Yılmaz Günaydin

Is Endodontic Treatment Necessary During Coronectomy Procedure

PURPOSE Close proximity of the inferior alveolar nerve (IAN) to the third molar roots can result in nerve injuries during extraction of third molars. Consequently, it is necessary to determine the relationship of the nerve and roots to avoid damage to the IAN. Computed tomography scans are widely used to determine the correct relationship between the IAN and lower third molars. PATIENTS AND METHODS The study consisted of 10 patients with 16 lower third molars in close relationship with the IAN who were divided into a study group and a control group. The patients in the study group were treated via coronectomies performed with endodontic treatments. The patients in the control group underwent coronectomies without endodontic treatment. The patients were followed up for at least 1 year. RESULTS We had to extract 7 of the roots because of the infection in 8 patients belonging to the study group, which were treated endodontically. Moreover, there were 3 cases of IAN damage because of the extraction in the study group. However, in the control group, no infection was determined and IAN damage was absent. CONCLUSION Coronectomy appears to be a reliable technique to protect the IAN from damage. This procedure has a low incidence of complications. Endodontic treatment does not affect the success of this method according to our results.

The close association between dental and periodontal treatments and oral ulcer course in behcet’s disease: a prospective clinical study

OBJECTIVE The aim of the study was to evaluate the influence of dental and periodontal treatments to the course of oral ulcers in patients with Behcets disease (BD). METHODS Fifty-eight consecutive BD patients with oral ulcers were studied. Twenty-nine patients were in the intervention group (F/M: 15/14, mean age: 39.6 +/- 6.9 years) and 29 (F/M: 15/14, 39.4 +/- 10.6 years) were followed with a conventional treatment approach. In addition to oral hygiene education, dental and periodontal treatments were carried out in the intervention group, whereas the control group was only given oral hygiene education. Patients were evaluated in the pre-treatment observation period (1 month), treatment period (1 month) and 6 months after treatment. RESULTS An increase in the number of new oral ulcers (4.1 +/- 3.5) was observed within 2 days during the treatment compared with 3-30 days during treatment month (2.3 +/- 1.2) (P = 0.002). However, 6 months after the treatment, the number of oral ulcers (1.9 +/- 1.5) was significantly lower compared with the pre-treatment observation (4.8 +/- 3.2) (P = 0.000) and treatment periods (6.4 +/- 2.3) in the intervention group (P = 0.05), whereas a similar oral ulcer presence was observed in the control group (2.8 +/- 2.4, 3.7 +/- 2.3 and 4.8 +/- 4.3, respectively) (P > 0.05). Dental and periodontal indices were also better in the intervention group during the 6-month follow-up. CONCLUSION Our results suggest that, in BD patients, dental and periodontal therapies could be associated with a flare-up of oral ulcers in the short term, but may decrease their number in longer follow-up. They also lead to a better oral health.

An Analysis of Maxillofacial Fractures: A 5-Year Survey of 157 Patients

The purpose of this study was to review retrospectively the outcomes for 157 patients treated for maxillofacial fractures between 1994 and 1999 at one military hospital in Turkey. Significant data were collected according to age, gender, time of injury, type of facial injuries, cause of injury, treatment methods, and postinjury and postoperative complications. Fractures resulting from gunshot wounds were excluded in this study. Fractures were examined in two groups according to the type of fracture, i.e., isolated or combined. Methods of fixation with closed or open reduction were used to treat the fractures. Fixation was performed with miniplates, compression plates, microplates, reconstruction plates, and wires for open reduction, and stabilization was performed with arch bars for closed reduction. Complications were recorded in two groups, i.e., postinjury and postoperative complications. There were 151 male patients (96.18%) and 6 female patients (3.82%). The patients ranged in age from 15 to 62 years (mean, 22.8 years). In our study, it was determined that the most significant causes of maxillofacial fractures were traffic accidents (69 cases, 43.95%) and fighting (42 cases, 26.75%). Most fractures were in the mandible (161 fractures). It was observed that most of the mandibular fractures were in the body (49 fractures, 30.43%) and condylar (42 fractures, 26.09%) regions. Of the 223 maxillofacial fractures, 63.68% (142 fractures) were treated with closed reduction and 36.32% (81 fractures) were treated with open reduction. Postinjury complications included infections (local infection or osteomyelitis), nerve injuries (alveolaris inferior, facial, lingual, and infraorbital nerves), and a salivary gland fistula, and postoperative complications included infection, facial asymmetry, and malocclusion.

Evaluation of oral or rectal midazolam as conscious sedation for pediatric patients in oral surgery.

This study was undertaken with a view to determine the acceptance and treatment possibilities of midazolam, depending upon its oral and rectal application for pediatric patients requiring an oral surgery procedure (tooth extraction) and having a pretreatment behavioral score of 1 or 2 according to the Frankl Scale. Oral (0.5 mg/kg) and rectal (0.35 mg/kg) midazolam was compared in view of acceptance of the mode of treatment and local anesthesia, level of amnesia, and adverse effects. Although oral or rectal midazolam application has similar characteristics in respect to ease of working, the oral midazolam application should generally be preferred because it is more easily accepted by pediatric patients.

Histomorphometric evaluation of the effect of systemic and topical ozone on alveolar bone healing following tooth extraction in rats

The aim of this study was to investigate the effects of systemic and topical ozone applications on alveolar bone healing following tooth extraction. One hundred and twelve male Wistar rats were divided into eight groups of 14 rats each; seven groups were experimental (A-G) and one formed the control group (K). The experimental groups were further divided into two sub-groups, with seven rats in each - sacrificed on days 14 and 28 (subgroups 1 and 2). The maxillary right central incisors were extracted under general anaesthesia following the administration of local anaesthesia. After sacrifice, semi-serial histological sections were prepared, and mineralized and trabecular bone and osteoid and osteoblast surfaces were measured. Measurements of the trabecular bone showed statistically higher values in the groups treated with systemic ozone (D(2): 50.01 ± 2.12; E(2): 49.03 ± 3.03; F(2): 48.76 ± 2.61; G(2): 50.24 ± 3.37) than in the groups that underwent topical ozone administration (A(2): 46.01 ± 3.07; B(2): 46.79 ± 3.09; C(2): 47.07 ± 2.12; P = 0.030 (G(2)-A(2), G(2)-B(2), G(2)-C(2))). Within the limitations of the current study, it may be concluded that postoperative long-term systemic ozone application can accelerate alveolar bone healing following extraction. However, additional studies are required to clarify the effects of the different ozone applications on new bone formation.

Histomorphometric analysis of new bone obtained by osteogenic periosteal distraction in ovariectomized rabbits

OBJECTIVE The aim of this study was to evaluate the effects of estrogen deficiency on newly formed bone obtained by osteogenic periosteal distraction histomorphometrically. STUDY DESIGN Thirty-six female rabbits were divided into 2 groups. The experimental group underwent a bilateral ovariectomy and a sham operation was applied to the control group to equalize the stress of ovariectomy surgery. Four weeks postoperatively, a gradual distraction of the mandibular corpus was performed. RESULTS In the experimental group, callus formation was delayed and the new bone was less mineralized; conversely, when histomorphometric measurements were compared statistically, there were no significant differences between the ovariectomized and sham-operated subgroups in the mean extent of newly formed bone tissue. CONCLUSIONS Although osteoporosis caused by the lack of estrogen has negative effects on osteogenic periosteal distraction (OPD), these negative effects do not appear to present a contraindication to OPD.

Effect of systemic administered zoledronic acid on osseointegration of a titanium implant in ovariectomized rats

OBJECTIVE The aim of this study was to evaluate whether zoledronic acid improves post-implant osseointegration in an ovariectomized rat model. MATERIALS AND METHODS A total of 36 female Wistar rats were subdivided into three groups: control (CTRL), ovariectomized (OVX) and ovariectomized + zoledronic acid (OVX/ZOL). Both OVX and OVX/ZOL groups underwent ovariectomy procedures, while the CTRL group received a sham operation. After a 90-day waiting period following surgery, the OVX/ZOL group received a weekly intravenous injection of 0.04 mg/kg zoledronic acid over a period of 6 weeks. The CTRL and OVX groups received intravenous injections of 0.9% NaCl, and the injections were administered with a dosing schedule that was identical to that of the OVX/ZOL group. After completing the 6-week injection regimen, every group received a titanium implant that was 1.6 mm in diameter by 4 mm in length, which was placed in the proximal metaphysis of the left tibia. All of the rats were sacrificed after 60 days and the tibia bones were harvested and processed for histological evaluation. RESULTS The percentage of bone-implant contact (BIC) varied significantly between groups. Histomorphometric analysis demonstrated that BIC was significantly higher in the OVX/ZOL group than in the OVX group. CONCLUSIONS Systemic zoledronic acid improved tibial titanium implant osseointegration in an oestrogen-deficient rat model.

The effect of cigarette smoking on the healing of extraction sockets: an immunohistochemical study.

Abstract The aim of this study was to investigate immunohistochemically the influence of cigarette smoking on the socket healing after tooth extraction in rats. Eighty-four male rats were divided into 3 groups; 2 groups were considered as experimental and the other as control. The animals in test 1 were exposed to smoking regimen before the surgery and after the surgery, but the animals in test 2 were exposed to the smoking regimen only before surgery. All animals’ maxillary right central incisors were extracted and killed at the 3rd, 7th, 15th, and 28th day. The samples taken on third day after tooth extraction were stained immunohistochemically with fibronectin antibody and the other with type I collagen antibody. On the third day after tooth extraction, samples in the control group were intense stained (3) (+++); in the test 1 they were slight positive (1) (+) and in the test 2 they were moderate positive (2) (+ +). As a result of scoring type I collagen antibody, there was no statistically significant difference between the groups at seventh day, but there were statistically significant differences between the groups at the 15th and 28th day (P = 0.000 and P = 0.001, respectively). Comparison of the paired intense scores of type I collagen antibody staining according to days within each groups were not statistically significant. As a result, we have found out that the healing process of the tooth extraction socket is negatively affected by cigarette smoke.

Effects of the hyperbaric oxygen on de novo bone formation during periosteal distraction.

Objective The purpose of this study was to investigate the effect of hyperbaric oxygen (HBO) therapy on de novo bone formation during periosteal distraction (PD). Materials and Methods Periosteal distraction was performed in 24 mature male New Zealand rabbits using a custom-designed device placed on the lateral surface of the mandibular corpus. Twelve rabbits (group H) were given adjunctive HBO treatment, whereas 12 rabbits (group N) were kept in a normal environment (normobaric oxygen). After a 7-day latency period, the same distraction protocol was applied to both groups. However, the rabbits in group H were treated with pure oxygen at 2.4 atm absolute for 25 times. Both groups were further divided into 2 subgroups and killed after consolidation periods of 4 and 8 weeks. Photodensitometric and histologic analyses were performed to evaluate the newly formed bone. Results There was no significant difference between the 4-week consolidated HBO group and the 8-week consolidated normobaric oxygen subgroup (P = 0.229). Moreover, there was better bone formation in the 8-week HBO group than in the 8-week control group. Conclusion The results of this study indicate that PD with HBO could be used to increase the quality and the quantity of the bone newly formed by PD.