2011 academic year was distrubuted. Results: The mean age of the students were 21,29 and 123 of them (%47,1) tought that they were at risk in terms of Hepatitis B virus (HBV). It was determined that 207 students vaccined against to HBV, and of them 142 (%54,4) had controlled their HBV serologies. Seven students stated that they are HBV carrier. It was determined that the ratio of female students that control their HBS serologies and completion of HBV vaccination are significantly higher than male students (p<0.01). It was observed that the number of students who perceived themselves at risk, got tested and developed a protective immune response showed a significant increase in the upper grades (p<0,01). While there was a significant difference between the preclinic students and clinic students in terms of the level of general information on infections that are transmitted by blood and othe body fluids, there was no significant difference among the two groups of students in terms of the level of information on risky procedures and preventive care. Conclusion: Dental students must be completed their hepatitis B virus vaccination in the first year, and their knowledge about infections transmitted by blood and body fluids and hepatitis B virus should be measured regularly and the number of education programs about current sterilisation and disinfection procedures must be increased. Key Words: Hepatit B virus, infection, knowledge level, dental students