Mutan Hamdi Aras

The Effect of Low-Level Laser Therapy on Trismus and Facial Swelling Following Surgical Extraction of a Lower Third Molar

OBJECTIVE The purpose of this study was to evaluate the effect of low-level laser therapy (LLLT) on postoperative trismus and edema after the removal of mandibular third molars. MATERIALS AND METHODS Thirty-two patients who were to undergo surgical removal of lower third molars were studied. Patients were randomly allocated to two groups, LLLT and placebo. Patients in the LLLT group received 12 J (4 J/cm(2)) low-level laser irradiation to the operative side intraorally 1 cm from the target tissue, and to the masseter muscle extraorally immediately after surgery. In the placebo group the handpiece was inserted into the operative side intraorally and was applied to the masseter muscle extraorally each for 1 min, but laser power was not activated. Inter-incisal opening and facial swelling were evaluated on postoperative days 2 and 7. Students t-test used to analyze the data. RESULTS It was determined that the trismus and the swelling in LLLT group were significantly less than in the placebo group on postoperative days 2 and 7. CONCLUSION Within the limitations of this study it can be concluded that LLLT can be beneficial for the reduction of postoperative trismus and swelling after third molar surgery.

Transmigrant maxillary canines

OBJECTIVE The objective of this study was to investigate the incidence and pattern of transmigrant maxillary canines. PATIENTS AND METHODS The records of 6000 patients who were presented to our oral and maxillofacial surgery services between January 1998 and January 2007 were reviewed. Observations were made as to the right/left localization and number of transmigrant canines; sex and age of patients; retained deciduous canines; and any other associated pathology. RESULTS A total of 12 patients presented with transmigrated maxillary canines with 6 females (age 15 to 37) and 6 males (age 17 to 57) in 6000 individuals (0.2%). All transmigrant canines were unilateral. The numbers of left and right transmigrant maxillary canines were equal. Ten individuals in 12 patients had not retained deciduous canines. None of these patients had any pathology associated with impacted canines. CONCLUSION The canine transmigration can occur not only in the mandible but also the maxilla. Further studies are necessary to examine this rare phenomenon to allow classification of transmigrant canines in the maxillary arch. Thus, the incidence, demographic factors, and etiology of this phenomenon can be clarified. How transmigrant maxillary canines pass on the contralateral side of the mid palatal suture must be completely clarified.

Comparison of diode laser and Er:YAG lasers in the treatment of ankyloglossia.

OBJECTIVES The purpose of this study was to compare the tolerance of lingual frenectomy with regard to a local anesthesia requirement and comparison of postsurgical discomfort experienced by patients operated on with both diode and erbium:yttrium-aluminium-garnet (Er:YAG) lasers. BACKGROUND Ankyloglossia, commonly known as tongue-tie, is a congenital oral anomaly characterized by a short lingual frenulum. A short lingual frenulum may contribute to feeding, speech, and mechanical tongue problems. METHODS Sixteen referred patients with tongue mobility complaints were included in this study. A GaAlAs laser device with a continuous wavelength of 808 nm was used in the diode group. Frenulums were incised by applying 2 W of laser power. The Er:YAG laser device with a continuous wavelength of 2940 nm was used in the Er:YAG group. Frenulums were incised by applying 1 W of laser power. The acceptability of the lingual frenectomy without local anesthesia and the degree of the postsurgical discomfort were evaluated. RESULTS Although the majority of patients (six) could be operated on without local anesthesia in the Er:YAG group, all patients could not be operated on without local anesthetic agent in the diode group. There were no differences between the two groups with regard to pain, chewing, and speaking on the first or seventh day after surgery, whereas patients had more pain in the Er:YAG group than in the diode group the first 3 h after surgery. CONCLUSIONS The results indicate that only the Er:YAG laser can be used for lingual frenectomy without local anesthesia, and there was no difference between the two groups regarding the degree of the postsurgical discomfort except in the first 3 h. In conclusion, these results indicate that the Er:YAG laser is more advantageous than the diode laser in minor soft-tissue surgery because it can be performed without local anesthesia and with only topical anesthesia.

Prevalence of the pneumatized articular eminence in the temporal bone

OBJECTIVES The pneumatized articular eminence (PAT) of the temporal bone has been identified as an asymptomatic radiolucent appearance defect in the temporal bone. Although it occurs very rarely, when present, it may represent the potential for complications following surgical manipulation of the temporomandibular joint. MATERIALS AND METHODS The record of 8107 patients who presented to our Oral and Maxillofacial Surgery services, between January 1998 and February 2008 was reviewed. Observations were made on the side and radiographic appearance of the PAT; and sex and age of patients. RESULTS Eighty-three of 8107 (1.03%) individuals had PAT with 41 females and 42 males. PATs were located on the right side in 60 individuals and in the left side in 50 individuals. PATs were unilateral in 56 cases and bilateral in 27 (totally 110 PAT). Forty-four of the PATs were unilocular type, and 66 of the PATs were multilocular type. CONCLUSIONS Treatment of PAT is unnecessary. However if a surgeon who is planning to perform eminoplasty or eminectomy on a patient who has PAT, he/she should be aware of the details of PAT. Moreover, fractures of the temporal bone with PAT can occur easier than temporal bone without PAT.

Simulation of sinus floor augmentation with symphysis bone graft using three-dimensional computerized tomography

The objective of this study was to evaluate the maximum amount of harvestable bone graft in the mandibular symphysis and the augmentation volume needed for different sinus lift levels (from 10 to 18 mm), in addition to calculating which sinus lift level can be acquired using the individuals symphysis bone graft volume with three-dimensional computerized tomography (3D CT) and software. Data from 15 CT scans was obtained from 15 adult patients (10 males, five females). The CT data, in DICOM format, was read into Mimics software from Materialize (Leuven, Belgium), with a slice thickness of 0.5 mm. The mandibular symphysis bone graft volumes and different levels of sinus lift augmentation volumes were calculated on the 3D images using Mimics software. It was determined that the average symphysis bone volume (3491.08+/-772.12 mm(3)) could provide approximately 14 mm of sinus lift height (3167.84+/-1067.65). 3D CT techniques and software can be used to calculate the required graft volume for sinus floor augmentation and symphysis bone graft volume, and the mandibular symphysis region can provide adequate bone volume for sinus lift augmentation.

Effects of Low-Level Laser Therapy as an Adjunct to Standard Therapy in Acute Pericoronitis, and its Impact on Oral Health-Related Quality of Life

OBJECTIVE The purpose of this study was to evaluate the effect of low-level laser therapy (LLLT) as an adjunct to standard therapy in acute pericoronitis. METHODS Eighty acute pericoronitis patients were randomly assigned to one of four LLLT groups: (neodymium:yttrium-aluminum garnet [Nd:YAG] 1064-nm: n=20, 8 J/cm2, 0.25 W, 10 Hz, 10 sec; 808-nm diode: n=20, 8 J/cm2, 0.25 W, continuous mode, 10 sec; 660-nm diode: n=20, 8 J/cm2, 0.04 W, continuous mode, 60 sec; or a placebo laser control group: n=20). After standard treatment, LLLT or a placebo laser were applied to the treatment area at a distance of 1 cm from the buccal site. Interincisal opening, pain perception, and oral health-related quality of life (OHRQoL) were evaluated at baseline, 24 h, and 7 days after laser application. The data were analyzed by the one-way ANOVA test. RESULTS We found that the trismus and the OHRQoL in the Nd:YAG and the 808-nm diode groups were significantly improved when compared with the 660-nm diode and control groups at 24 h (p<0.05). No statistically significant differences were detected on day 7 among the groups with regard to any of the parameters evaluated. CONCLUSIONS The results demonstrate that both the 1064-nm Nd:YAG and the 808-nm diode lasers were effective in improving trismus and OHRQoL in acute pericoronitis. Taking into account the limitations of this study, we conclude that the 1064-nm Nd:YAG laser has biostimulatory effects and improves OHRQoL, making it suitable for LLLT.

Mandibular mucormycosis in immunocompromised patients: report of 2 cases and review of the literature.

Mucormycosis, also known as zygomycosis, is an opportunistic fungal infection caused by a series of fungi in the Mucorales family in people with immune disorders. It is harmless to a healthy person, but when it has invaded the internal organs, it is frequently fatal in immunocompromised patients. It is known for having a very poor prognosis; however, with aggressive medical and surgical management, survival rates are currently thought to exceed 80%. It has 7 predominant clinical forms: rhinocerebral, pulmonary, cutaneous, gastrointestinal, central nervous system, disseminated, and, rarely, miscellaneous (ie, bone, kidney, cardiac, mediastinum, oral). Although oral involvement of this condition has been reported relatively frequently in the literature, mandibular involvement is a rarer condition than oral involvement. The purpose of this article is to report the treatment of isolated cases of mandibular mucormycosis and a review of the literature.

Does Low-Level Laser Therapy Have an Antianesthetic Effect? A Review

Because local anesthetics are vasodilators, they tend to be absorbed into the bloodstream from the operative field as a result of the vasodilation of peripheral arterioles. To counteract this vasodilation, vasoconstrictive agents are often included in local anesthetic solutions to provide a longer duration of anesthesia. Low-level laser therapy (LLLT) has the same benefits, such as microcirculation activation and more-efficient tissue metabolism, analgesic effects, and vasodilatation. If LLLT is used to prevent pain postoperatively, improvements in local circulation and increased vasodilatation may increase the absorption of a local anesthetic agent. This may reduce the duration of the anesthesia, thereby allowing postoperative pain management to begin sooner. The maximal intensity of pain occurs during the first hours after surgery, when the local anesthetic has worn off. Theoretically, postoperative pain control can be increased with the use of a local anesthetic with a more-prolonged action. If a treatment method has both analgesic and antianesthetic effects, then the method may block its own effects. We review whether LLLT applied postoperatively to operated-on areas has an antianesthetic effect, that is, whether pain in the first hours after surgery was greater for patients who received LLLT than for control patients. Not too much evidence supports the antianesthetic effects of LLLT. However, additional experimental and clinical studies must be performed to investigate the effects of LLLT on the duration of anesthesia.

Effects of low-level laser therapy on osteoblastic bone formation and relapse in an experimental rapid maxillary expansion model

AIMS AND OBJECTIVES The aim of this study was to investigate the effects of low-level laser therapy (LLLT) on osteoblastic bone formation and relapse during expansion of rat palatal sutures. MATERIALS AND METHODS Thirty-two Wistar rats were randomly allocated into two groups of 16 rats each. In the first group, LLLT was applied 4 days after expansion commenced. Seven days after expansion, retainers were applied for 10 days. The second group was similarly treated, with the exception of laser therapy. All rats were sacrificed on day 7 (n = 1) (the end of the expansion period; laser group (LG) 1 [LLLT 1] and control group (CG) 1 [control 1]) and day 17 (n = 8) (the end of the retention period; LG 2 [LLLT 2] and CG 2 [control 2]) for histological assessment. RESULTS The LLLT 1 group had significantly higher numbers of osteoclasts than did the control 1 group (P = 0.036). No significant between-group difference in osteoblast cell or capillary numbers was evident when day 7 and 17 data were compared. CONCLUSION Histologically, LLLT stimulated bone formation, as revealed by analysis after the retention period. LLLT during expansion may accelerate bone healing.

Treatment of traumatized maxillary permanent lateral and central incisors horizontal root fractures

Traumatic injuries of teeth are the main cause of emergency treatment in dental practice. Horizontal root fractures are more frequently observed in the maxillary anterior region and young male patients. The most common type of root fracture is in the middle third, followed by apical, and coronal part. This case report describes two horizontal root fractures of the maxillary right central and lateral incisors due to a sport injury. The lateral incisor was healed satisfactorily without treatment. The central incisor was endodontically treated.