Yasar Ozkan

General health, dental status and perceived dental treatment needs of an elderly population in Istanbul

BACKGROUND Comprehensive data on the oral health status and dental treatment needs of the elderly population in Turkey are deficient. OBJECTIVES This pilot study determined the general and dental health status, perceived medical and dental treatment needs of an elderly population dwelling in residential homes in Istanbul. METHOD Subjects at three different residential homes, namely one belonging to the state and two supported by foundations in Istanbul (N=121, female: 63 and male: 58) were involved in this study. A detailed questionnaire was prepared and dental examinations were conducted. Information was collected related to age, education levels, financial status, current physical functional status, general health, mental health, previous dental history, current dental status, oral hygiene practices and denture hygiene of these elderly people. The prevalence of edentulism, the presence and type of dental prostheses, dental and denture status and denture cleanliness were further evaluated. RESULTS The three most prevalent reported general health problems were associated with genito-urinary problems (24%) followed by cardiovascular (18%) and respiratory problems (14%) varying significantly between genders, with males suffering more from cardiovascular problems than females (p < 0.05). Females showed significantly higher gastrointestinal and orthopaedic problems than males (p < 0.05). Females were more frequently edentulous than males but denture hygiene was significantly better in females than in males (p < 0.05). Brushing frequency did not significantly increase denture hygiene (p = 0.6). More than one-third of the subjects had not been to the dentist within the previous 5-10 years, mainly due to lack of demand, followed by the cost of the dental care and fear. More than two-thirds of denture-wearing subjects wore their dentures only during eating. CONCLUSIONS There was significant perceived dental treatment and care need for the sample population of elderly studied.

The effect of different attachment systems with implant-retained overdentures on maximum bite force and EMG.

OBJECTIVE To compare the effect of different attachment systems with implant-retained overdentures on maximum bite force and muscle activity using electromyography (EMG). BACKGROUND Denture retention and stability is of considerable interest in prosthetic dentistry. MATERIALS AND METHODS Thirty-five patients were examined: 15 edentulous patients treated with mandibular implant-retained overdentures (MIRO) and maxillary dentures (MCD) (two implant-ball attachment) (BC); 10 edentulous patients treated with MIRO and MCD (four implants-bar attachments) (BRC); 10 patients with edentulous mandibular treated with MIRO and maxillary fixed partial dentures (MFPD) (two implant-ball attachments) (BF). Before implant placement all patients received new dentures. After using these dentures for 3 months the maximum bite force and electrical activity of masseter muscle were measured. Two or four implants were then inserted into the intraforaminal region. After osseointegration periods, patients were treated with MIRO which duplicated their dentures and after three months the measurements were repeated. The data were collected and statistically analysed. RESULTS Muscle activity and chewing ability increased in the second period of measurements. Also chewing time was significantly decreased at the first measurements. The highest muscle activity was observed in the group of patients treated with group BF. CONCLUSION The EMG values of the masseter muscle significantly increased when an implant attachments was used in the overdenture.

Maxillary sinus floor augmentation using bovine bone grafts with simultaneous implant placement: a 5-year prospective follow-up study.

Purpose:The aim of this study was to evaluate the 5 year clinical results of maxillary sinus floor augmentation using bovine bone grafts with simultaneous implant placement. Material and Methods:A total of 28 patients were enrolled in the study, and a total of 84 implants were placed into the grafted sites. Unilateral or bilateral sinus augmentation was performed, and implants were inserted into the augmented sinuses. After osseointegration and insertion of the prosthesis, the implants were evaluated by clinical and radiographic parameters. Results:The cumulative implant survival rate after 60 months of loading was 100%. Periimplant bone loss was at clinically acceptable levels (0.146 and 0.34 mm after 1 and 5 years, respectively). Conclusions:Bovine bone grafts used in 1-stage sinus augmentation yields sufficient quality and volume of bone for predictable simultaneous implant placement.

Clinical and Radiographic Evaluation of Early Loaded Maxillary Anterior Single-Tooth Bone-Level Implants

PURPOSE The aim of this study was to evaluate the clinical and radiographic outcomes of early loaded platform-switched implants in the anterior maxilla. MATERIALS AND METHODS In this study, patients were treated with implants that supported all-ceramic single-tooth crowns and were followed for 2 to 4 years. Implants were evaluated on the basis of clinical and radiographic parameters, including Plaque Index, Sulcus Bleeding Index, peri-implant probing depths (PDs), Papilla Index, soft tissue recession, and marginal bone levels. Statistical analyses were performed. RESULTS Fifty-five implants were placed in 47 patients. At the recall examinations, all implants had successfully integrated, demonstrating healthy peri-implant soft tissues as documented by standard clinical parameters. At the time of recall, 7 implants had been followed for 4 years, 30 implants for 3 years, and 18 implants for 2 years. Plaque accumulation scores of 2 and 3 were not noted at any point during the study. At baseline, the mean PD was 2.1 ± 0.6 mm, at 2 years it was 2.2 ± 0.6 mm, at 3 years it was 2.2 ± 0.6 mm, and at 4 years (7 implants), the mean PD was 1.9 ± 0.4 mm. There were no statistically significant differences between time intervals. Complete papilla fill was seen for 49 implants. All implants showed less than 0.5 mm of marginal bone loss; mean bone loss at the time of final recall was 0.12 ± 0.22 mm. Seven implants showed an increase in the level of bone contact. There were no statistically significant differences over time. CONCLUSION Bone-level implants with a platform-switched design are a successful treatment modality for anterior single-tooth implants.

Comparison of ultrasound-guided and conventional arthrocentesis of the temporomandibular joint

Arthrocentesis of the temporomandibular joint (TMJ) can be done either conventionally or under ultrasonographic guidance, and we have compared the effectiveness of the two techniques. Twenty patients who required arthrocentesis of the TMJ were randomly assigned to ultrasonographically guided (US-guided) and conservative arthrocentesis (n=10 in each group). The number of relocations of the first and second punctures, pain experienced during each procedure measured using a visual analogue scale (VAS), and the duration of the procedure were the main outcome variables. The pain score compared with the maximal interincisal mouth opening measured preoperatively, immediately after operation, at 1 week, and 1 and 3 months, were secondary outcome variables. No patient in either group developed a complication, and there was no significant difference between the two groups, except that US-guided arthrocentesis took significantly longer than the conventional technique (p=0.000). US-guided arthrocentesis of the TMJ was no more successful than the conventional technique, and took longer. Further studies with more patients are required to validate these findings.

Maxillary Sinus Augmentation for Dental Implants

Pneumatization of the maxillary sinus secondary to posterior maxillary tooth loss is an extremely common finding. Significant atrophy of the maxilla prevents dental implant placement in this region. Grafting the floor of the maxillary sinus has emerged as the most common surgical modality for correcting this inadequacy. Graft material is introduced into the space created inferior to the sinus membrane. Various grafting materials and techniques might be used in this procedure. The aim of this article is to review the essentials of maxillary sinus augmentation, clarify this procedure for otolaryngologists, explain its function, and describe the augmentation materials, techniques, and complications.

Influence of a Biodegradable Synthetic Hydrogel Used as a Guided Bone Regeneration Membrane in Sinus Floor Augmentation

Amac: Sinus tabani ogmentasyonunda, benzer kemik doldurucu materyal kullanildiginda polietilen glikol (PEG) hidrojel membranin, standart kollajen membranla klinik, histolojik ve radyolojik olarak karsilastirilmasidir. Yontemler: Calismamizda 14 hastada, 20 sinus tabani ogmentasyonu operasyonu planlandi. 10 calisma (n=10) ve 10 kontrol grubu (n=10) olmak uzere operasyonlar yapildi. Operasyon sirasinda tum hastalara kemik doldurucu materyal olarak inorganik sigir grefti (Bio-Oss®, Geistlich Pharma AG, Isvicre), koruyucu membran olarak kontrol grubu hastalarina kollajen membran (Bio-Gide®, Geistlich Pharma Ag, Isvicre), calisma grubu hastalarina ise PEG-membran (Membragel®, Institu Straumann AG, Isvicre) uygulandi. 1, 3 ve 7. gunlerde hastalardan visual anolog skala skorlari (VAS) alindi. Calisma ve kontrol grubu hastalarindan radyolojik degerlendirme icin dental volumetrik tomografiler cekildi ve en az 6 ay sonra dental implantlar yerlestirildi. Dental implantlar yerlestirilirken implant yuvalarindan alinan materyaller, histopatolojik olarak incelendi. Implantlarin rezonans frekans analizleri (RFA) intraoperatif ve postoperatif 3 ay sonra olmak uzere iki defa yapildi. Bulgular: Histolojik inceleme sonuclarina gore, calisma ve kontrol gruplari kiyaslandiginda yumusak doku/sert doku orantisi arasinda ve farkli zamanlarda yapilan RFA olcumleri arasinda istatisksel olarak anlamli bir fark bulunamadi. Calisma ve kontrol grubundaki hicbir hastada postoperatif enflamasyon saptanmadi ya da membran aciga cikmadi. Farkli zamanlarda yapilan VAS skorlari analizinde de anlamli bir fark bulunamadi. Sonuc: PEG-membranin, sinus tabani ogmentasyonunda kollajen membrana alternatif olarak tercih edilebilecek bir bariyer membran oldugu bulundu.