Mahmut Sumer

Effect of Surgical Drill Guide on Heat Generated From Implant Drilling

PURPOSE The purpose of this study was to evaluate the heat generated in bone by 2 implant drill systems in vitro with and without using surgical drill guides. MATERIALS AND METHODS Temperature was measured with K type thermocouple in vitro using the bovine femoral cortical bone model. A constant drill load of 2.0 kg was applied throughout the drilling procedures via a drilling rig at a speed of 1,500 rpm. Two different implant drill systems-System A (with external irrigation) and System B (with both external and internal irrigation)-were evaluated. The samples were divided into 4 groups. System A test group 1 (TG1) included the following: 20 samples for drilling with surgical drill guides; control group 1 (CG1): 20 samples for classical implant site preparation. System B test group 2 (TG2) included the following: 20 samples for drilling with surgical drill guides; control group 2 (CG2): 20 samples for classical implant site preparation. Heat was measured at the final drill in the drilling sequence (4.2 and 4.4 mm). Thermocouples were placed at a 1-mm distance from the osteotomy area at depths of 3, 6, and 9 mm. Heat measurements were recorded out to 50 uses by a software program. Data were subjected to the Mann-Whitney U and Kruskal-Wallis tests. The alpha level was set a priori at 0.05. RESULTS The mean maximum temperatures at the depths of 3, 6, and 9 mm using surgical drill guides were 34.2 degrees , 39.7 degrees , and 39.8 degrees C, respectively, although without using surgical drill guides the values were 28.8 degrees , 30.7 degrees , and 31.1 degrees C. A statistically significant difference was found at the depths of 3, 6, and 9 mm between using surgical drill guides and classical drilling procedure. CONCLUSIONS From a heat generation standpoint, we conclude that preparing an implant site with using surgical drill guides generates heat more than classical implant site preparation regardless of the irrigation type.

Cytokine and chemokine levels in radicular and residual cyst fluids.

BACKGROUND Cytokines were thought to play an important role for the expansion of odontogenic cysts. The purpose of this study was to evaluate the cytokine and chemokine levels of radicular and residual cyst fluids. METHODS Cyst fluids were aspirated from 21 patients (11 radicular and 10 residual cysts) and the levels of interleukin-1 alpha (IL-1alpha), tumor necrosis factor-alpha (TNF-alpha), monocyte chemotactic protein-1 (MCP-1), and regulated upon activation normal T cell expressed and secreted (RANTES) were determined by ELISA using commercially available kits. RESULTS Both radicular and residual cyst fluids contained IL-1alpha, TNF-alpha, MCP-1, and RANTES, concentrations of which were significantly higher in the radicular cyst fluids than those in the residual cysts (P < 0.001 for IL-1alpha, TNF-alpha, and RANTES; P < 0.01 for MCP-1). Compared to the other mediators, the concentration of IL-1alpha was found to be highest in both of the cyst fluids. In addition, positive correlations were found between IL-1alpha, TNF-alpha, MCP-1, and RANTES in radicular and residual cyst fluids. CONCLUSION If the radicular cyst is inadvertently left behind following tooth extraction, some degree of inflammation may carry on. Residual cysts, although to a lesser extend than radicular cysts, have the potential to expand.

Concrescence of a mandibular third molar and a supernumerary fourth molar: Report of a rare case

Concrescence represents a rare developmental anomaly in which two fully formed teeth are joined along the root surfaces by cementum. Maxillary molars are the teeth most frequently involved, especially a third molar and a supernumerary tooth. Very few cases have been reported about the concrescence of a third molar and a supernumerary tooth. According to our current knowledge, this case report is the first in the literature in which concrescence is observed between a third molar and a supernumerary fourth molar in the mandible.

Comparison of Heat Generation During Implant Drilling Using Stainless Steel and Ceramic Drills

PURPOSE The purpose of this study was to compare the heat generated from implant drilling using stainless steel and ceramic drills. MATERIALS AND METHODS A total of 40 fresh bovine femoral cortical bone samples were used in this study. A constant drill load of 2.0 kg was applied throughout the drilling procedures via a drilling rig at a speed of 1,500 rpm. Two different implant drill types (stainless steel and ceramic) were evaluated. Heat was measured with type K thermocouple from 3 different depths. Data were subjected to the independent-sample t test and Pearson correlation analysis. The α level was set a priori at 0.05. RESULTS The mean maximum temperatures at the depths of 3 mm, 6 mm, and 9 mm with the stainless steel drill were 32.15°C, 35.94°C, and 37.05°C, respectively, and those with the ceramic drill were 34.49°C, 36.73°C, and 36.52°C, respectively. A statistically significant difference was found at the depth of 3 mm (P = .014) whereas there was no significant difference at the depths of 6 and 9 mm (P > .05) between stainless steel and ceramic drills. CONCLUSION Within the limitations of the study, although more heat was generated in the superficial part of the drilling cavity with the ceramic drill, heat modifications seemed not to be correlated with the drill type, whether stainless steel or ceramic, in the deep aspect of the cavity. Further clinical studies are required to determine the effect of drill type on heat generation.

Nasolabial cyst: case report with CT and MRI findings.

Nasolabial cysts are uncommon primarily unilateral soft tissue lesions located adjacent to the alveolar process above the apices of the maxillary incisors. Clinical features of the nasolabial cysts are smooth fluctuant soft tissue swelling between the upper lip and nasal aperture with obliteration of the nasolabial fold and elevation of the nasal ala. A nasolabial cyst is described including its features on CT and MRI exams.

Alveolar ridge expansion-assisted orthodontic space closure in the mandibular posterior region

Orthodontic closure of old, edentulous spaces in the mandibular posterior region is a major challenge. In this report, we describe a method of orthodontic closure of edentulous spaces in the mandibular posterior region accelerated by piezoelectric decortication and alveolar ridge expansion. Combined piezosurgical and orthodontic treatments were used to close 14- and 15-mm-wide spaces in the mandibular left and right posterior areas, respectively, of a female patient, aged 18 years and 9 months, diagnosed with skeletal Class III malocclusion, hypodontia, and polydiastemas. After the piezoelectric decortication, segmental and full-arch mechanics were applied in the orthodontic phase. Despite some extent of root resorption and anchorage loss, the edentulous spaces were closed, and adequate function and esthetics were regained without further restorative treatment. Alveolar ridge expansion-assisted orthodontic space closure seems to be an effective and relatively less-invasive treatment alternative for edentulous spaces in the mandibular posterior region.

Keratocystic odontogenic tumor: case report with CT and ultrasonography findings

Keratocystic odontogenic tumor (KCOT) is a benign odontogenic tumor with a potentially aggressive and infiltrative behavior. KCOT is most commonly occurred in mandible and demonstrate a unilocular, round, oval, scalloped radiolucent area, while large lesions may appear multilocular. An important characteristic of KCOT is its propensity to grow in an antero-posterior direction within medullary cavity of bone causing minimal expansion. Definitive diagnosis relies on histological examination. In this report, a KCOT that had an expansion both buccal and lingual cortical bone is described including its features in computed tomography and ultrasonographic exams. The lesion was removed surgically via an intraoral approach under local anesthesia and histologically reported as a KCOT.

Temperature Variation During Apicectomy with Er:YAG Laser

OBJECTIVE The purpose of this in vitro study was to evaluate the generated temperature of the Er:YAG laser, with three different pulse durations for apicectomy, compared with tungsten bur and surgical saw. BACKGROUND DATA Apicectomy is an endodontic surgery performed to remove the root apex and curette adjacent periapical tissue because of lesions of the apical area that are not healing properly. METHODS Sixty single-rooted extracted human teeth were resected by three cutting methods: tungsten bur, surgical saw, and Er:YAG laser irradiation with three different pulse durations; pulse duration 50 μs, pulse duration 100 μs, and pulse duration 300 μs. Teflon-insulated, type K thermocouples were used to measure temperature changes during the apicectomy process. Data were analyzed using the general linear models procedure of the SPSS statistical software program. RESULTS Although there was no statistically significant difference for the mean values of temperature changes at 1 mm away to the cutting site of teeth, there was statistically significant difference among groups for the mean values of temperature changes at 3 mm away to the cutting site of teeth. Additionally, there was statistically significant difference among groups for the total time required for apicectomy. CONCLUSIONS The laser irradiation with pulse duration 50 μs appears to have the lowest temperature rise and the shortest time required for apicectomy of the three pulse durations. However, Er:YAG laser for apicectomy in all pulse durations could be used safely for resection in endodontics in the presence of sufficient water.

The evaluation of palatal bone thickness for implant insertion with cone beam computed tomography

The palate is an alternative anchoring site for orthodontic implants and screws. The use of osseointegrated implants in the intermaxillary suture has recently been described as a fast, effective, and low-cost technique for patients with atrophy of the maxillae. The aim of this study was to use cone beam computed tomography (CBCT) to evaluate the thickness of the bone surrounding the intermaxillary suture in relation to the insertion of osseointegrated implants. CBCT images of 144 patients (72 males, 72 females) aged 35-86 years were evaluated. The vertical bone height of the intermaxillary suture was measured using coronal and sagittal Images 5, 10, 15, 20, and 25 mm posterior to the incisive foramen. The mean bone thicknesses from the anterior to the posterior region were 5.59, 4.38, 3.91, 3.95, and 3.94 mm, respectively. Bone thickness was significantly different among the five anteroposterior areas of the suture, but there were no significant differences between males and females, or among age groups. The highest part of the intermaxillary suture was in the anterior region. Three-dimensional imaging is recommended to accurately identify palate bone thickness for implant placement.

Odontoameloblastoma: Report of a Case

Odontoameloblastoma (OA) is an extremely rare mixed odontogenic tumor with odontogenic mesenchyme displaying the histologic characteristics of ameloblastic fibroma and complex odontoma. OA occurs predominantly in children and young adults. The majority of the tumours are associated with unerupted teeth. OA is generally asymptomatic and occurs in either jaws with slight inclination for mandible. Review of the literature exhibits only four reported cases in the posterior maxilla. This report presents an OA in the posterior region of the maxilla of an 11-yearold female. The lesion was surgically treated, no recurrence has been observed on follow-up.