A decision analysis for periapical surgery : retrospective study

Periapical surgery is now a reliable therapeutic procedure for the treatment of teeth with periapical lesions, particularly when orthograde retreatment is problematic. However, little information is available regarding treatment planning of cases referred for periapical surgery. Therefore, this study was conducted to analyze and evaluate the factors that affect the decision-making process for periapical surgery. This study retrospectively assessed clinical and radiographic data from patients undergoing periapical surgery. The factors involved in deciding to perform periapical surgery were classified into technical, biological, and combined factors. Out of 821 patients, 544 (66.3%) underwent endodontic treatment/retreatment, 204 (24.8%) were treated with coronal restorations and 60 (7.3%) were treated with post. Periapical surgery was indicated for biological reasons in 35% of patients and for technical reasons in 17.9%. The common biological factor was persistent clinical symptoms (19.7%). The most common technical cause was failure of previous endodontic treatment (66.3%). Nearly half of all periapical lesions (45%) were <5 mm in size. Periapical surgery was justified in only 434 (52.9%) subjects. We suggest that it is very important for patients to be informed and encouraged about endodontic retreatment in order to reduce unnecessary surgical procedures

RETROSPECTIVE ANALYSIS OF MANDIBULAR FRACTURES CASES IN CENTER OF THE EASTERN ANATOLIA REGION OF TURKEY

Objectives: The aim of this retrospective study is to evaluate the etiology of mandibular fractures, the distribution of the age and gender of mandibular fracture patients, the anatomical regions where these fractures are located, and the treatment modalities used in mandibular fracture cases.Materials and Methods: This study employed data obtained via clinical records and the files of patients diagnosed with a mandibular fracture who were treated from 2011 to 2015 at the Department of Oral and Maxillofacial Surgery, Ataturk University.  The etiology of these patients’ mandibular fractures, the distribution of these patients’ age and gender, the anatomical regions where these patients’ fractures were located, and the treatments applied to these patients were recorded by analyzing the obtained data.  Descriptive statistical analysis was performed using Microsoft Excel software.Results: 137 mandibular fracture sites were seen in 103 patients. Of these patients, 81 (79%) were male and 22 (21%) female, making the male-to-female ratio 3.7:1. The patients’ ages ranged between 4 and 78 years, and the mean age was 31.4. Of the various etiologies of mandibular fractures, traffic accident (42 patients, 41%) was most frequent, followed by violence (28 patients, 27%), fall (24 patients, 23%). Of the various anatomical sites where mandibular fractures occurred, the condylar site (36 patients, 26%) was the most common, followed by the body (24%), symphysis and parasymphysis (23%), angle (18%). 58 patients (56%) were treated with closed reduction 42 patients (41%) were treated with open reduction. Three patients (3%) did not receive any treatment.Conclusions: Traffic accidents are the most common etiologic factor of mandibular fracture cases in center of the Eastern Anatolia Region of Turkey. Males and young individuals are the most affected. The condylar site is the most common anatomical site.  Both closed and open reduction methods are commonly used for the treatment of mandibular fractures

Determining the margin of safety for damaging the sphenoid sinus with nasal septum osteotome during le fort i surgery in young adults

Nasal septum (Obwegeser) osteotome is a basic instrument used for separating the nasal septum and maxilla during Le Fort I osteotomy. If this instrument is placed too high or tilted into the nasal cavity, sphenoid sinus and various adjacent vital structures may be damaged and serious bleeding, neurological complications, or blindness or even death may occur. The aim of this study is to determine the margin of safety for damaging the sphenoid sinus and the adjacent structures with nasal septum osteotome in the young adults: 49 male and 51 female patients between 15 and 25 ages who required a Cone Beam Computed Tomography (CBCT) examination as part of their routine examination. In the study sample consisting of CBCT images, the aimed surgical line, the line between spina nasalis anterior and vomer and the base of sphenoid sinus (undesired line), and tilt angle between surgical and undesirable lines were measured. As the primary outcome of this study, margin of safety for damaging the sphenoid sinus and adjacent vital structures with nasal septum osteotome during Le Fort surgeries in young adults recommended as 5 mm and 12 0. For this reason the importance of planning with preoperative CBCT before Le Fort I osteotomies has been revealed

Evaluation of Blood Titanium Levels and Total Bone Contact Area of Dental Implants

The purpose of this study was to evaluate the effect of total implant-bone surface contact area of dental implants applied on partial or total edentulous patients on the increase in the level of blood titanium level. Changes of the blood titanium levels were evaluated after placement of the dental implants in 30 patients including 15 females and 15 males. Patients were divided into 3 groups as dental implants were applied on only maxilla, only mandible, or both of them. Taking into the consideration anatomic formation and prosthetic indication, dental implant-bone total contact area was calculated and saved for each patient after dental implants placement. Blood samples of the patients taken preoperatively and postoperatively at 12 weeks were analyzed by ICP-MS device. Blood titanium levels of preoperative and postoperative blood samples were analyzed for each patient and results were evaluated statistically. In the evaluation after analyzing blood titanium level changes, while a statistically significant decrease was observed in Group 1 patients, a statistically significant increase was observed in Group 2 and Group 3 patients to blood titanium level. A statistically significant difference was observed between Group 1 and Group 2 and between Group 1 and Group 3 patients of blood titanium levels. The change of the blood titanium level was not related to total implant-bone surface area, number of the implants, and gender. In our study, no correlation was found between change of blood titanium level and total contact area with bone of dental implants. We believe that more accurate results can be obtained with biopsy of tissues and organs on animal studies

Evaluation of Blood Titanium Levels and Total Bone Contact Area of Dental Implants

The purpose of this study was to evaluate the effect of total implant-bone surface contact area of dental implants applied on partial or total edentulous patients on the increase in the level of blood titanium level. Changes of the blood titanium levels were evaluated after placement of the dental implants in 30 patients including 15 females and 15 males. Patients were divided into 3 groups as dental implants were applied on only maxilla, only mandible, or both of them. Taking into the consideration anatomic formation and prosthetic indication, dental implant-bone total contact area was calculated and saved for each patient after dental implants placement. Blood samples of the patients taken preoperatively and postoperatively at 12 weeks were analyzed by ICP-MS device. Blood titanium levels of preoperative and postoperative blood samples were analyzed for each patient and results were evaluated statistically. In the evaluation after analyzing blood titanium level changes, while a statistically significant decrease was observed in Group 1 patients, a statistically significant increase was observed in Group 2 and Group 3 patients to blood titanium level. A statistically significant difference was observed between Group 1 and Group 2 and between Group 1 and Group 3 patients of blood titanium levels. The change of the blood titanium level was not related to total implant-bone surface area, number of the implants, and gender. In our study, no correlation was found between change of blood titanium level and total contact area with bone of dental implants. We believe that more accurate results can be obtained with biopsy of tissues and organs on animal studies

Diş Hekimliği Fakültesi Son Sınıf Öğrencileri ve Diş Hekimlerinin Maksillofasiyal Travma Muayenesi Konusunda Bilgi Düzeylerinin Değerlendirilmesi

Amaç: Bu çalışmanın amacı diş hekimliği fakültesi son sınıf öğrencileri ve mezun diş hekimleri için maksillofasiyal travmalara yaklaşım ile ilgili bilgi düzeylerini değerlendirmektir. Yöntem: Atatürk Üniversitesi Diş Hekimliği Fakültesinde son sınıfta okuyan öğrenciler ve Erzurum ilinde çalışmakta olan diş hekimlerine, maksillofasiyal travma bilgi düzeylerini ve yaklaşımlarını değerlendirmek amacıyla hazırlanan 20 soruluk bir anket formu uygulandı. Çalışmada 91 son sınıf öğrencisi ve 51 mezun diş hekimi yer almıştır. Bulgular: Bilgi düzeyini değerlendiren 13 sorunun 11’inde, doğru cevabın, sadece 2 soruda ise yanlış cevap seçeneğinin daha çok tercih edildiği görülmüştür. Katılımcılara yöneltilen ve klinik yaklaşımı değerlendiren 7 adet subjektif değerlendirme sorularının tamamı için, her iki grup tarafından da negatif sonuçlar elde edilmiştir. Sonuç: Hem son sınıf öğrencisi hem de mezun diş hekimlerinin maksillofasiyal travmalar konusundaki bilgi düzeylerinin kabul edilebilir olmasına rağmen katılımcıların bu konuda yeterli özgüvene sahip olmadıkları görülmüştür. Bu konudaki teorik bilgilerin, klinik olarak güçlendirilmesi gerektiği ve gereken eğitim stratejisinin oluşturulması gerekliliği sonucuna varılmıştır.Purpose: The aim of this study is to evaluate the level of knowledge about the maxillofacial trauma approach for senior dental school students and dentists. Methods: A 20-question survey was prepared to evaluate the knowledge levels and approaches of maxillofacial trauma and conducted to the last year students of Ataturk University Faculty of Dentistry and dentists working in the province of Erzurum. The study included 91 senior dental students and 51 dentists. Results: For 11 answers of the 13 questions that assessed the level of knowledge, it’s showed that the correct answer was preferred, only for two answers, the false choice was preferred. For all of the 7 subjective assessment questions directed to the participants and assessing the clinical approach, negative results were obtained by both groups. Conclusion: Despite the level of knowledge about maxillofacial trauma for both senior students and dentists were acceptable, it’s showed that participants were not self-confident enough in this issue. This is concluded that theoretical knowledge on this issue should be strengthened clinically and a suitable education strategy should be established

Evaluation of knowledge levels of senior dental students and dentists on maxillofacial trauma assessment

Amaç: Bu çalışmanın amacı diş hekimliği fakültesi son sınıf öğrencileri ve mezun diş hekimleri için maksillofasiyal travmalara yaklaşım ile ilgili bilgi düzeylerini değerlendirmektir. Yöntem: Atatürk Üniversitesi Diş Hekimliği Fakültesinde son sınıfta okuyan öğrenciler ve Erzurum ilinde çalışmakta olan diş hekimlerine, maksillofasiyal travma bilgi düzeylerini ve yaklaşımlarını değerlendirmek amacıyla hazırlanan 20 soruluk bir anket formu uygulandı. Çalışmada 91 son sınıf öğrencisi ve 51 mezun diş hekimi yer almıştır. Bulgular: Bilgi düzeyini değerlendiren 13 sorunun 11’inde, doğru cevabın, sadece 2 soruda ise yanlış cevap seçeneğinin daha çok tercih edildiği görülmüştür. Katılımcılara yöneltilen ve klinik yaklaşımı değerlendiren 7 adet subjektif değerlendirme sorularının tamamı için, her iki grup tarafından da negatif sonuçlar elde edilmiştir. Sonuç: Hem son sınıf öğrencisi hem de mezun diş hekimlerinin maksillofasiyal travmalar konusundaki bilgi düzeylerinin kabul edilebilir olmasına rağmen katılımcıların bu konuda yeterli özgüvene sahip olmadıkları görülmüştür. Bu konudaki teorik bilgilerin, klinik olarak güçlendirilmesi gerektiği ve gereken eğitim stratejisinin oluşturulması gerekliliği sonucuna varılmıştır.Purpose: The aim of this study is to evaluate the level of knowledge about the maxillofacial trauma approach for senior dental school students and dentists. Methods: A 20-question survey was prepared to evaluate the knowledge levels and approaches of maxillofacial trauma and conducted to the last year students of Ataturk University Faculty of Dentistry and dentists working in the province of Erzurum. The study included 91 senior dental students and 51 dentists. Results: For 11 answers of the 13 questions that assessed the level of knowledge, it’s showed that the correct answer was preferred, only for two answers, the false choice was preferred. For all of the 7 subjective assessment questions directed to the participants and assessing the clinical approach, negative results were obtained by both groups. Conclusion: Despite the level of knowledge about maxillofacial trauma for both senior students and dentists were acceptable, it’s showed that participants were not self-confident enough in this issue. This is concluded that theoretical knowledge on this issue should be strengthened clinically and a suitable education strategy should be established

Case Report - Chondrosarcoma in the forefoot

Chondrosarcoma is a tumour rarely seen in the foot. An 18-year-old male patient visited our clinic with the complaints of swelling and pain in his right foot. On plain radiographs, there were lytic areas in the fifth metatarsal and the fourth and fifth fingers of the right foot. Computerized tomography revealed that there were mass lesions in the fourth and fifth fingers\u2032 phalanges, causing a wearing off irregularly limited to adjacent fat plans and hypodense calcifications the fifth metatarsus, occurring destruction in bone. An open biopsy was taken from the region of the lesion under local anaesthesia. Histopathological diagnosis was reported as low-grade chondrosarcoma. We applied ray amputation to the patient under general anaesthesia from the fourth finger disarticulation and the fifth metatarsus. In a 3-year follow-up, no local recurrence and metastasis were observed. The difference of our case from the ones reported in the literature is that the patient was young (18-year-old) and had a lesion involving two different compartments synchronously as localization