Süleyman Bozkaya

Florid cemento-osseous dysplasia: report of a case documented with clinical,radiographic, biochemical and histological findings

Florid cemento-osseous dysplasia (FCOD) has been described as a condition that characteristically affects the jaws of middle-aged black women. This condition has also been classified as gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis, multiple estenosis and sclerotic cemental masses. It usually exhibits as multiple radiopaque cementum-like masses distributed throughout the jaws. Radiographically, FCOD appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. Computed tomography, because of its ability to give axial, sagittal, and frontal views, is useful in the evaluation of these lesions. This article reports the case of a 45-year-old white man who was diagnosed with FCOD on the basis of clinical, radiographic, biochemical and histological findings. It is of major importance to realize that all dentists have a unique opportunity as well as ethical obligation to assist in the struggle against wrong dental treatments that might save patients dental health. This case report illustrates the point that periapical radiolucencies may represent benign fibro-osseous lesions that may be overlooked or result in unnecessary endodontic treatment. Key words:Florid cemento-osseous dysplasia, florid osseous dysplasia, fibro-osseous lesions.

Effect of Platelet-Rich Plasma on the Outcome of Early Loaded Dental Implants: A 3-Year Follow-up Study

This study evaluated the effect of local application of platelet-rich plasma (PRP) on the outcome of early loaded implants. Two implants were placed in the posterior region or bilaterally symmetric to the median line of the maxilla. Then, PRP was either applied or not applied to the implant sockets. Outcome measures were prosthesis and implant success as well as biological and prosthetic complications. Stability of individual implants was assessed manually and with a resonance frequency analysis device. The implant stability quotient (ISQ) was recorded on the operation day, on postoperative day 4, and at postoperative week 1. At the end of the first postoperative week, implants with ISQ values >60 were early loaded on day 7 with metal-ceramic crowns. Measurements were repeated at postoperative weeks 2, 3, and 4 and at postoperative months 6, 12, 24, and 36. One of the 64 implants was dropped out after 3 months of loading. No prosthesis failed. There were no prosthetic complications. Statistical analysis r...

The Comparison of Porous Titanium Granule and Xenograft in the Surgical Treatment of Peri‐Implantitis: A Prospective Clinical Study

BACKGROUND Regarding the current approach, there is no evidence to show which treatment technique is the most accurate and useful in peri-implant defects. PURPOSE The aim of this study is comparing the effect of porous titanium granule (PTG) with rotary titanium brush and the use of xenograft and collagen membrane in the treatment of intra-bony peri-implant defects. MATERIALS AND METHODS Twenty-two patients, suffering peri-implantitis defects were included this study. Patients were divided into two groups: The PTG group used rotary titanium brush, PTG, and platelet rich fibrin (PRF) membrane. The XGF group used xenograft bone substitute, collagen membrane, and PRF membrane. Clinical measurements and cone beam computed tomography per region were recorded as baseline and sixth month after surgery. RESULTS The mean CAL values were improved from 5.29 ± 1.06 to 3.59 ± 0.88 mm in PTG group, while in XGF group; these values were improved from 4.77 ± 1.05 to 3.30 ± 0.58 mm. Radiographic bone filling values displayed a statistically significant difference between of groups. In PTG groups, these radiological values increased more than the XGF group. CONCLUSIONS PTG may be more appropriate for peri-implantitis surgery than xenograft due to inert structure and comfortable use of PTG to provide mechanical support for enlarging the surface area of the implant.

Experimental evaluation of the effects of Ankaferd Blood Stopper and collagenated heterologous bone graft on bone healing in sinus floor augmentation.

PURPOSE The aim of this study was to evaluate the effect of collagenated heterologous bone graft (CHBG) and Ankaferd Blood Stopper (ABS), a plant extract, on bone healing after sinus floor augmentation. MATERIALS AND METHODS Thirty-six New Zealand rabbits were used. Bilateral sinus augmentation was performed, and 72 bone defects were created. The maxillary sinuses were grafted with four different biomaterials: blood clot (control group), CHBG (Apatos Mix, OsteoBiol, Tecnoss) (graft group), ABS (ABS group), and ABS + CHBG (ABS+graft group). The rabbits were sacrificed at 1, 4, and 8 weeks after surgery. Histochemical and immunohistochemical examinations were performed on all samples. Staining with hematoxylin-eosin and Masson trichrome was performed, and bone marker activity was evaluated. RESULTS Lymphocyte infiltration was high at the first week in all groups and decreased from 1 to 8 weeks. All materials were biocompatible. Osteoclast numbers increased in the control group from 1 to 8 weeks and decreased in the other groups. There was no new bone formation in week 1 in all groups. New bone formation increased in all groups from 1 to 8 weeks, and at the fourth week, new bone formation was greater in the ABS and ABS+graft groups than in the other groups. There were osteoclasts around the bone graft materials, but degeneration of the graft was seen only in the ABS+graft group at week 8. CONCLUSION ABS accelerates bone healing in sinus augmentation procedures and can be used alone or with CHBG. CHBG has osteoconductive properties, and ABS can accelerate bone graft degeneration.

Implant-supported hybrid prosthesis: Conventional treatment method for borderline cases.

An implant-supported hybrid prosthesis is an acrylic resin complete fixed dental prosthesis and supported by implants might be a solution in extreme cases that the need of the restoration for esthetics, function, lip support, and speech. This clinical report aims to present the esthetic and functional prosthetic rehabilitation of three borderline cases with implant-supported hybrid prostheses. Patient 1 (62-year-old man) and Patient 2 (61-year-old man) presented a chief complaint of a compromised esthetic. After clinical evaluations, in Patient 1, 8 implants in the maxilla and 7 implants in mandibula were observed. Patient 2 had 7 implants in the maxilla and 7 implants in mandibula, which were previously placed. The intra-arch dimension of both patients was excessive and an insufficient peri-oral soft tissue support was observed. Patient 3 was a 61-year-old man had 2 implants with a history of previously implanted graft infection and implant loss on his maxillary posterior jaw. An excessive intra-arch dimension was observed in clinical examination. In addition, massive bone defect and insufficient soft tissue support were examined. In all patients, implant-supported hybrid prostheses were successfully performed. The clinical and radiologic findings were satisfactory. After 3 years of follow-up, no functional, phonetic, or esthetic problems with the restorations were noted. These case reports suggest that implant-supported hybrid prostheses can be a reliable alternative treatment procedure when a porcelain-fused metal fixed restoration does not satisfy a patient′s requirements for esthetics, phonetics, oral hygiene, and oral comfort.

Zygomatic miniplates for skeletal anchorage in orthopedic correction of Class III malocclusion: A controlled clinical trial

Objective To evaluate the effects of facemask therapy, which was anchored from the zygomatic buttresses of the maxilla by using two miniplates, in skeletal Class III patients with maxillary deficiency. Methods Eighteen skeletal Class III patients (10 girls and 8 boys; mean age, 11.4 ± 1.28 years) with maxillary deficiency were treated using miniplate-anchored facemasks, and their outcomes were compared with those of a Class III control group (9 girls and 9 boys; mean age, 10.6 ± 1.12 years). Two I-shaped miniplates were placed on the right and left zygomatic buttresses of the maxilla, and a facemask was applied with a 400 g force per side. Intragroup comparisons were made using the Wilcoxon test, and intergroup comparisons were made using the Mann-Whitney U-test (p < 0.05). Results In the treatment group, the maxilla moved 3.3 mm forward, the mandible showed posterior rotation by 1.5°, and the lower incisors were retroclined after treatment. These results were significantly different from those in the control group (p < 0.05). No significant anterior rotation of the palatal plane was observed after treatment. Moreover, changes in the sagittal positions of the maxillary incisors and molars were similar between the treatment and control groups. Conclusions Skeletally anchored facemask therapy is an effective method for correcting Class III malocclusions, which also minimizes the undesired dental side effects of conventional methods in the maxilla.

Evaluation of bone graft harvesting techniques from anterior ilium.

Abstract Autogenous bone harvest from the anterior ilium is a common procedure in the surgical field. In the current study, a retrospective analysis was performed regarding the bone graft harvesting techniques from the anterior ilium. The retrospective analysis with a 1-year period included 16 patients who had undergone iliac bone grafting for oral and maxillofacial reconstruction. Medial and lateral approaches were assessed. No major complications were observed. One patient undergoing medial approach and 2 patients undergoing lateral approach experienced gait disturbances at the postoperative period. Harvesting bone from the anterior ilium did not result in greater donor site morbidity or complications in the early term. The medial approach revealed an earlier recovery time than the lateral one. Anterior ilium is a good choice for the reconstruction of jaws, but donor site morbidity remains a problem and should be considered in the treatment plan.

Neutrophil lymphocyte ratio predicts postoperative pain after orthognathic surgery

Background and Aim: Postoperative pain is well known and usually disturbing complication of surgery. Inflammation plays an important role in the development and progression of postoperative pain. We aimed to investigate possible relationship between preoperatively measured neutrophil-lymphocyte ratio (NLR) – as an inflammation marker – and postoperative analgesic demand in patients underwent orthognathic surgery. Materials and Methods: We retrospectively investigated medical and anesthesia records of 177 patients underwent orthognathic surgery. Demographical data, preoperative NLR, type of surgery, modified Mallampati score, difficulty degree of intubation, duration of surgery, and postoperative analgesic (tenoxicam – as the first drug of choice, paracetamol, tramadol, or pethidine) usage were recorded. A cutoff value of NLR ≥2 was determined for inflammation threshold. Two groups (Group 1 NLR ≥2, Group 2 NLR <2) were compared for analgesic doses, numbers of patients needed analgesic treatment, and other parameters. Results: Mean administered tenoxicam dose was significantly higher in Group 1 than in Group 2 (P < 0.0001). Further, ratio of patients treated with tenoxicam in Group 1 was significantly higher than that in Group 2 (χ2 = 4.779, P = 0.029). Conclusions: Preoperatively measured NLR may help to predict postoperative analgesic demand in patients undergoing orthognathic surgery, and thus sufficient postoperative pain control can be achieved with various preventive treatments taken at the perioperative period such as preemptive analgesia, local anesthetic administration at the end of surgery, or early administration of analgesics.

Is age a determinant for nausea and vomiting in disabled patients after dental treatment under sedation

Background and Aim: Postoperative nausea and vomiting (PONV) is one of most frequently encountered problems after dental treatment of mentally and/or motor disabled patients under sedation or general anesthesia. In this study, we aimed to investigate whether PONV incidence in disabled patients differs between adults (≥18 years) and children/teenage (<18 years). Also investigating complication rates related with anesthesia protocols were additional objectives of the study. Materials and Methods: We retrospectively evaluated anesthesia reports of 664 cases undergone different dental treatment procedures under deep sedation with various anesthetic agents. Two study groups (Group 1 consisted from patients with special needs <18 years, while Group 2 consisted from patients ≥18 years) were created. PONV incidence and other complications recorded. Results: There was no statistical difference between groups in terms of used anesthetic agent except midazolam (P < 0.017), while higher female/male ratio and longer duration of anesthesia was recorded in Group 2 (P = 0.043 and P = 0.046, respectively). We found significantly higher PONV rates in disabled patients under 18 years (P = 0.006). Hypoxia (peripheral oxygen saturation (SpO2) <90%) and bradycardia (heart rate <50/minute) were observed in only two patients. Conclusion: PONV is more common in disabled patients younger than 18 years and dental treatment procedures under deep sedation can be provided with acceptable complication rates in patients with special needs.

Prevalence and characteristics of impacted permanent molars in a Turkish subpopulation

Background: The aim of the present study was to evaluate the prevalence and characteristics of impacted permanent molars in a Turkish subpopulation. Materials and Methods: A total of 45816 panoramic radiographs of patients aged more than 13 years were examined retrospectively to determine the presence, number, location, position, and related complications. The patients′ age and sex were noted. During statistical analysis, descriptive statistics and cross-tabulations, Chi-square test, and Fisher′s exact were used. The P value was set at 0.05. Results: The prevalence of impacted permanent molars was found to be 0.18% in this population. In total, 109 impacted first/second molars were observed in 83 patients, 18 cases had two or more impacted permanent molars. Impacted first/second molars were observed significantly more frequently in male patients than in female patients (P < 0.05). Mandible was a more common region of impaction (P < 0.05) whereas there was no significant difference between the left and right sides (P > 0.05). According to the position of the impacted permanent molars, 58 were detected as vertical direction, 28 were impacted as mesioangular, 12 were impacted as distoangular, 9 were impacted as horizontal, and 2 were impacted as buccolingual direction. In this study, cystic changes related to impacted teeth were observed in 14 (12.9%) cases and root resorption, carious lesion of the neighboring teeth were uncommon, our findings showed that majority of impacted first/second molars were found to be asymptomatic. Conclusions: Early diagnosis and treatment of eruption disturbances may avoid impaction in complicated orthodontic treatment.