Merva Soluk Tekkeşin

Clinical and histopathological investigation of odontomas: review of the literature and presentation of 160 cases.

PURPOSE The purpose of the present study was to evaluate the clinical and histopathologic aspects of different types of odontomas. MATERIALS AND METHODS One hundred sixty odontoma cases sent to the Institute of Oncology, Department of Tumor Pathology, Istanbul University from 1971 through 2010 were investigated. These tumors were compared by age of patient, gender of patient, localization, histopathologic type, clinical diagnosis, and clinical and microscopic features. RESULTS Odontomas were classified histopathologically as complex, compound, or mixed. Of all investigated cases, 99 were complex, 57 were compound, and 4 were mixed odontomas. The mean age at diagnosis was 27.9 years, and odontomas were diagnosed most frequently at 10 to 19 years of age. CONCLUSIONS From the perspective of community health, the presence of odontomas within the jaws is important because these constitute 21% to 67% of all odontogenic tumors. The present study showed 2 interesting findings that differed from previous studies. These are the lower incidence rate of odontomas within the category of odontogenic tumors and the higher incidence of complex odontomas over compound odontomas.

The Use of Platelet-Rich Fibrin in Combination With Biphasic Calcium Phosphate in the Treatment of Bone Defects: A Histologic and Histomorphometric Study

Background Platelet-rich fibrin (PRF) is a leukocyte and platelet concentrate containing many growth factors. Its potential for hard tissue augmentation as a sole grafting material or in combination with other grafting materials has been investigated in many studies. Objective The aim of this histologic study was to evaluate the efficacy of PRF mixed with biphasic calcium phosphate (BCP) on bone regeneration in surgically created bone defects. Methods Defects 5 mm in diameter were created in both tibias of 6 sheep. The defects were left empty or grafted with BCP, PRF, or BCP+PRF. Animals were killed at 10, 20, and 40 days. The specimens underwent histologic and histomorphometric analysis. Results None of the groups displayed any signs of necrosis. Inflammation was observed in all groups at 10 days; 2 specimens of PRF+BCP and all empty defects showed inflammatory cell infiltration at 20 days. During the 40-day evaluation period, the PRF+BCP group showed the highest ratios of new bone. The other 3 groups showed statistically similar results. In the BCP and PRF+BCP groups, the residual graft ratios were decreased at consecutive time intervals. The difference between the 2 groups was not statistically significant during follow-up. Conclusions The current study revealed a histomorphometric increase in bone formation with the addition of PRF to BCP in surgically created defects in sheep tibia.

Effect of blueberry pretreatment on diethylnitrosamine-induced oxidative stress and liver injury in rats.

Diethylnitrosamine (DEN) treatment increases the generation of reactive oxygen species (ROS), apoptosis, necrosis and proliferation in the liver. Blueberries (BB; Vaccinium corymbosum L.) contain polyphenols and other active components and have high antioxidant capacities. We investigated the effect of BB pretreatment on DEN-induced liver injury and oxidative and nitrosative stress in male rats. Rats were fed with 5% and 10% BB containing diet for six weeks and DEN (200mg/kg; i.p.) was applied two days before the end of this period. Liver function tests were determined in serum and histopathological evaluation was performed in the liver tissue. Apoptosis-related proteins, Bax and B cell lymphoma-2 (Bcl-2) and proliferating cell nuclear antigen (PCNA) expressions were also examined. Oxidative and nitrosative stress were evaluated in the liver by measuring thiobarbituric acid reactive substances, diene conjugate, protein carbonyl and nitrotyrosine levels, and glutathione levels and glutathione peroxidase, superoxide dismutase and glutathione transferase (GST) activities. Pretreatment with high dose of BB reduced apoptotic, necrotic and proliferative changes in the liver induced by DEN. Dietary BB also decreased hepatic lipid peroxidation, protein oxidation and nitrotyrosine levels together with increased GST activity. In conclusion, BB may have an inhibiting effect on acute liver injury by reducing apoptosis, necrosis, proliferation, oxidative and nitrosative stress in DEN-treated rats.

Keratocystic odontogenic tumors: predictive factors of recurrence by Ki-67 and AgNOR labelling.

Purpose: The purpose of the present study was to investigate the possible role of Ki-67 and argyrophilic nucleolar organizing regions (AgNOR) between the recurrent and nonrecurrent keratocystic odontogenic tumors (KCOTs). Another aim was to compare the correlation between these two markers. Materials and Methods: 22 KCOTs were evaluated retrospectively. The actual proliferative activity of the KCOT was measured by Ki-67 labelling index and argyrophilic nucleolar organizing regions AgNOR count per nucleus. Results: Recurrence occurred in 3 patients (13.6%) during the follow-up period (mean follow-up, 37.8 months) The Ki-67 and AgNOR counts were significantly higher in the recurrent lesions comparing to the non-recurrent lesions. (p=0,045; p=0,049) The correlation between Ki-67 and AgNOR counts was found to be positive (r=0,853 p=0,0001). Conclusion: Within the limit of the present study, it is thought that Ki-67 and AgNOR might be helpful as a prognostic marker for the recurrences of KCOTs. These markers reinforced the meaning of the new classification of the lesion as an odontogenic tumor. Enucleation with curettage or decompression following enucleation with curettage is a simple and appropriate surgical model for the treatment of KCOT despite the relative high recurrence rate. On the other hand, the conservative treatment can be chosen only if there is no coronoid invasion, no interruptive cortical lysis and no tissular invasion.

Effect of fibroblast growth factor and enamel matrix derivative treatment on root resorption after delayed replantation

BACKGROUND Periodontal ligament (PDL) healing and long term prognosis of replanted avulsed teeth should rely on several factors including length of extra-oral dry time and type of the storage medium. The status of periodontal ligament is critical for the healing of replanted teeth. Different substances have been used for root surface treatment to promote formation of PDL and increase the survival of avulsed teeth submitted to replantation. AIM The purpose of this study was to assess the effect of recombinant basic fibroblast growth factor 2 (bFGF) and enamel matrix derivative (EMD) on root resorption after delayed replantation. DESIGN 18 freshly extracted single-rooted incisor and premolar teeth were extracted from the beagle dogs and immersed in whole bovine milk for 45 and 60 min (n = 3 each). Following storage period, sockets washed and teeth were treated with bFGF and EMD and replanted into the sockets. After 8 weeks, dogs were sacrificed, specimens processed to 4-μm thick serial sections for histopathologic examination and morphometric assessments. Thus, the proportions of the roots that exhibited signs of surface resorption, inflammatory resorption, and replacement resorption, that is, ankylosis and normal PDL were noted. RESULTS The percentage of root resorption was in the following order: EMD>milk>bFGF for 45 min and milk>EMD>bFGF for 60 min. For all groups, teeth stored 60 min showed significantly higher incidence of PDL resorption than those stored for 45 min (P < 0.01). The highest incidence of replacement resorption was observed in teeth treated with EMD for 60 min. After 8 weeks, the least resorption was found in bFGF-treated group (P < 0.01). CONCLUSIONS The findings of this study suggest that use of bFGF favored the formation of new periodontal ligament; prevent ankylosis and resorption process following delayed replantation of teeth while EMD shows replacement resorption, which may turn to ankylosis.

Odontogenic and nonodontogenic cysts in Istanbul: Analysis of 5088 cases

The aim of this study was to determine the prevalence of 5088 odontogenic and nonodontogenic cysts over a 40‐year period in the Turkish population and to compare results with findings in the literature.

Does partial expander deflation exacerbate the adverse effects of radiotherapy in two-stage breast reconstruction?

BackgroundThe optimum protocol for expander volume adjustment with respect to the timing and application of radiotherapy remains controversial.MethodsEighteen New Zealand rabbits were divided into three groups. Metallic port integrated anatomic breast expanders of 250 cc were implanted on the back of each animal and controlled expansion was performed. Group I underwent radiotherapy with full expanders while in Group II, expanders were partially deflated immediately prior to radiotherapy. Control group did not receive radiotherapy.The changes in blood flow at different volume adjustments were investigated in Group II by laser Doppler flowmetry. Variations in the histopathologic properties of the irradiated tissues including the skin, capsule and the pocket floor, were compared in the biopsy specimens taken from different locations in each group.ResultsA significant increase in skin blood flow was detected in Group II with partial expander deflation. Overall, histopathologic exam revealed aggravated findings of chronic radiodermatitis (epidermal atrophy, dermal inflammation and fibrosis, neovascularisation and vascular changes as well as increased capsule thickness) especially around the lower expander pole, in Group II.ConclusionsExpander deflation immediately prior to radiotherapy, may augment the adverse effects, especially in the lower expander pole, possibly via enhanced radiosensitization due to a relative increase in the blood flow and tissue oxygenation.

Oral Focal Mucinosis: A Case Report and Review of the Literature / Oral Fokal Müsinozis: Olgu Sunumu ve Literatürün Gözden Geçirilmesi

Öz Oral fokal müsinozis, ender görülen klinikopatolojik bir antite olup, kutanöz fokal müsinozis veya kutanöz miksoid kistin mukozadaki karşılığıdır. Etiyolojisi tam olarak bilinmemektedir. Genellikle genç erişkinlerde meydana gelir. Lokalizasyon olarak en sık dişetinde, ikinci sıklıkta sert damakta görülür. 19 yaşında erkek hasta; sert damakta yerleşim gösteren, ağrısız 2 cm çapında kitle ile kliniğe başvurdu. Eksizyonel biyopsi uygulandı ve histopatolojik inceleme için bölümümüze gönderildi. Mikroskopik incelemede, düzgün sınırlı miksomatöz bir bağ dokusu içinde bipolar, fusiform ya da yıldızsı biçimde fibroblastlardan oluşan lezyon izlendi. Bu olgu sunumu ile dişeti ve palatinal bölgedeki nodüler lezyonların ayırıcı tanısında oral fokal müsinozis tanısının da klinisyenler ve patologlar tarafından akılda tutulması gerektiği vurgulanmıştır Abstract Oral focal mucinosis is a rare clinicopathological entity that represents the mucosal counterpart of cutaneous focal mucinosis or cutaneous myxoid cyst. The aetiology is unknown. Oral focal mucinosis is most common in young adults. The gingiva is the most common site and the hard palate is the second most common location. A 19-year-old male patient presented with a 2 cm painless mass localized to the palatal side. An excisional biopsy was taken and sent for histopathologic evaluation to our department. Histopathologic findings were a well-circumscribed lesion composed of myxomatous connective tissue that contained bipolar, fusiform or stellate shaped fibroblasts. The aim of this study was to bring oral focal musinosis diagnosis to the attention of clinicians and pathologists when considering the differential diagnosis of gingival and palatal nodules

Odontogenic lesions in a pediatric population: Review of the literature and presentation of 745 cases.

OBJECTIVES Pediatric odontogenic lesions are rare clinical entities and are not well addressed in the otolaryngology literature. Knowledge of the biologic and clinical behavior of these lesions and their basic features such as location and age are key aspects for otolaryngologists in developing an early clinical differential diagnosis, such that they can provide adequate treatment. METHODS Six thousand histologically-diagnosed odontogenic lesions from a 40-year period were reviewed. Pediatric patients (745 cases, 12.7%) aged up to 17 years were selected and reevaluated. The patients were divided into three age groups according to dentition periods: primary dentition (0-5 years), mixed dentition (6-12 years), and permanent dentition (13-17 years). Clinical data, including age, sex, and location, were collected from pathology records. RESULTS Of the total of 745 cases, 596 specimens (80%) were diagnosed as odontogenic cysts and 149 specimens (20%) were diagnosed as odontogenic tumors. The most frequent odontogenic cysts were radicular cysts (48.4%), followed by dentigerous cysts (16.7%). The most common odontogenic tumor was odontoma (8.05%). CONCLUSION This study shows that all odontogenic lesions in the pediatric group are benign. Odontogenic tumors are relatively rare in this age group. Knowledge of the biological and histopathological behaviors of odontogenic lesions and their basic features such as location and age is a key aspect for developing an early clinical differential diagnosis and providing adequate treatment.

Topical single-dose vascular endothelial growth factor has no effect on soft tissue healing

Background: Vascular endothelial growth factor (VEGF) production in dermal wounds has been evaluated for evidence that it plays a probable role in wound healing. Events such as increased vascular permeability and concentration of inflammatory cells on the site of injury, produced by VEGF, were linked to tissue repair. Aim: The present study aimed to evaluate the effects of single-dose topical administration of VEGF on wound healing. Materials and Methods: A total of 30 male Wistar albino rats weighing 250-280 g were used in this study. In addition, 2-cm-long skin incisions were created over bilaterally exposed skin of the tibia region in each rat. VEGF plasmid 2 μg was administered locally into the right side wound bed of each animal. No other procedure besides skin closure was administered on the left side. To determine histologic assessments, skin samples were obtained from six anesthetized rats at each interval (4, 8, 12, 16 and 30 days) through excisional biopsy. The tissues were fixed in 10% neutral-buffered formalin for 1 week and then embedded in paraffin wax. Transverse sections of the embedded tissue 5-7 μm thick were stained with hematoxylin and eosin (H and E). Results: There was no significant difference regarding necrosis, epithelialization, inflammation, fibroblast activity, ulcerative formation, or hemorrhage between experimental and control groups. No statistically significant difference was found between the groups regarding granulation tissue formation and epidermal thickness. Conclusion: The administration method and dosage of VEGF is a major factor in terms of its effectiveness. The results of the present study did not evaluate the effectiveness of single-dose 2 μg topical administration of VEGF; however, various doses of VEGF plasmid should be tested in future studies in order to provide beneficial effects from topical administration of VEGF.