Nurettin Heybeli

Assessment of outcome of carpal tunnel syndrome: a comparison of electrophysiological findings and a self-administered Boston questionnaire.

The relationship between nerve conduction studies and the self-administered Boston Questionnaire that measures the severity of symptoms and functional status in carpal tunnel syndrome was assessed in 44 patients with idiopathic carpal tunnel syndrome. The patients were examined preoperatively and 3 and 6 months postoperatively. Although both the clinical outcome and electrophysiological findings improved significantly after surgery, we observed no correlation between improvements in nerve conduction and the questionnaire scores.

Comparison of open carpal tunnel release and local steroid treatment outcomes in idiopathic carpal tunnel syndrome

Abstract. To compare the efficacy of local steroid injection and open carpal tunnel release, a symptom and functional status questionnaire (Boston Questionnaire) and sensory and motor nerve conduction studies were performed in 90 patients with electrophysiologically proven idiopathic carpal tunnel syndrome, of whom 44 were treated surgically and 46 by two-dose steroid injection. Electrophysiologic studies and the Boston Questionnaire were applied before and at the 3rd and 6th months after treatment. Both groups showed significant improvement at first follow-up. The surgically treated group showed a significant and further improvement of symptoms and conduction values between the 3rd- and 6th-month evaluations, whereas no significant change was observed in the patient group treated by steroid injection. By the end of follow-up, 5% of the hands in the open carpal tunnel release (OCTR) group and 13% of the hands in the local steroid injection (LSIG) group showed electrophysiological worsening, and 5% of the hands in the OCTR group and 22% of the hands in the LSIG group showed symptomatic worsening. Our results show that steroid injection provides an improvement comparable with that from surgical release of the median nerve at a 3-month interval. However, this improvement is not long-lasting.

Endemic fluorosis in Turkish patients: relationship with knee osteoarthritis.

Abstract. Fluoride excess primarily effects dental and skeletal tissues, leading to a condition known as endemic fluorosis. The radiological and clinical features of endemic fluorosis vary in different parts of the world. The aim of this study was to investigate the clinical and radiological features of endemic fluorosis in Turkish patients. Physical examination and radiological investigations were performed in 56 patients with endemic fluorosis and 40 age- and sex-matched controls. Knee osteoarthritis (OA) was the main abnormality in both groups, both clinically and radiologically. The radiological severity of knee OA was greater in the endemic fluorosis group than in controls (P=0.01). Osteophytes at the tibial condyles and superior margin of the patellar articular surface of the femur, polyp-like osteophytes on the non-weight-bearing medial side of the femoral condyle, and popliteal loose bodies were detected more frequently in the endemic fluorosis group than in controls (P=0.0001). We suggest that the presence of atypically located osteophytes in the knees may be a feature of endemic fluorosis in Turkish patients and that endemic fluorosis may increase the severity of OA in the knees.

Multiple huge osteomas of the mandible causing disfigurement related with Gardner's syndrome: case report

As osteomas of the bones including the jaws may be the initial symptom or clinical finding in the Gardners syndrome, this entity should always be included in the differential diagnosis. A 20-year-old boy was referred to our clinic from another medical center. Extra-oral examination of the patient revealed an obvious asymmetry and disfigurement of the left mandibular corpus, angle and ramus. A panoramic radiograph revealed two huge osteomas at the angle, ramus and two smaller osteomas at the inferior border of the mandible. At the same time, there were an impacted canine and premolar. Diffuse sclerosis of the whole mandible was also seen. Upon the suspicion of Gardners syndrome, barium passage radiographs of the intestine were requested and multiple polyps were observed. All of these findings led us to the diagnosis of Gardners syndrome. The oral and maxillofacial surgeon and the dentist needs to be aware of the components of this entity because manifestations in the head and neck including epidermoid cysts, osteomas, odontomas, exostoses, supernumerary and impacted teeth are common. At the same time, osteomas causing disfigurement on the face related with Gardners syndrome with increased uptake in scintigraphic examination should be treated by surgical excision of the lesions.

A Histological Study of Human Derived Tooth-Hydroxyapatite (THA)

Different types of bone-graft substitutes have been developed and are in the market worldwide to eliminate the drawbacks of autogenous grafting. They vary in composition, strength, osteoinductive and osteoconductive properties, mechanism and rates by which they are resorbed and remodelled. Tooth derived hydroxyapatite (THA) is a novel biomaterial. This study was performed to determine the histological properties of THA on animals. A commercial coralline HA (CHA, Proosteon 200, Interpore Cross, USA) was used as control material. 20 sheeps were used and divided into 2 groups. Human THA (Group A) and CHA (Group B) materials were implanted to the tibiae of 10 sheeps for each group. The histological examinations of surrounding bone response were done 12 weeks after implantation. There was no significant difference histologically between group A and B. All materials were found to be surrounded by new bone tissue. THA was found to be as efficient as the standard CHA on histological basis. In addition, economical production of THA should be taken into consideration. Therefore, THA may be a viable alternative on bone grafting provided that clinical trials will be completed.

Calcium Phosphate Accelerated Setting Time of o-Ethoxybenzoic Acide (EBA) Temporary Cement

The temporary crowns and bridges are usually cemented into place w ith a zinc oxideeugenol composition. ZOE cements reduce the efficacy of dentine-bonding s ystem . Their disadvantages, include low strength and abrasion resistance, high solubili ty, and fast disintegration in oral fluids, and minor anticarrogenic action. However EBA systems have higher strength, lower solubility, and does not inhibit vinyl polymerization. They have very good corr elation with restorative composite materialsused and the tissue. Calcium phosphate has properti es res mbling the main inorganic phase of hard tissues such as enamel, dentine. Propertie s such as setting time or strength of the cements appear to be influenced markedly by the additi on of calcium phosphate. In this study 5 % calcium phosphate was added to classical EBA formula tion. New EBA cement is stronger and has longer working time than the ordinary EBA formulation.