Dentijeröz kist tedavisinde ortodontik traksiyon: olgu bildirimi

INTRODUCTION: Impacted third molars increase the risk ofcystic follicular tissue changes. The presence of impactedthird molars and bone defects caused by cysts increasethe risk of mandibular angle fractures during surgical procedures. The aim of this case presentation was to describean alternative method for the extraction of an impactedthird molar where a miniscrew was used for the orthodontic traction of the impacted tooth and, thus, a mandibularangle fracture risk as well as the amount of bone defectwas reduced.CASE REPORT: A 68-year-old male patient had been referredto the Department of Oral Surgery, Ege University withpain and swelling complaint at the third molar area. Hispanoramic radiograph revealed the presence of a dentigerous cyst and a severely impacted third molar at themandibular angle. Following the intraoral and radiographicevaluation, a miniscrew was inserted into the buccal cortex between the canine and first premolar. An attachmentwas bonded to the available exposed surface of the impacted molar and light, continuous extrusive force was applied with a coilspring. A powerarm was used in order tobypass the soft tissue curvature and to prevent soft tissueimpingement. After a traction period of 8 months, themolar was surgically removed.CONCLUSION: Orthodontic extrusion of impacted molarswith miniscrews prior to surgical removal may be an alternative treatment option for reducing the risk ofmandibular angle fracture in the presence of bone defectsTANITIM: Üçüncü molar dişlerin gömülü kalması, kistik foliküler doku transformasyonunu ve özellikle dentijeröz kist oluşumu riskini artıran etkenlerden biridir. Dentijeröz kistler genişleme potansiyeline sahiptir ve komşu kemiği rezorbe ederek kemiğin bütünsel ve yapısal direncini zayıflatır. Bu kistlerin tedavisinde enükleasyon ve ilgili dişin çekimi ya da marsupyalizasyon ve kist kavitesinin dekompresyonu hedeflenir. Kemikte meydana gelen defektin büyük hacimli olması ve gömülü dişin mandibuler kanala yakın olması, dişin çekimi esnasında mandibuler sinir hasarı veya mandibula kırığı riskini artırır. Bu olgu bildiriminde iatrojenik mandibula kırığı riski taşıyan gömülü üçüncü moların ortodontik traksiyon sonrası çekimi ile dentijeröz kistin tedavi süreci sunulmaktadır. OLGU BİLDİRİMİ: Sol mandibuler korpus bölgesinde ağrı ve şişlik şikâyeti ile Ege Üniversitesi Diş Hekimliği Fakültesine başvuran 68 yaşındaki erkek hastanın yapılan klinik muayenesinde sol mandibuler dişsiz kret bölgesinde ödem tespit edilmiştir. Radyografik incelemede bilateral gömülü mandibuler üçüncü molar dişler ve solda dentijeröz kiste bağlı kortikal sınırlara ulaşan kemik defekti izlenmiştir. Yapılan tomografik incelemede bukkal korteksin fenestre olduğu belirlenmiştir. Kemik defektinin sınırları sebebiyle kırık riskini engellemek amacıyla kist marsupyalize edilmiş, aynı seansta ekspoze edilen gömülü molara ortodontik ataşman yerleştirilmiştir. Premolar bölgesine yerleştirilen mini vida ile kemikten ankraj alınarak gömülü moların angulus bölgesinden traksiyonu gerçekleştirilmiş, kist kavitesinin dekompresyonu ve diş hareketi ile anguler bölgede kemiğin kalınlaşması sağlanmıştır. Sekiz ay süren traksiyon periyodunu takiben molar dişin çekimi gerçekleştirilmiştir. SONUÇ: Kemik defektinin büyüklüğü ve gömülü dişin yaşamsal anatomik dokularla ilişkisine bağlı iatrojenik komplikasyon riski taşıyan dentijeroz kistlerin tedavisinde cerrahi girişim öncesi gömülü dişin ortodontik traksiyonu, güvenli cerrahi için bir tedavi alternatifi olabilir

Bisphosphonate induced osteonecrosis of jaws: Multicenter retrospective study

Bifosfonatlar (BP), metastatik kemik hastalıkları ve osteoporoz tedavisinde kullanılan kemik rezorbsiyonu inhibitörleridir. Bifosfanat kullanımına bağlı çenelerde gelişen osteonekroz (BBÇO), çenelerinde radyasyon tedavisi görmemiş, bifosfanat kullanan ya da kullanmış hastalarda mandibula ya da maksillada 8 haftadan daha uzun süren kemik ekspozu ile karakterize bir durum olarak tanımlanmıştır. Bu çalışmada farklı merkeze yönlendirilen BBÇO vakaları retrospektif olarak sunulmuştur. 2012 ve 2013 yıllarında GATA Haydarpaşa Eğitim Hastanesi Diş Hekimliği, Kocaeli Üniversitesi Diş Hekimliği Fakültesi, ve Kırıkkale Üniversitesi Diş Hekimliği Fakültesi, Ağız, Diş ve Çene Cerrahisi kliniklerine başvuran BBÇO tanısı konulmuş 18 hastanın demografik özellikleri, anamnez bulguları, klinik muayene bulguları, bifosfanat çeşidi ve kullanım bilgileri (süre, uygulama yolu) ve eğer varsa ilgili sebep açısından değerlendirmeleri yapılmıştır. Hastaların 12' sinde mandibula (% 67), 5' inde maksilla (%28) ve 1 hastada ise hem mandibula hem maksillada (%5) BBÇO izlendi. Hastaların 2 tanesi osteoporozis (% 11) nedeniyle 16 hasta ise (% 89) onkolojik tedavi nedeniyle bifosfanat grubu ilaç kullanmaktaydı. Tıp ve diş hekimliğini ortak olarak ilgilendiren konu olması itibariyle bifosfanat grubu ilaç tedavisine başlanacak hasta gruplarının ortak klinikler tesis edilerek takip edilmeleri ve bilgi paylaşımlarıyla ortaya çıkabilecek olası komplikasyonların azaltılabileceğini düşünmekteyiz.Bisphosphonates (BP) are inhibitors of bone resorption used in the treatment of metastatic bone diseases and osteoporosis. Bisphosphonate induced osteonecrosis of the jaws (BIONJ) is defined as the exposed bone lesions which are present for 6 to 8 weeks in patients who used or using medication of BP and did not received radiotherapy on head and neck area. In the present study, cases of BIONJ from different medical centers are presented. Eighteen patients who were diagnosed with the BIONJ and referred to Oral and Maxillofacial Surgery clinics of GATA Haydarpasa Teaching Hospital, Kocaeli University Faculty of Dentistry and Kirikkale University Faculty of Dentistry between the years 2012 to 2013 were included in study. Patients were evaluated in terms of demographic characteristics, medical history, symptoms, clinical findings, drugs (time, the path of the application) and relevant reasons. Of the 18 patients, 12 of the cases were in the mandible (67%) and 5 were in the maxilla (28%) while one patient presented BIONJ both in the mandible and maxilla. 2 of patients were prescribed the bisphosphonates with osteoporosis while 16 of them were because of the oncologic treatment. Conclusions: We believe that the numbers of cases would be reduced if the patients would be informed and treated in joint facilities of medicine and dentistry

Can Reproductive Characteristics Predict Bladder Cancer in Women with Haematuria?

WOS: 000328273000028PubMed: 24175784Background: Among women with haematuria, defining individuals under high risk for bladder cancer based on reproductive factors prior to cystoscopy would be of great benefit in the management of this condition. The aim of this study was to compare age and reproductive factors such as menopausal status, parity, age at first delivery and age at the last delivery between women who have haematuria with or without bladder cancer. Materials and Methods: A total of 463 patients underwent diagnostic cystoscopy in Duzce University Faculty of Medicine between 1 June 2008 and 1 June 2013. Female patients who presented with persistent microscopic or macroscopic haematuria and underwent standard evaluation for haematuria including urinalysis, urine culture, urine cytology, urinary tract imaging with excretory urography or computerized tomography with contrast enhancement and endoscopic evaluation of the urethra and bladder were included in this study. Exclusion criteria were tobacco use and high risk occupations for bladder cancer such as textile, dry cleaning, painting and etc. Forteen women had hematuria due to benign conditions, and 18 due to bladder cancer. Data were retrospectively retrieved from the medical records of Duzce University Hospital. Results: Patients with haematuria due to benign reasons did not significantly differ from patients who were found to have bladder cancer in terms of age (p=0.28), menopausal status (p=0.29), mean parity (p=0.38), being nulliparous (p=0.57), parity >= 3 (p=0.22), age = 30 years at last delivery (p=0.26), age >= 35 years at last delivery (p=0.23) and percentage of the patients with advanced age (>= 65 years) (p=0.18). Conclusions: It is difficult to predict a high risk for developing bladder cancer in women with haematuria based solely on reproductive factors

Changes In Hypertension Prevalence, Awareness, Treatment, And Control Rates In Turkey From 2003 To 2012

Objectives: The study aimed to assess the current epidemiology of hypertension, including its prevalence, the awareness of the condition and its treatment and control, in Turkey to evaluate changes in these factors over the last 10 years by comparing the results with the prevalence, awareness, treatment, and control of hypertension in Turkey (PatenT) study data (2003), as well as to assess parameters affecting awareness and the control of hypertension. Methods: The PatenT 2 study was conducted on a representative sample of the Turkish adult population (n = 5437) in 2012. Specifically trained staff performed the data collection. Hypertension was defined as mean SBP or DBP at least 140/90 mmHg, previously diagnosed disease or the use of antihypertensive medication. Awareness and treatment were assessed by self-reporting, and control was defined as SBP/DBP less than 140/90 mmHg. Results: Although the prevalence of hypertension in the PatenT and PatenT 2 surveys was stable at approximately 30%, hypertension awareness, treatment, and control rates have improved in Turkey. Overall, 54.7% of hypertensive patients were aware of their diagnosis in 2012 compared with 40.7% in 2003. The hypertension treatment rate increased from 31.1% in 2003 to 47.4% in 2012, and the control rate in hypertensives increased from 8.1% in 2003 to 28.7% in 2012. The rate of hypertension control in treated patients improved between 2003 (20.7%) and 2012 (53.9%). Awareness of hypertension was positively associated with older age, being a woman, residing in an urban area, a history of parental hypertension, being a nonsmoker, admittance by a physician, presence of diabetes mellitus, and being obese or overweight; it was inversely associated with a higher amount of daily bread consumption. Factors associated with better control of hypertension were younger age, female sex, residing in an urban area, and higher education level in Turkey. Conclusion: Although some progress has been made in recognizing hypertension from 2003 to 2012, there is still a large population of untreated or inadequately treated hypertensives in Turkey. Strengthening of population-based efforts to improve the prevention, early detection, and treatment of hypertension is needed

Changes in hypertension prevalence, awareness, treatment, and control rates in Turkey from 2003 to 2012

Objectives: The study aimed to assess the current epidemiology of hypertension, including its prevalence, the awareness of the condition and its treatment and control, in Turkey to evaluate changes in these factors over the last 10 years by comparing the results with the prevalence, awareness, treatment, and control of hypertension in Turkey (PatenT) study data (2003), as well as to assess parameters affecting awareness and the control of hypertension. Methods: The PatenT 2 study was conducted on a representative sample of the Turkish adult population (n = 5437) in 2012. Specifically trained staff performed the data collection. Hypertension was defined as mean SBP or DBP at least 140/90 mmHg, previously diagnosed disease or the use of antihypertensive medication. Awareness and treatment were assessed by self-reporting, and control was defined as SBP/DBP less than 140/90 mmHg. Results: Although the prevalence of hypertension in the PatenT and PatenT 2 surveys was stable at approximately 30\%, hypertension awareness, treatment, and control rates have improved in Turkey. Overall, 54.7\% of hypertensive patients were aware of their diagnosis in 2012 compared with 40.7\% in 2003. The hypertension treatment rate increased from 31.1\% in 2003 to 47.4\% in 2012, and the control rate in hypertensives increased from 8.1\% in 2003 to 28.7\% in 2012. The rate of hypertension control in treated patients improved between 2003 (20.7\%) and 2012 (53.9\%). Awareness of hypertension was positively associated with older age, being a woman, residing in an urban area, a history of parental hypertension, being a nonsmoker, admittance by a physician, presence of diabetes mellitus, and being obese or overweight; it was inversely associated with a higher amount of daily bread consumption. Factors associated with better control of hypertension were younger age, female sex, residing in an urban area, and higher education level in Turkey. Conclusion: Although some progress has been made in recognizing hypertension from 2003 to 2012, there is still a large population of untreated or inadequately treated hypertensives in Turkey. Strengthening of population-based efforts to improve the prevention, early detection, and treatment of hypertension is needed