Timuçin Baykul

Early diagnosis of oral cancer.

Survival rates for oral cancer are very poor, at approximately 50% overall, and have not improved markedly in recent decades despite advances in therapeutic interventions. Detecting oral cancer at an early stage is believed to be the most effective means of reducing rates of death, morbidity and disfigurement from this disease. Tobacco and alcohol consumption and pre-malign lesions are the most common aetiological factors. The proportion of patients presenting with oral cancer at an advanced stage is troubling. Early diagnosis is the most effective way of reducing the individual burden of the disease, decreasing morbidity and mortality and improving quality of life. For early diagnosis, healthcare providers should perform oral cancer examinations as part of their patient care regime, and need to be knowledgeable about early signs of oral carcinoma. Oral cancer awareness among the public should also be improved.

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.

Avascular necrosis of the mandibular condyle causing fibrous ankylosis of the temporomandibular joint in sickle cell anemia.

Avascular necrosis, which most commonly affects the femoral head, is a well-recognized entity in orthopedic surgery. Maxillofacial surgeons have recently recognized that a similar process may also be at work in the temporomandibular joint because of the involvement of the mandibular condyle. Avascular necrosis of the mandibular condyle in association with sickle cell anemia is an infrequent finding. In this report, a patient with avascular necrosis of the mandibular condyle in the late stage causing fibrous ankylosis of the temporomandibular joint in sickle cell anemia is presented.

Ectopic third molar in the mandibular sigmoid notch: Report of a case and literature review.

Purpose: To evaluate the etiopathogenesis, clinical features and surgical approaches for removal of ectopic third molars in the mandible. Methods: We report a case of an impacted mandibular third molar dislocated on mandibular sigmoid notch. 20 cases of ectopic mandibular third molars reported in the English-language literature, identified from Pubmed and Medline databases are also reviewed. Results: Among the 20 article reported in the presented study, ectopic third molars were generally located in the condylar region. The common symptoms of the clinical examination were pain, trismus, swelling, temporomandibular joint syndroms or no symptoms. Conclusions: Ectopic third molar may be asymptomatic initially with clinical manifestations, later on as adjacent structures are affected. The surgical approach must be carefully planned for the aim of choosing the more conservative technique that produces the minimum trauma to patients. Key words:Ectopic third molar, sigmoid notch, cyst.

Three-dimensional anatomic analysis of the lingula and mandibular foramen: a cone beam computed tomography study.

PurposeThe authors analyzed the anatomic location differences of the mandibular foramen (MF) and lingula in a cone beam computed tomography study, aiming to obtain information that could be used when performing mandibular osteotomies and the inferior alveolar nerve block (IANB). MethodsThree-dimensional mandibular computed tomography images were reconstructed from data for 139 patients (278 sides) aged between 9 and 18 years (growth group, 27 patients) and aged 19 to 71 years (adult group, 112 patients). ResultsIn the adult group, positive correlations were seen between right and left measurements. In the growth group, there are significant differences in lingula-anterior and MF-posterior ramus measurements. In the adult group, there are significant differences between man and woman MF-gonion distance measurements. Differences were seen in edentulous and asymmetry patients. ConclusionsThe MF is an important anatomic landmark for ramus surgery and IANB. When applied to ramus operations and IANB, the anatomic data provided by this study may help surgeons gain more understanding of nerve position during surgery.

Influence of immediate and permanent obturators on facial contours: a case series

IntroductionRehabilitation of patients after surgical removal of carcinomas in facial skeleton is one of the most difficult therapies of the stomatognathic system. Significant deformation of tissues, dysfunctions of the stomatognathic system with concurrent biological imbalance of the oral cavity environment frequently affect the treatment to become arduous. Scars and contraction of the oral crevice may cause serious psychological deficiencies that are another aspect of the treatment schedule.Case presentationThree Turkish patients ages 46 (male), 61 (male) and 24 (female) who experienced similar operations were rehabilitated with maxillary obturators. The situations was ideal for patient no 1. Patient no 2 could not receive an immediate obturator and patient no 3 rejected using permanent obturator. The paper describes the advantages of a surgical obturator which is constructed before operation and inserted immediately following partial maxillectomy and expresses long term complications when neglecting the use of definite obturator prosthesis, in the light of three cases.ConclusionThe primary objective of oral-maxillofacial and plastic surgeons and prosthodontists when treating tumors is to eliminate disease and to improve the quality of life including the facial contours which influences the psychological condition of patient. Neglecting immediate obturator construction may cause serious facial appearance problems due to soft tissue contracture. When permanent obturator is rejected, serious contracture of soft tissues and facial disharmony is inevitable.

Maxillary sinus perforation with presence of an antral pseudocyst, repaired with platelet rich fibrin.

The maxillary sinus lifting procedure is an important preprosthetic surgical procedure for the creation of adequate bone volume in the edentulous posterior maxilla for the placement of dental implants. The presence of a maxillary sinus cyst has been considered a contraindication for this operation. Perforation of the membrane and hence the elongation of the healing time for implant placement is the most common complication in this type of procedure. The purpose of the case is to show the safely repair of the large sinus perforation during the sinus lifting with presence of the antral pseudocyst. In this case, we present a patient who had a maxillary sinus lifting procedure in the presence of antral pseudocysts. No complications were seen during follow-up periods and all implants are functioning successfully. Platelet-rich fibrin may be used safely when large perforation occurs during the sinus lifting with the presence of an antral pseudocyst.

Misdiagnosed widespread eosinophilic granuloma of the mandible.

Abstract Eosinophilic granuloma is the most common expression of Langerhans cell histiocytosis and corresponds with typical bone lesions. Early clinical signs can occur in the mandible and can cause extensive destruction of the periodontal tissues. Pathologic fracture is an unusual finding. A case of misdiagnosed eosinophilic granuloma in a 45-year-old man treated with free fibula flap and implant-supported overdenture prosthesis is reported. Free fibula flap with dental implants is a safe and reliable method for comprehensive functional and aesthetic mandibular defect reconstruction.

Surgical difficulties, success, and complication rates of orthodontic miniplate anchorage systems: Experience with 382 miniplates

Purpose: The aim of this study was to evaluate the complications and success rates of the miniplates using both maxilla and mandible for orthodontic anchorage in growing patients. Materials and Methods: One hundred and fifty-five consecutive patients (range 8.7–13.8 years) with Class II and III malocclusion without congenital or acquired deformities were included in this study. A total of 382 titanium miniplates were placed by the same surgeon. All miniplates were inserted under local anesthesia. Loading of the miniplates with a force of 200 g with the help of elastics or functional devices were initiated 3 weeks after surgery. Results: The overall success rate of miniplate anchorage in terms of stability was 96.8%. Twenty-one patients reported irritation of the mucosa of the cheeks or lower lip after the surgery in the mandible group. Twelve miniplates needed to be removed and were successfully replaced. Conclusion: Skeletal anchorage miniplates is effective for correcting malocclusions. Success depends on proper presurgical patient counseling, minimally invasive surgery, good postsurgical instructions, and orthodontic follow-up.

The use of platelet-rich fibrin (PRF) and PRF-mixed particulated autogenous bone graft in the treatment of bone defects: An experimental and histomorphometrical study

Background: Various materials and techniques have been developed to facilitate bone healing process and reduce its healing period. In recent studies, it is pointed out that, platelet-rich fibrin (PRF) which is derived autogenously from the own blood of the individuals, increase regeneration and accelerate the healing of the wound, due to the consisting various growing factors. The aim of the experimental study is to evaluate the efficiency of PRF and PRF/autogenous graft combination on bone healing in different time intervals. Materials and Methods: A total of 24 skeletally mature New Zealand rabbits were used. Animals were divided randomly into two groups. Two bone defects with a diameter 3, 3 mm were created on the right and left tibia in all group animals. Only particulate autogeneous bone graft, only PRF, combination of PRF and autogeneous bone graft and empty bone cavity, were performed to all animals. The animals in the first experimental group were sacrificed after 30 days. The animals in the second experimental group were sacrificed after 60 days from the operation. Histomorphometrical and statistical analysis was performed. The data were analyzed using Tukey test (P < 0.05 for osteoblast number, P < 0.01 for osteoclast and new bone area values). Results: Histomorphometrical analyzes showed that either PRF used alone or used in conjuction with autogenous bone graft, PRF accelerated the healing of the bone defects. There were statistically significant differences in osteoblast, osteoblast and new bone area values in PRF alone and autogenous graft with PRF than the other groups. Conclusion: Our preliminary result demonstrated that PRF increase new bone formation and has a positive effect on early bone healing.