Mehmet Ali Erdem

Oral and maxillofacial considerations in Gardner's Syndrome.

Gardners Syndrome is a variant of familial adenomatosis polyposis (FAP) with a triad consisting of polyps of the colon, multiple osteomas and surface tumors of soft and hard tissue. The intestinal polyps have a %100 risk of undergoing malignant transformation, therefore early identification of this disease is very important. There are several symptoms of Gardners syndrome in the oral and maxillofacial surgery, which can be discovered during routine dental examination. We report a case of a 25-year old male patient with Gardners syndrome who has not any intestinal polyps but osteomas in the mandible and jaw deformalities.

A new method to estimate dental age

Abstract Objective. The aim of this study was to evaluate the accuracy of Demirjians method in estimating the dental age in Turkish children and to estimate the validity of Demirjians standards for the studied population. Materials and methods. Panoramic radiographs of 756 northwestern Turkish children aged 5–13 years were examined. The new method for dental age estimation for both genders was studied to determine the relationship between dental age, chronological age and Demirjians scores. Descriptive statistics were used and analysis of correlation was carried out between chronological age, dental age and Demirjians scores. The difference between dental age and the chronological age was determined with the paired t-test. Results. The results showed that northwestern Turkish children had delays in dental maturity. The new method was applied to Demirjians scores and dental age scales for both genders were obtained. The tables were used to adapt Demirjians scores to dental age determination in Turkish children using the new formula. Conclusions. The developmental standards used by Demirjian are not suitable for northwestern Turkish children. The methods for determining dental development must have population-specific standards. The established gender-specific equations and the new tables are more appropriate for dental age assessment in northwestern Turkish children.

Pleomorphic adenoma of the palate.

Pleomorphic adenoma is the most common mixed benign tumor of major salivary glands. Approximately 80% of these tumors arise in the parotid gland, whereas 7% arise in the minor salivary glands. The most common sites for minor salivary gland where pleomorphic adenoma arises are the palates followed by lips and cheek. We report a palate mass in a 46-year-old male patient. The initial cytologic diagnosis by fine-needle aspiration biopsy was pleomorphic adenoma. This report describes a case of pleomorphic adenoma regarding all distinctive diagnoses with the review of the literature.

In Vitro Antifungal Activity of Ankaferd Blood Stopper Against Candida albicans

BACKGROUND Candida albicans is a memeber of the oral flora that can lead to various complications in immunosupresive patients after oral surgery processes. Ankaferd Blood Stopper® (ABS) is a medical plant extract that is safe to use in patients with dental surgery bleedings in Turkey. OBJECTIVE The study evaluated the antifungal activity of ABS medicinal plant extract against C albicans using the agar diffusion and broth microdilution methods. METHODS The plant extract antifungal activity was assessed in vitro either by applying the ABS extract directly and by applying different concentrations of ABS onto Candida culture. For these experiments, an agar diffusion method was used. To determine the minimum inhibitory concentration (MIC), a broth microdilution method was used. RESULTS Different volumes of the active substance (10, 20, 30, and 40 μL) were applied onto Candida (0.5 McFarland solution) cultivated plate; Candida growth was inhibited in accordance with the volumes of ABS. However, when various dilutions of ABS (1:2, 1:20, 1:40, and 1:80) were added as drops containing 20 μL, no antifungal effects were found. No MIC values were identified using broth microdilution. When different dilutions of ABS containing 100 μL of 0.5 McFarland solution of C albicans were cultured depending on the time (10, 20, 30, and 40 minutes), the effect of the duration was not significant. CONCLUSION The various tests were carried out to investigate antifungal effects of ABS on Candida, but none were found.

Peripheral facial nerve paralysis after upper third molar extraction.

Abstract Peripheral facial nerve paralysis (PFNP) after mandibular interventions has been reported in the literature. In most cases, paralysis begins immediately after the injection of the mandibular anesthesia, and duration of facial weakness is less than 12 hours. However, there are few documented cases of PFNP after maxillary dental or surgical procedures. A variety of mechanisms have been associated to PFNP, including viral reactivation, demyelination, edema, vasospasm, and trauma. The purpose of this presentation was to report a rare case of facial paralysis that occurred after an upper third molar extraction. The cause of the PFNP and the importance of the multidisciplinary approach in the management are emphasized.

Focal cemento-osseous dysplasia of mandible.

Fibro-osseous lesions are disturbances in bone metabolism in which normal bone is replaced by a connective tissue matrix that then gradually develops into cemento-osseous tissue. Typically, the lesion is asymptomatic and is detected on routine radiographic examination. Radiologically, this lesion has three stages of maturation: pure radiolucent, radiopaque/mixed radiolucent, and radiopaque appearance. During these stages the lesion can be misdiagnosed. In this case report a 69-year- old patient with a a complaint of painless swelling of the left mandibular molar and premolar area is presented along with a review of the differential diagnoses considered in order to reach a final diagnosis of focal cemento-osseous dysplasia.

Myxofibroma of the maxilla, current concepts, and differential diagnosis

Odontogenic myxomas represent a small portion of all odontogenic tumors. A myxoma of the bone is a rare lesion that occurs almost exclusively in the jaws. An odontogenic myxoma has a variable clinical and radiological appearance, and it should be considered in the differential diagnosis of radiolucent and mixed radiolucent–radiopaque lesions of both jaws in all age groups. Myxomas consist of an accumulation of mucoid ground substance with little collagen, the amount of which determines whether it is called a myxofibroma. This paper presents the case of a 39-year-old male with a solid whitish red, nonulcerative, nontender expansion of both the buccal and palatal sides of the right upper alveolar bone. Results of a radiological examination revealed a unilocular radiolucency with cortical expansion and displacement of both the right upper second premolar and the first molar. The lesion was totally excised, and the histopathological examination showed a myxofibroma. Healing was uneventful, and there was no recurrence 12 months after surgical excision. Complete removal of the tumor, leaving no remnants attached to the soft tissue or bone, should be considered because of the well-known potential of myxofibromas to recur.

Effects of polymethylmethacrylate on the stability of screw fixation in mandibular angle fractures: A study on sheep mandibles

Aim: Malfixed miniplates can impair fracture healing, and the screw pilot holes may widen during repeated fixation trials. This in vitro study explored the extent to which screw fixation of mandibular angle fractures could be improved by augmenting the drilling holes with polymethylmethacrylate (PMMA). Materials and Methods: We measured stabilization by recording specimen displacement under a vertical force of 50 N applied using a hydraulic tester. We included 20 hemimandibles from sheep (average weight 40 kg). The specimens were randomly divided into two groups of 10 and pilot holes were created in the angulus region using a drill 1.2 mm in diameter. Next, we performed osteotomies simulating angulus fracture repair. In group 1, the fracture site was fixed using non-compression miniplates and four screws were inserted to the maximal possible extent employing a mechanical screwdriver. In group 2, the pilot drill holes were filled with PMMA prior to miniplate fixation. Then vertical forces of 50 N were applied to the molar region and the displacements were measured. The Shapiro-Wilks test was used to compare the two groups. Result: The maximum average displacement in the experimental group was significantly lower than that in the control group (p=0.026). Thus, PMMA-augmented screws better stabilized bone, affording reliable fixation.

The Accuracy of New and Aged Mechanical Torque Devices Employed in Five Dental Implant Systems

Purpose Friction-style and spring-style torque wrenches are used to tighten implant abutments and prosthetic screws. The mechanical stability of these torque wrenches is crucial for the implant–abutment connection. The purposes of this study were to assess the performance of five brands (Straumann, Zimmer, Implant KA, Bredent, and Biohorizons) of wrench and to evaluate possible changes in applied torque values of aged wrenches. Materials and Methods Five new and aged wrenches that had been used approximately 250 times in a 1-year period were tested. The torque applied by friction- and spring-style wrenches was measured with a specially designed strain gauge indicator. Descriptive statistics, the one-sample t-test, and the independent-samples t-test were used to analyze values obtained from all torque wrenches. Results The accuracy of new and aged torque devices of all brands except Bredent differed significantly from the target values, but the mean values for aged and new wrenches did not differ significantly from each other (p > 0.05). Values for the spring- and friction-type torque wrenches deviated from the target values by 11.6% and 10.2%, respectively. Conclusion The accuracy of aged torque wrenches is adequate for prosthetic screw tightening, but that of new torque wrenches is unsatisfactory and must be examined carefully before delivery.

TOOTH EXTRACTION FROM A PATIENT WITH CAVERNOUS HEMANGIOMA IN MAXILLOFACIAL REGION: CASE REPORT

Hemangiomas are benign vascular tumors which represent a rapid growth pattern followed by the involution phase. Generally, they are located in the soft tissues and are usually diagnosed in the first decade of life. Hemangiomas are mostly asymptomatic and rarely affect jaw bones. Mandible is affected more often than maxilla. If there is no complication present, treatment may not be necessary. Treatment planning of hemangiomas should be done by considering the location and the size of the lesion as well as the proximity to vital anatomical structures. The aim of this case report is to describe the procedures of tooth extraction in a patient who had been diagnosed as having maxillary cavernous hemangioma.