Konik ışınlı bilgisayarlı tomografi ile pineal bez kalsifikasyonunun boyutu ve prevalansının incelenmesi (KIBT)

Objectives: This study aimed to investigate the prevalence and dimensions of pineal gland calcification on cone-beam computed tomography (CBCT) in patients undergoing dental treatment. Materials and Methods: We retrospectively examined CBCT scans in which the pineal gland appeared in the field of view and noted the presence of pineal gland calcification (PGC). Anteroposterior, lateral, and area measurements of the PGCs were made by the same observer. Variables such as age and gender were recorded for each patient from previous clinical examination data. Results: Among 220 patients (135 females, 85 males), the prevalence of pineal gland calcification was 33.6%. There was no significant difference between males and females (p>0.05). PGC was strongly associated with older age (p<0.001). The PGCs had mean anteroposterior and lateral dimensions of 2.56±0.98 mm and 3.39±1.29 mm, respectively, and the mean total calcified area was 5.45±3.75 mm2. Conclusions: This study showed no correlation between age, gender, and PGC size. However, the average calcified area was found to be significantly larger in men than women.Amaç: Bu çalışmada diş tedavisi yapılan hastalarda konik ışınlı bilgisayarlı tomografi (KIBT) ile Pineal bez kalsifikasyonunun prevalansı ve boyutlarının değerlendirilmesi amaçlandı. Materyal ve Metot: Bu retrospektif çalışmada pineal bezin fov aralığında olduğu konik ışınlı bilgisayarlı tomografiler seçilmiştir. Pineal bez kalsifikasyonu görünürlüğü not edilmiştir. Anteroposterior, lateral ve alan ölçümleri tek bir gözlemci tarafından yapılmıştır. Her hastanın yaş, cinsiyet gibi değişkenleri, klinik muayene verileri kullanılarak kaydedilmiştir. Bulgular: 220 hastada (135 kadın, 85 erkek) pineal bez kalsifikasyonu prevalansı %33.6 dır. Erkekler ve kadınlar arasındaki fark anlamlı değildir. Pineal bez kalsifikasyonu, genç hastalarla karşılaştırıldığında yaşlı hastalarda yüksek oranda görüldü. PGC'nin ortalama anteroposterior, lateral uzunluğu sırasıyla 2,56±0,98 mm ve 3,39±1,29 mm idi. Ortalama toplam kalsifiye alan 5,45±3,75 mm2 idi. Sonuçlar: Bu çalışmada yaş, cinsiyet ve lineer ölçümler arasında herhangi bir ilişki bulunmadı. Ancak erkeklerde ortalama kalsifiye alan kadınlara göre anlamlı derecede yüksek bulunmuştur

Does mallampati score affect the technical success of the inferior alveolar nerve block and posterior mandibular surgical procedures?

Background and Aim: The aim of this randomized prospective study was to assess the effect of Mallampati score on the technical success of the inferior alveolar nerve block and posterior mandibular surgical procedures. Material and Methods: A total of 150 adult patients who required inferior alveolar nerve blocks for dental surgery in the lower posterior region were included in this study. A research fellow documented the Mallampati score, age, gender, and body mass index of patients. A resident blinded to the Mallampati scoring performed the local anaesthesia and surgical procedures and documented the technical difficulty scores during the inferior alveolar nerve block and surgical procedures, latent period of local anaesthesia, and total volume of injected anaesthetic solution. The data were statistically analyzed. Results: There were statistically significant differences between the patients with different Mallampati scores in terms of age, technical difficulty score of inferior alveolar nerve block, and technical difficulty score of surgical procedure (p<0.05). Technical difficulty scores of the inferior alveolar nerve block were significantly higher in Mallampati class III and IV patients than in class I patients. Technical difficulty scores of the surgical procedure were significantly higher in Mallampati class II, III, and IV patients than in class I patients. Conclusions: The knowledge and/or clinical assessment regarding Mallampati classification in the field of dentistry is scarce and should be improved. Dental clinicians should be aware of the possible relationship between high Mallampati score and unsuccessful inferior alveolar nerve block or technical difficulty of a posterior mandibular surgical procedure

Long-term effects of botulinum toxin a injection on pain and quality of life in patients with myofascial pain of masticatory muscles: A retrospective study

Introduction: Favorable effects of botulinum toxin type A (BoNT/A) on muscle hyperactivity and pain has led to its' use in the treatment of temporomandibular joint disorders, related to muscle pain and masticatory myofascial pain. Objectives: The aim of this retrospective study was to evaluate the short- and long-term effects of trigger point injections of BoNT/A in patients with myofascial pain syndrome. Material and Methods: The study included 17 individuals aged 19-57 years (mean, 33 years), with 2 years of follow-up records. Visual analogue scale (VAS), pressure-pain threshold (PPT), and maximum mouth opening (MMO) were applied to evaluate pain and dysfunction. Mood and sleep quality were assessed using Beck's depression inventory (BDI) and Pittsburgh sleep quality index (PSQI). All evaluations were repeated before (T0) as well as at 4 weeks (T1), 6 months (T2), and 2 years (T3) after BoNT/A injection. Results: VAS score was lower at all 3 post-injection time points compared to T0 (p < 0.001). Significant increases in PPT and MMO measurements were also observed at T1, T2, and T3 compared to T0. BDI scores were significantly reduced at T1 and T2 compared to T0 (p < 0.05). PSQI decreased significantly between T0 and T1 (p < 0.001), but increased at T3 (p < 0.05). Conclusions: BoNT/A injections are an effective treatment alternative that relieve myofascial pain and mouth opening restriction, and subsequently improve quality of life in both the short- and long-term

Düşük gonial açı posterior mandibuladaki implant etrafındaki kemik kaybı miktarını etkiler mi?

Background: The purpose of this study was to investigatewhether there is a role of the low gonial angle on marginal boneresorption around the implants placed in the posterior mandible. Methods: This retrospective study, including 20 patients with 46implants followed 36 months were inserted in the mandibularedentulous posterior area. Patients without systemic diseasewere included in this study. The gonial angle was measured on apanoramic x-ray; Patients with a gonial angle of more than1250were classified as high gonial angle, and those with lessthan 1200 were classified as a low gonial angle group. Mesialand distal marginal bone resorption and implant angulation withthe occlusal plane were measured via Image J software (National Institutes of Health; version 1.5i, USA). Independent samples t test was used to compare measured variables between high andlow gonial angle groups. Results: The mean marginal bone resorption (MBL) was0.27±0.16 mm for the mesial side and 0.27±0.13mm for thedistal side in the LGA group. In the HGA group, MBL was0.77±0.28mm for the mesial side and 0.71±0.27mm for thedistal side. There was no statistical significance between HGAand LGA groups regarding marginal bone resorption. However,implant angulation with the occlusal plane was correlated withmarginal bone resorption in the HGA group. Conclusion: The result of this study is that a low gonial angle isnot directly a risk factor for marginal bone resorption around thedental implant. However, implants should be placedperpendicular to the occlusal plane as possible in the HGAgroup.Amaç: Bu çalışmanın amacı; posterior mandibulaya yerleştirilen implantların etrafındaki marjinal kemik rezorpsiyonunda, düşük gonial açının bir rolünün olup olmadığının araştırılmasıdır. Gereç ve Yöntemler: Bu retrospektif çalışmada; 36 aylık takibi olan toplam 20 hastada yapılan 46 implant alt çene posterior dişsiz alana yerleştirildi. Sistemik hastalığı olmayan olgular çalışmaya dahil edildi. Gonial açı panaromik röntgen üzerinde ölçülüp; 1250 den fazla olan hastalar yüksek gonial açı, 1200 den az olanlar ise düşük gonial açı grubu olarak sınıflandırıldı. Mezial, distal marjinal kemik rezorpsiyonu ve implantın okluzal düzlemle olan açılanması Image J yazılımı (National Institutes of Health; sürüm 1.5i, USA) ile ölçüldü. Yüksek (HGA) ve düşük gonial açı grupları (LGA) arasındaki farkı karşılaştırmak için bağımsız gruplar t testi kullanıldı. Bulgular: Ortalama marjinal kemik rezorpsiyonu (MBL), düşük gonial açı grubunda; mezial taraf için 0.27 ± 0.16 mm ve distal taraf için 0.27 ± 0.13 mm idi. Yüksek gonial açı grubunda mezial taraf için 0.77 ± 0.28mm ve distal taraf için 0.71 ± 0.27mm idi. Yüksek ve düşük gonial açı grubu arasında marjinal kemik rezorpsiyonu açısından istatistiksel olarak anlamlı bir fark bulunmadı. Ancak; yüksek gonial açı grubunda; implantın okluzal düzlem ile açılanmasının marjinal kemik rezorpsiyonu ile korele olduğu tespit edildi (p<0.05). Sonuç: Bu çalışmanın sonucunda, düşük gonial açının implant çevresindeki marjinal kemik rezorpsiyonu açısından doğrudan bir risk faktörü olmadığı görülmüştür. Bununla birlikte; implantlar HGA grubunda mümkün olduğunca oklüzal düzleme dik olarak yerleştirilmelidir

Dental implant cerrahisi ile ilgili cerrahi komplikasyonların Clavien-Dindo Sınıflandırması kullanılarak değerlendirilmesi

Background: The aim of this study is to evaluate the surgicalcomplications encountered in the implants performed by the same surgeon between 2016-2019 using the Clavien-Dindoclassification used to grade the severity of surgicalcomplications. Methods: This retrospective study includes a total of 1171implants performed in 368 cases undergoing dental implantsurgery. Complications related to the operation were recordedand these complications were evaluated according to theClavien-Dindo Classification system. Possible effects of otherfactors such as age, gender, smoking, Diabetes mellitus andimmediate implant placement on complications were alsoevaluated. Results: A total of 98 complications have been reported,including flap dehiscence, numbness, infection, the apical part ofthe dental implant in the maxillary sinus, lack of primary stability,and cortical bone perforation. Smoking and immediateimplantation were found to be risk factors for flap dehiscence (p 0.05). Sonuç: Clavien-Dindo sınıflandırması dental implant cerrahisindehem komplikasyonların standardizasyonu hem de klinisyenlerinkomplikasyonların sonuçlarını anlamalarına yardımcı olmak içinyararlı olabilir. Clavien-Dindo sınıflandırma sisteminin geniş biryelpazede kullanılması, implant cerrahisinde farklı tekniklerdekarşılaşılan komplikasyonların farklı cerrahlar ve merkezlerarasında karşılaştırılmasına olanak sağlayacaktır

MANAGEMENT OF ATYPICAL MANDIBULAR CORONOID PROCESS ELONGATION WITH BILATERAL INTRAORAL CORONOIDOTOMY

Bilateral coronoid hyperplasia is characterized by a progressive limitation in mandibular movement secondary to mechanical impingement of the elongated coronoid processes on the posterior surface of the zygomatic bones. The etiology of coronoid hyperplasia remains uncertain, with various proposed theories. As it is an unusual and infrequent clinical entity, hyperplasia of the coronoid process is often overlooked or diagnosed too late. A 27-year old, ASA I, male patient referred to our clinic because of his restricted mouth opening. Bilateral coronoid hyperplasia was detected after detailed temporomandibular joint examination. Restricted mouth opening was successfully treated by bilateral intraoral coronoidotomy with additional physiotherapy. The aim of this case report were emphasizing the mandibular coronoid process elongations as an unignorable differential diagnosis of the asymtomatic mandibular hypomobility cases additionally to the temporomandibular joint and masticator muscles dysfunctions and were describing its successful treatment by intraoral surgery and physiotherapy

Comparing the accuracy and precision of digital model transfer methods used in virtual orthognathic planning

Objectives: The hard and soft tissues of the head and neck, dentition, and temporomandibular joint are the determining elements in orthognathic surgery planning. The accuracy and precision of the relationship between the jaws at the beginning of treatment and their final position depend on an accurate dentition record. The aim of this study was to determine the simplest and most feasible virtual dental model transfer method for three-dimensional orthognathic planning according to clinical applicability, technical difficulty, effective costs, accuracy, and precision. Material and Methods: A total of ten spherical porcelain markers were placed in plaster models of the maxilla and mandible of a patient. The models were scanned using an intraoral optical scanner, an extraoral digital model scanner, and cone-beam computerized tomography. To evaluate reliability, each measurement was repeated 10 times at 1-week intervals and the distances between points were measured horizontally and vertically. The findings obtained in the study were evaluated statistically using IBM SPSS Statistics 2.2 program. Results: Measurements obtained with the extraoral model scanner did not differ from the digital caliper method (P > 0.05), while there were significant differences between the digital caliper and the other methods (intraoral 3D scanner P = 0.000; CBCT P = 0.001). Conclusion: Although all of the measurements showed high consistency among all methods, the most accurate results were obtained with the extraoral digital model scanner. (r = 0.99, P = 0.01, P < 0.05)

The prevelance of removal of miniplates used in orthognathic surgery: A retrospective study with long-term follow-up

Amaç: Bu çalışmanın amacı ortognatik cerrahi uygulanmış hastalarda miniplak ile ilişkili gelişen komplikasyonların uzun dönemli takip sürecince değerlendirilmesidir. Materyal ve Metod: Araştırmaya 2004-2017 yılları arasında ortognatik cerrahi uygulanmış hastalar dahil edilmiştir. Miniplak söküm nedeni, miniplak sökümü uygulanan bölge, ortognatik cerrahi ile miniplak söküm işlemi arasında geçen süre ve miniplak sökümü sonrasında bulgu ve semptomlarda iyileşme durumu değerlendirilmiştir. Bulgular: Araştırmaya dahil edilen 70 hastanın 11’inde (%15,7) toplam 19 adet miniplak söküm işlemi uygulanmıştır. Ortalama takip süresi 7,65+2,81 (3,5-15,3 yıl) yıl olup; ortognatik cerrahi ile miniplak çıkartılma işlemleri arasında geçen süre ortalama 1.52 yıldır (4 ay-6 yıl). Miniplak söküm nedenleri enfeksiyon (%45,5), soğuk hassasiyeti (%18,2), miniplağın palpe edilebilir hale gelerek hastada rahatsızlık oluşturması (%9), miniplağın bulunduğu bölgeye başka bir cerrahi uygulama yapılacak olması (%18,2) ve hasta isteği olarak sıralanabilir (%9). Toplam 13 adet (%11,6) miniplak mandibuladan çıkartılmış; 6 adet (%3,06) miniplak ise maksilladan çıkartılmıştır. Çene ucunda miniplak söküm işlemi uygulanmamıştır. Enfeksiyon nedeniyle mandibuladan miniplak sökülme oranının %69, maksilladan miniplak sökülme oranının ise %16,6 olduğu görülmüştür (p<0,05). Miniplak bulunan bölgeye uygulanacak başka bir cerrahi işlem nedeniyle maksilladan toplam 3 adet (%50) miniplak sökülmüş, mandibulada ve çene ucunda ise bu nedenle miniplak söküm işlemi uygulanmamıştır (p<0,05). Sonuç: Kliniğimizde 13 yıllık bir süreçte ortognatik cerrahi uygulanmış hastalarda miniplak söküm prevelansının %15,7 olduğu görülmüştür. Miniplak ile ilişkili komplikasyonlar ortognatik cerrahiden ortalama 1,5 yıl sonra gelişmiş, postoperatif 5. yıldan sonra miniplaklar ile ilişkili herhangi bir komplikasyon görülmemiştir.Aim: The aim of this study was to evaluate the complications associated with miniplates in patients who underwent orthognathic surgery, in the long-term follow-up period. Materials and Methods: Patients who underwent orthognathic surgery between 2004-2017 were included in this study. The reason for miniplate removal, the region where miniplate removal was performed, the time between orthognathic surgery and miniplate removal, and the improvement in signs and symptoms after miniplate removal were evaluated. Results: A total of 19 miniplate removal procedures were performed in 11 (15.7%) of the 70 patients included in the study. The mean follow-up period was 7.65 + 2.81 (3.5-15.3 years) years. The mean time between orthognathic surgery and miniplate removal procedure was 1.52 years. The reasons for miniplate removal were infection (45.5%), cold sensitivity (18.2%), palpable plate (9%), planning another surgery to the region where the miniplate was located (18.2%), and patient request (9%). A total of 13 (11.6%) miniplates were removed from the mandible; 6 miniplates (3.06%) were removed from the maxilla. None of the miniplates located on the chin was removed. The rate of miniplate removal from the mandible due to infection was found as 69%, and the rate of miniplate removal from the maxilla due to infection was 16.6% (p <0.05). 3 miniplates (50%) were removed from the maxilla for sinus lifting and rhinoplasty. On the other hand, no miniplate was removed neither from the mandible nor the chin for another surgery (p <0.05). Conclusion: It was observed that the prevalence of miniplate removal was 15.7% in patients who underwent orthognathic surgery in our clinic for a period of 13 years. Complications associated with miniplate developed 1.5 years after orthognathic surgery, and no complication was observed in the period 5 years after the operations

The Surgical Predictability of Maxillary Advancement and Impaction in Le Fort I Osteotomy

Objective:The aim of this study was to evaluate and compare the amount of preoperatively planned surgical movement of the maxilla and postoperatively obtained maxillary repositioning.Materials and Method:Thirty-one patients (16 female and 15 male) were included in this study. Fifteen combined maxillary advancement and impaction, 5 isolated maxillary impaction, and 11 isolated maxillary advancement surgeries were performed by the same surgical team. The 31 patients were divided into 2 groups: group 1 (GoGnSN≤38°) and group 2 (GoGnSN>38°). Various measurements from the horizontal and vertical reference lines were used to compare the predicted maxillary movement and the postoperatively obtained maxillary position. All variables were evaluated by Student's 2-tailed paired t tests.Results:There were statistically significant differences between the preoperatively planned and surgically obtained impaction movements of all evaluated landmarks, but no significant difference was seen between the planned and obtained advancement movement. For the differences between the planned and acquired maxillary advancement movements, 51% were within 2 mm of prediction. For the differences between the planned and the acquired maxillary anterior impaction movements, 51% were within 1 mm of the prediction. The difference was 35% for the impaction of posterior maxilla.Conclusion:The predictability of vertical movement of the maxilla via Le Fort I osteotomy was lower than that for sagittal movement. The difference between planned surgical movement and actual surgical outcome should be taken into consideration during treatment planning

An alternative distraction osteogenesis method for atrophic posterior mandible: Case report

Vertical lenghtening by distraction osteogenesis has been widely used for reconstruction of dentoalveolar defects. However if bone height between the alveolar crest and the anatomical structures is insufficient, performing an appropriate osteotomy and placement of distractors in desired position is impossible. In the presented case sagittal lengthening of the posterior mandible with distraction osteogenesis was achieved. After horizontal augmentation of the crest by intraoral cortical bone graft, 2 implants were inserted to the distraction area