Recurrence rate of odontogenic keratocyst treated by enucleation and peripheral ostectomy : retrospective case series with up to 12 years of follow-up

Odontogenic keratocysts have been reported with high recurrence rates in the literature so various treatment modalities from simple enucleation to resection have been performed to achieve the cure. The purpose of this retrospective study was to investigate the recurrence rate of odontogenic keratocysts (OKCs) treated by enucleation and peripheral ostectomy. An electronic search of the database of the Hacettepe University, Faculty of Medicine, Department of Pathology, was undertaken to identify patients histologically diagnosed with OKCs treated at Department of Oral and Maxillofacial Surgery between 2001 and 2015. In total, 81 patients were studied. The mean age at the time of diagnosis was 42 years, and the male:female ratio was 1:0.7. OKCs were located primarily in the posterior mandibular region (41%). Twenty-seven patients were re-examined to determine the recurrence rate. The mean follow-up period was 5 years (range, 1?12 years). The recurrence rate was 14.8%. The relationship between location of the lesion and recurrence was not statistically significant (p = 0.559). There was also no statistically significant relation between the recurrence rate and treatment option of teeth involved in the lesion (p = 0.579). The authors conclude that treatment of OKCs by enucleation with peripheral ostectomy is associated with minimal morbidity and is preferred over other aggressive treatment modalities. Meticulous radiographic examination and careful surgical resection may decrease the recurrence rate of OKCs

İki Farklı Geometriye Sahip Dental İmplantların Tip 2 Kemikte Oluşturduğu Stres Değerlerinin Sonlu Elemanlar Analizi ile Değerlendirilmesi

In recent years, dental implantology has come to the forefront in the literature of dentistry, and it is a reality that is at the forefront of the most debated issues in international dental congresses. Implant systems have gained a great importance today as an alternative to conventional prosthetic approaches for restoring aesthetic, function, and phonation to the patient by removing tooth deficiencies. During the development of dental implants, as well as subperiosteal implants, endosteal implants with subgroups such as blade, transosseos, transmanceribular, bicortical, root or cylindrical are described. Recent developments have shown that endosteal implants with conical or cylindrical shape are superior to other systems in their success and superiority, and thus have increased in popularity. The purpose of this study is; The stresses occurring in the cortical and trabecular layers of the bone during the placement of the dental implants of 3.75 mm in diameter and 10 mm in length with the conical and cylindrical geometries in the Type 2 bones of the bone classification of Lekholm and Zarb are gradually measured and compared every 2 mm. Thus, possible problems that may occur during and after dental implant application will be foreseen and possible precautions will be taken against possible complications. In this way the quality of life of the patients will also be increasedİÇİNDEKİLER ONAY SAYFASI iii YAYIMLAMA VE FİKRİ MÜLKİYET HAKLARI BEYANI iv TEŞEKKÜR v ÖZET vi ABSTRACT vii İÇİNDEKİLER viii ŞEKİLLER x TABLOLAR xiii SİMGELER VE KISALTMALAR xvi 1.GİRİŞ 1 2.GENEL BİLGİLER 2 2.1. Tarihçe 2 2.2. İmplant Sınıflaması 7 2.3. Dental İmplantlarının Materyalleri 9 2.4. Dental İmplant Bölgeleri ve Tasarımı 11 2.5. Protetik Bağlantılar 13 2.6. Osseointegrasyon 14 2.6.1. Osseointegrasyonun Biyolojisi 14 2.6.2. Kemik İyileşmesinin Optimizasyonu 16 2.7. Yüzey Özellikleri 16 2.7.1. Fiziksel (Mekanik) Metotlar 17 2.7.2. Kimyasal Metotlar 18 2.7.3. Biyokimyasal Metotlar 20 2.8. Oral İmplantolojide Diagnoz 21 2.8.1. İmplant Endikasyonları 21 2.8.2. İmplant Kontrendikasyonları 22 2.8.3. Oral İmplantolojide Diş Eksikliklerinin Sınıflandırılması 23 2.8.4. İmplant Uygulanacak Bölgedeki Kemik Miktarı Ve Yoğunluğunun Değerlendirilmesi 31 ix 2.9. Dental İmplantlarda Başarı Kriterleri 33 2.10. İmplant Diş Hekimliği İçin Stres Tedavi Teoremi 36 2.11. Biyomekanik Kavramlar 39 2.11.1. Stres (Gerilim) 39 2.11.2. Gerinme(Strain) 40 2.11.3. Poisson Oranı 40 2.11.4. Elastisite Modülü (Young Modülü) 40 2.11.5. Von Mises Stresi 40 2.12. Sonlu Elemanlar Stres Analizi Yöntemi 41 3. MATERYAL VE METOD 42 3.1. Geometrik Modellerin Oluşturulması 42 3.1.1. Mandibulanın Modellenmesi 43 3.1.2. İmplantların Modellenmesi 45 3.2. Oluşturulan Modellerin Sonlu Eleman Analizi için Hazır Hale Getirilmesi 45 3.3 Analizi Yapılacak Matematiksel Modellerin Oluşturulması 46 3.4. Modellerde Kontak Yüzeylerin Belirlenmesi 47 3.5. Sonlu Elemanlar Analizi Programında Modellere Uygulanan Yükler ve Sınır Koşulları 47 3.6. İstatistiksel Analiz 48 4. BULGULAR 50 5. TARTIŞMA 86 6. SONUÇLAR VE ÖNERİLER 95 7. KAYNAKÇA 97 8. ÖZGEÇMİŞ 109Son yıllarda dental implantolojinin diş hekimliği literatüründe öne çıktığı ve uluslararası diş hekimliği kongrelerinde en çok tartışılan konuların başında geldiği bir gerçektir. Diş eksikliklerini ortadan kaldırarak estetik, fonksiyon ve fonasyonun hastaya yeniden kazandırılması konusunda konvansiyonel protetik yaklaşımlara alternatif olarak implant sistemleri günümüzde büyük bir önem kazanmıştır. Dental implantların gelişimi sırasında subperiosteal implantların yanı sıra blade, transosseos, transmandibular, bikortikal, kök veya silindirik gibi alt gruplara sahip endosteal implantlar tanımlanmıştır. Son dönemlerdeki gelişmelerle kök veya silindirik şekle sahip endosteal implantların diğer sistemlere oranla başarısı ve üstünlüğü gösterilmiş ve böylece yaygınlığı artmıştır. Bu çalışmanın amacı; konik ve silindirik geometriye sahip, 3.75mm çapında ve 10 mm uzunluğundaki dental implantların, Lekholm and Zarb’ın yaptığı kemik sınıflamasında yer alan Tip 2 kemiğe yerleştirilmesi sırasında kemiğin kortikal ve trabeküler katmanlarında oluşan stresslerin aşamalı olarak her 2mm de bir ölçülmesi ve karşılaştırılmasıdır. Böylece dental implant uygulaması sırasında ve sonrasında oluşması muhtemel sorunlar öngörülerek, yaşanacak olası komplikasyonlara karşı önlem alınabilecektir. Bu şekilde hastaların yaşam kaliteleri de artmış olacaktır

Deviation of Dental Implants Placed by Guided Implant Surgery in Bone Structures with Different Densities

Purpose: This study aimed to evaluate the deviations of implants with two different geometries placed with a bone-supported stereolithographic surgical template into the bone of Misch classification densities of D2, D3, and D4. Materials and Methods: Eight maxilla and eight mandible models were macrodesigned according to the jaw geometries. Bone densities of these models were created in parallel with the most frequently observed densities in the locations: D3 bone density in the anterior maxilla, D4 bone density in the posterior maxilla, D2 bone density in the anterior mandible, and D3 bone density in the posterior mandible. A bone-supported stereolithographic surgical template was prepared in accordance with the jaw models and planning and used to place 64 NobelParallel Conical Connection RP 4.3 × 13 mm and 64 NobelActive 4.3 × 13 mm implants on the models. Global deviation, lateral deviation, angular deviation, and depth deviation between planned and placed implants were calculated with Hypermesh. The Kruskal-Wallis test was used to analyze the differences between deviation data of the study groups, and the Mann-Whitney U test was used for pairwise comparisons of groups with significant differences. Significance was evaluated as P .05). When the data of all studies were evaluated, the deviation values for all maxillary and mandibular implants were examined regardless of bone and implant type; no statistical difference was found between the arches in terms of deviation type (P > .05). Conclusion: Regardless of the macrogeometry of the dental implants placed with the guide, no significant difference was observed between the deviation values of the different bone densities they were applied to

Large dentigerous cyst of the mandible that surgically enucleated following 9-months marsupialization in a young female patient: A case report

Dentigerous cyst is the most common type of developmental odontogenic cyst and it is commonly associated with the crown of an impacted tooth. Owing their asymptomatic behavior it is likely to cause significant bone resorption/ expansion and tooth displacement. This case report presents a large developmental dentigerous cyst located at the ramus mandible of a 30-year-old female patient that was managed conservatively by surgical approach after 9-month marsupialization treatment. ©Copyright 2019 by Gazi University Medical Facult