Serhat Atilgan

Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey

Objective The purpose of this study was to review and compare the differences between mandibular fractures in young and adult patients. Material and Methods Patients treated at the Oral and Maxillofacial Department of Dicle University during a five-year period between 2000 and 2005 were retrospectively evaluated with respect to age groups, gender, etiology, localization and type of fractures, treatment methods and complications. Result 532 patients were included in the study, 370 (70%) males and 162 (30%) females, with a total of 744 mandibular fractures. The mean age of young patients was 10, with a male-female ratio of 2:1. The mean age of adult patients was 28, with a male-female ratio of 3:1. The most common causes of injury were falls (65%) in young patients and traffic accidents (38%) in adults. The most common fracture sites were the symphysis (35%) and condyle (36%) in young patients, and the symphysis in adults (36%). Mandibular fractures were generally treated by arch bar and maxillomandibular fixation in both young (67%) and adult (39%) patients, and 43% of the adult patients were treated by open reduction and internal fixation. Conclusion There was a similar gender, monthly and type of treatment distribution in both young and adult patients in the southeast region of Turkey. However, there were differences regarding age, etiology and fracture site. These findings between young and adult patients are broadly similar to those from other studies. Analysis of small differences may be an important factor in assessing educational and socioeconomic environments.

Influence of caffeic acid phenethyl ester on bone healing in a rat model

Objective To examine the effects of caffeic acid phenethyl ester (CAPE; a component of honey bee-hive propolis with antioxidant, anti-inflammatory, antiviral and anticancer properties) on bone regeneration and fibrotic healing in a rat model. Methods Male Sprague–Dawley rats (n = 63; mean age 7 weeks; weight 280–490 g) were randomly divided into three groups: A, cranial defect with no bone healing treatment (n = 21); B, cranial defect treated with CAPE (n = 21); C, cranial defect treated with CAPE and β-tricalcium phosphate/hydroxyl apatite (n = 21). Rats were anaesthetized with ketamine (8 mg/100 g) by intraperitoneal injection and a cranial critical size bone defect was created. Following surgery, CAPE (10 µmol/kg) was administered by daily intraperitoneal injection. Seven rats in each group were killed at days 7, 15 and 30 following surgery. Bone regeneration, fibrotic healing and osteoblast activity were evaluated by histopathology. Results Statistically significant differences in healing were found between all groups. There were no statistically significant within-group differences between day 7 and 15. At day 30, bone healing scores were significantly higher in groups B and C compared with group A. Conclusion CAPE significantly improved bone-defect healing in a rat model, suggesting that CAPE has beneficial effects on bone healing.

A Three Dimensional Analysis of Reconstruction Plates used in Different Mandibular Defects

ABSTRACT In this study, the reasons of breaking of the reconstruction plates used in mandibular continuity or mandibular defects were investigated. The study was conducted on 3 cases in which reconstruction plates were used for tumor resection or invasive wound. The objective was to evaluate the mechanical stress in reconstruction plates by means of the finite element method. Three dimensional model of reconstruction plate was exposed to chewing force. A commercial finite element solver (ANSYS) was then applied to this plate to compute the stresses generated in chewing situation. Stress analyses have been carried out by applying Von Mises Yielding Criteria. In the standard reconstruction plate, the results of the finite element analysis revealed that stress resulting from the simulated functional loadings which far exceeded the strengths of the components. The main application of this study was the prediction of fractures as a consequence of known forces. If it was assumed that the patient executes several thousand masticatory movements within a week, a dynamic strain would be present due to the large number of changes in loading, so that there was a danger of a fatigue fracture at the point of the stress concentration (as seen in the analysis), as is also confirmed by clinical practice.

Effects of caffeic acid phenethyl ester on palatal mucosal defects and tooth extraction sockets.

Aim The purpose of this study was to evaluate the effects of caffeic acid phenethyl ester (CAPE) on palatal mucosal defects and tooth extraction sockets in an experimental model. Materials and methods Forty-two male Sprague-Dawley rats with a mean age of 7 weeks and weighing 280–490 g were used in this study. The rats were randomly divided into two groups: group A (the control group, n=21) and group B (the experimental group, n=21). Under anesthesia with ketamine (8 mg/100 g, intraperitoneally), palatal mucosal defects were created and tooth extraction was performed in the rats in groups A and B. Group A received no treatment, whereas group B received CAPE. CAPE was injected daily (10 μmol/kg, intraperitoneally). The rats were killed on days 7, 14, and 30 after the procedures. Palatal mucosa healing and changes in bone tissue and fibrous tissue were evaluated histopathologically. Result Pairwise comparisons showed no statistically significant difference between days 7 and 14 in either group (P>0.05). At day 30, bone healing was significantly better in group B (CAPE) than in group A (control) (P<0.05). Fibrinogen levels at day 30 were significantly higher in group A (control) than in group B (CAPE) (P<0.05). Pairwise comparisons showed no statistically significant difference in palatal mucosa healing levels between days 7 and 14 in both groups (P>0.05). Conclusion In conclusion, the findings of this study suggest that CAPE can significantly improve tooth socket healing.

Long-term effects of antihypertensive medications on bone mineral density in men older than 55 years

Introduction In this study, we investigated the effects of long-term antihypertensive treatment with calcium channel blockers or beta blockers on the bone mineral density of maxilla, as determined by cone-beam computed tomography (CBCT). Material and methods This retrospective study was conducted on CBCT images of men older than 55 years who had received different dental indications. Data were grouped into three categories according to the antihypertensive medication history of the patients: group A included patients who had been taking beta-blocker treatment for more than 5 years, group B included patients who had been taking calcium channel blocker treatment for more than 5 years, and the control group included patients who had never used any hypertensive medications before. Results Statistically significant differences were observed between the beta blocker and calcium channel blocker groups. Conclusion In hypertension treatment, beta blockers may be preferred to calcium channel blockers in patients at high risk for osteoporosis and bone resorption.

A Comparison of Microleakage Scores of Five Different Types of Composite Resins

ABSTRACT This study aimed to perform a comparative assessment of microleakage in Class V cavities among five different composite resins. For this purpose 100 fresh caries-free human permanent molars were randomly assigned to one of five groups (n=20). Clearfil Majesty Esthetic + Clearfil S3 Bond (Group I), TPH Spectrum + Xeno V (Group II), Gradia Direct Anterior + G Bond (GC) (Group III), Premise + Optibond All in One (Group IV) and Charisma + iBond (Group V) were applied and polymerized under LED. Specimens were varnished, immersed in 0.5% methylene and sectioned bucco-palatinally/lingually, and microleakage scores were determined. Gingival and occlusal microleakage scores among groups were statistically significant (p<0.05) (p=0.043, p=0.005). Occlusal microleakage scores for Clearfil Majesty Esthetic and Premise were lower than in the other groups. Charisma had the highest microleakage scores, with no difference among the other groups (p>0.05). In conclusion occlusal and gingival microleakage scores were satisfactory except for Charisma.

Displaced lower third molar tooth into the submandibular space: Two case reports.

The aim of this article is to emphasize that the accidental displacement of a lower third molar during extraction is a rare, but potentially serious complication. We present two case reports on a lower third molar tooth dislodged into the submandibular space following its removal from the sockets and the subsequent management of this rare complication. Differences in the direction of displacement, the size of fragment, delay in retrieval, and tissue reactions can all influence this potential serious complication and hence no one technique is uniformly applicable. Though a rare complication, clinicians must be aware of possible lower third molars dislodgement into tissue spaces and the necessity to initiate prompt and appropriate management.

An Experimental Comparison of the Effects of Calcium Sulfate Particles and β-Tricalcium Phosphate/Hydroxyapatite Granules on Osteogenesis in Internal Bone Cavities

ABSTRACT This experimental study was carried out to investigate the effect of medical grade calcium sulphate and β-tricalcium phosphate/hydroxyapatite on new bone formation. Additionally, the study compared these materials for infection, resorption, biocompatibility, immune reaction, fibrotic encapsulation, foreign body reaction and physical attachment. Forty, five-month-old female Wistar Albino rats were used. The 40 rats in the study were divided into 2 groups. Medical grade calcium sulphate particles (SurgiPlasterR Bio-Lok International Company) were applied to the rats in group 1 and β-tricalcium phosphate/hydroxyapatite granules (CamceramR Cam Implants by an osteotech, Inc. Company) to those in group 2. On days 10, 21, 30 and 60 postoperatively the femurs were sacrificed and investigated histopathologically. The Mann-Whitney U test was applied to the data obtained as a result of the histopathological analysis of the specimens. No statistically significant differences were observed between the 2 groups. In conclusion, it was determined that both materials resulted in similar fibrous tissue and inflammation responses, that their biocompatibilities were very good and that they did not cause foreign body reaction. Osteogenesis also was observed in the 2 groups after day 21. The effects of calcium sulphate on bone formation were faster than those of β-tricalcium phosphate/hydroxyapatite. Osteogenesis was not completed to the same extent in the calcium sulphate group as in the β-tricalcium phosphate/hydroxyapatite group.

Malpractise in a Child with Mandibular Fracture: A Case Report

ABSTRACT This study aims to discuss malpractise case report and treatment principles for pediatric mandibular fractures. In our study an 11-year-old girl was reffered to our clinic with facial asymmetry who were treated with titan mech for mandibular fracture when she was 4 years old. Titan mech was to be left in her mouth for seven years. Under local anesthesia titan mech and screws were removed by intra-oral approach. Furthermore distraction osteogenesis was planned for the treatment of facial asymmetry. As a result of this paper we recommend that screws and plates should be removed as soon as healing period is over and especially in pediatric cases, doctors must have a greater responsibility about therapy period.

Systemic and local zoledronic acid treatment with hydroxyapatite bone graft: A histological and histomorphometric experimental study.

In this study, the aim was to compare the relative efficacy of systemic and local zoledronic acid (ZA) on a hydroxyapatite (HA) bone graft in a rat critical-size calvarial bone defect. In total, 84 female rats were divided into four groups: Empty control (EC) group with no treatment applied; HA group, in which only HA bone graft material was used in the calvarium; and HA plus local ZA (HA+LZA) and HA plus systemic ZA (HA+SZA) groups, in which animals received ZA locally or systemically, respectively, with HA bone graft material in the calvarium. A 5-mm standardised critical-size calvarial bone defect was created with a standard trephine drill and the respective treatment was applied. Rats were sacrificed 7, 14 and 28 days later. The numbers of osteoclasts and osteoblasts, and degree of bone formation were evaluated histopathologically and histomorphometrically. Statistically significant differences were detected between the HA, HA+LZA and HA+SZA groups and the EC group for new bone formation (P<0.05). Osteoblast numbers in the HA+LZA and HA+SZA groups were significantly higher compared with those in the EC and HA groups (P<0.05). No statistically significant difference was detected between the HA+LZA and HA+SZA groups in new bone formation or osteoblast number (P>0.05). Bone formation was significantly higher in the HA group than in the EC group (P<0.05). The numbers of osteoclasts in the HA+LZA and HA+SZA groups were significantly higher than those in the groups EC and HA (P<0.05); however, there was no significant difference between groups HA+LZA and HA+SZA (P>0.05). Within the limitations of this study, systemic or local administration of ZA enhanced new bone formation with a HA bone graft in a rat critical-size calvarial defect model.