Tamer Zerener

Primary malignant melanoma

Malignant melanomas (MM) of the oral cavity are extremely rare, accounting for 0.2% to 8.0% of all malignant melanomas. Malignant melanomas is more frequently seen at the level of the hard palate and gingiva. Early diagnosis and treatment are important for reducing morbidity. Malignant melanoma cells stain positively with antibodies to human melanoma black 45, S-100 protein, and vimentin; therefore, immunohistochemistry can play an important role in evaluating the depth of invasion and the location of metastases. A 76-year-old man developed an oral malignant melanoma, which was originally diagnosed as a bluish reactive denture hyperplasia caused by an ill-fitting lower denture. The tumor was removed surgically, and histopathological examination revealed a nodular-type MM. There was no evidence of recurrence over a 4-year follow-up period.

Congenital granular cell tumor in newborn.

The congenital granular cell tumor (CGCT) is quite scarce at the infant. The patient, who has a 2-day-old female newborn, was admitted to the Department of Pediatric Dentistry. Baby had a smooth surfaced, non-fixated mass, found on the anterior part of the mandibular alveole, developing from the gingival mucosa. Clinical examination showed a 1 cm Χ 1 cm Χ 1.8 cm pedunculated, regular, pink colorful soft-tissue gob on the alveolar crest to the left side of the mandible. The gob was removed on the seventh postnatal day under general anesthesia. Then, the specimen was evaluated histopathologically. Post-operative recovery and surgical site healing was satisfactory. The CGCT is a rare, degenerative or reactive lesion of the oral cavity. The mass may surgically remove if the diagnosis is not definite clinically and this can lead therapeutic effect.

Extremely Rare Form of Impaction Bilateral Kissing Molars: Report of a Case and Review of the Literature

Kissing molars (KM) or rosette formation is a term that is used to describe impacted teeth contacting occlusal surfaces in a single follicular space and their roots pointing in opposite directions. In some cases kissing molars can be seen but occurrence of bilateral kissing molars is extremely rare phenomenon in the dental literature and the aetiology of this phenomenon is still unknown. In this paper we describe a case and review of the literature and discuss the management of this pathology. In our case, extremely rare form of impacted bilateral kissing molars was extracted surgically. The decision of extraction of asymptomatic kissing molars represents surgical dilemma. There may be many surgical complications; on the other hand in some cases surgical intervention is unavoidable. Few treatment options were described in the literature. This phenomenon can be sign of various medical conditions that may require further investigation. In this paper, our treatment option is in agreement with the literature suggesting the surgical removal of both teeth at either side of the mandible.

Management of Obstructive Sleep Apnea by Maxillomandibular Advancement Surgery

Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent episodes of partial or complete collapsibility of upper airway during sleep. The use of nocturnal positive airway pressure that pneumatically stents open the upper airway has been considered the first-line treatment of OSA. However, in the last two decades, maxillomandibular advancement (MMA) has been widely suggested as the most effective craniofacial surgical technique for the treatment of OSA in adults. It has been shown that the pharyngeal and hypopharyngeal airway could be enlarged with MMA surgery by physically expanding the facial skeletal framework. Tissue tension could be increased by forward movement of the maxillomandibular complex. Thus, collapsibility of the velopharyngeal and suprahyoid musculature could be decreased, and lateral pharyngeal wall collapse could be improved. Recent systematic reviews and meta-analyses showed that most of the subjects reported satisfaction after MMA with improvements in quality of life (QOL) measures and most of OSA symptomatology. According to the recent updates, MMA appears to be the most successful surgical option for the treatment of OSA, and it could be an excellent alternative procedure for nonresponders, or deniers of ventilation therapy.

Immediate Reconstruction Using Autogenous Bone Graft in Huge CompoundOdontoma

Odontoma is placed into the odontogenic tumor classifications. But it is known as a hamartomatous lesion or a developmental abnormality rather than a odontogenic tumour. It is subclassified into 2 types: (a) compound odontoma: consisting of many little teeth like structures (denticles) (b) complex odontoma: the feature is not like a tooth but it is made of dental tissues in irregular amounts. In this paper, we present two different compound odontoma cases treated by a similar technique using “Autogenous Bone Cover”. Very large odontomas were enucleated and surgical side was covered with autogenous bones. After that, autogenous bones were fixed by reconstruction plates and mini titan screws, in order to avoid a possible fracture. After one year of follow up period, healings of the patients were uneventful.

Volumetric Evaluation of Safe Zone for Bone Harvesting From Symphysis Region by Using Cone Beam Computed Tomography.

Objectives:The aim of the present study was to retrospectively make a volumetric evaluation of symphysis sites of patients by the use of cone beam computed tomography (CBCT). Methods:This retrospective study evaluated dentate symphysis region of the mandibles in CBCT scans taken for different reasons in 90 patients (45 women and 45 men). Three-dimensional (3D) data were obtained using a CBCT device Kodak 9000 3D CMOS sensor with optical fiber. CBCT images were then transferred as digital imaging and communications in medicine files and imported into a volumetric-rendering software 3D DOCTOR (Able Software Corp., Lexington, MA) capable of measurements of vector based-segmentation technology for volumetric measurements. Results:The total average bone volume is 2616.45 mm3. Significant differences in average bone volume were found between group I and group IV (P < 0.001). Higher bone volume was obtained in the male groups (2903.01 mm3) than in the female groups (2329.88 mm3). Conclusions:CBCT is a good candidate for 3D assessment of high-contrast structures in the oral region. We suggest that the use of 3D computed tomography in combination with a software program is a dependable means of measuring the volume of the symphysis bone graft.