Oral verrüköz karsinomun floresans rehberli rezeksiyonu

Oral verrükoz karsinomanın (OVC) cerrahi tedavisinde rezeksiyon sınırlarının doğru belirlenmesi hastalığın prognozu ve reküransı açısından oldukça önemlidir. Ameliyat sırasında malignite ve rezeksiyon sınırlarının belirlenmesi genellikle dokunun normalden farklı görünüşüne göre yapılmaktadır. Direkt floresans ışık rehberliğinde yapılan rezeksiyon yeni bir metot olup, ameliyat sırasında lezyon sınırlarının konvansiyonel yöntemlerden daha güvenilir ve kolay şekilde yapılmasını sağlar. Bu vaka raporunda, direk floresans ışık rehberliğinde OVC rezeksiyonu uygulaması sunulmuştur

Orthognathic treatment in Greig cephalopolysyndactyly syndrome: A case report

Typical Greig cephalopolysyndactyly syndrome (GCPS) is characterized by preaxial polydactyly or mixed preand postaxial polydactyly, true widely spaced eyes, macrocephaly. Individuals with mild GCPS may have subtle craniofacial findings. The diagnosis of GCPS is based on clinical findings and family history. GLI3 is the only gene known to be associated with GCPS. It has an autosomal dominant inheritance. The literature fails in documentations of any treatment protocol for defective jaw relationship in these patients. Therefore, we report on a patient with GCPS presenting polysyndactyly, frontal bossing, high forehead, skeletal Class III deformity due to maxillary retrognathism and mandibular prognathism, treated with orthognathic surgery by means of double jaw surgery and orthodontic treatment with fixed appliances

Perceptions of preoperative expectations and postoperative outcomes from orthognathic surgery: Part I: Turkish female patients

This Study was conducted in Turkish female patients to investigate their preoperative concerns, motivation, expectations, preoperative preparation for surgery and perception of outcomes concerning orthognathic surgery. Thirty women, with an age range of 18 to 31 years (mean age 21.8 +/- 3.8 years), participated in the study. The expectations and the results of orthognathic treatment were assessed based on the patients' Subjective appraisal. Patients completed questionnaires before and after the operations, designed to investigate the preoperative and postoperative psychological impact of the surgery, the perception of problems with physical and psychological functioning, self-image, body image and satisfaction with surgical outcome. The questionnaires were evaluated statistically with SPSS 11.5 for Windows. The patients' perception of their psychological improvement, faith in the surgical team, physical functioning, self-esteem, social confidence, body image and satisfaction after dentofacial correction were higher than the preoperative levels. The conclusions of the study support the theory that enhancement of facial appearance by orthognathic Surgery improves the psychological status of females with growth disturbances of the jaw

Extraction of a deeply impacted lower third molar by sagittal split osteotomy

Extraction of deeply impacted wisdom molars from the lower jaw with the bone osteotomy may necessitate removal of extra bone and complicate the procedure with damage to the inferior alveolar nerve and iatrogenic fractures of the mandible. In such cases, the sagittal split osteotomy offers excellent exposure to the operative field and minimizes bone loss at the mandibular ramus. The presented case includes removal of a deeply impacted lower third molar presenting mild infection from the mid-ramus using the sagittal split of the mandible. The sagittal split osteotomy, which appears to be a reliable technique, should be the method of preference when lower molars are deeply positioned between buccal and lingual cortices. © 2009 Mosby, Inc. All rights reserved

Vestibuloplasty with Retroauricular Skin Grafts for Dental Implant Rehabilitation in Vascularized Fibula Grafts: Two Case Reports

The aim of this study was to present the use of retroauricular full-thickness skin grafts in vestibuloplasty surgeries for dental implant rehabilitation in vascularized fibula grafts. Two patients underwent mandibular reconstruction with vascularized fibula grafts due to mandibular gunshot injuries. Inadequate sulcus gaps secondary to mandibular soft tissue deficiencies were managed by full-thickness autologous skin grafts harvested from the retroauricular region. Dental rehabilitation was achieved by implants placed in free fibula grafts. In both cases, complete graft survival was achieved. Cosmetic and functional outcomes were satisfactory. Owing to its high resiliency and elasticity and its thin and hairless structure, full-thickness retroauricular skin graft is an effective treatment modality in the management of intraoral soft tissue deficiencies. Patients with gunshot injuries present great functional and esthetic demands, and every report presenting new treatment modalities is helpful in the management of the condition

The role of computer-aided 3D surgery and stereolithographic modelling for vector orientation in premaxillary and trans-sinusoidal maxillary distraction osteogenesis

Background Maxillary distraction osteogenesis is a challenging procedure when it is performed with internal submerged distractors due to obligation of setting accurate distraction vectors. Methods Five patients with severe maxillary retrognathy were planned with Mimics 10.01 CMF and Simplant 10.01 software. Distraction vectors and rods of distractors were arranged in 3D environment and on STL models. All patients were operated under general anaesthesia and complete Le Fort I downfracture was performed. Results All distractions were performed according to orientated vectors. All patients achieved stable occlusion and satisfactory aesthetic outcome at the end of the treatment period. Conclusion Preoperative bending of internal maxillary distractors prevents significant loss of operation time. 3D computer-aided surgical simulation and model surgery provide accurate orientation of distraction vectors for premaxillary and internal trans-sinusoidal maxillary distraction. Combination of virtual surgical simulation and stereolithographic models surgery can be validated as an effective method of preoperative planning for complicated maxillofacial surgery cases. Copyright (C) 2009 John Wiley & Sons, Ltd

TME artroskopisi uygulanan dejeneratif temporomandibuler eklem hastalarında eklem hastalarında sinoviyal mikrovaskülarizasyonun power doppler ultrasonografi ile değerlendirilmesi

TME ARTROSKOPİSİ UYGULANAN DEJENERATİF TEMPOROMANDİBULER EKLEM HASTALARINDA SİNOVİYAL MİKROVASKÜLARİZASYONUN POWER DOPPLER ULTRASONOGRAFİ İLE DEĞERLENDİRİLMESİ Bu çalışmanın amacı, TME sinovitis olgularında, sinoviyal enflamasyonun ve mikrovaskülarizasyonun ortaya konulması ve TME artroskopisinin sinoviyal mikrovaskülarizasyonu hangi yönde değiştirdiğini tespit etmektir. Çalışmamızda, dejeneratif TME bulguları tespit edilen, MRI ve klinik bulgular ile TME sinovitis saptanan hastaların, artroskopi öncesi Power Doppler Ultrasonografi (PDUSG) ile sinoviyal mikrovaskülarizasyonu tespit edildi. Artroskopi sonrası 3 aylık PDUSG tetkikleri ile artroskopi uygulamasının sinoviyal mikrovaskülarizasyonu hangi yönde etkilediği takip edildi. Bu çalışma Marmara Üniversitesi Dişhekimliği Fakültesi Ağız-Diş-Çene Hastalıkları ve Cerrahisi Anabilim Dalı’na TME şikayetleri ile başvuran bireyler üzerinde yapılmıştır. Klinik muayeneleri M.Ü.D.F. Ağız-Diş-Çene Hastalıkları ve Cerrahisi Anabilim Dalı’nda yapılan hastalar M.Ü.T.F. Hastanesi Radyoloji Anabilim Dalı’na TME MRI ve PDUSG tetkikleri için gönderilmiştir. Tedaviye alınan hastaların MRI ve PDUSG tetkikleri doğrultusunda M.Ü.D. F. Protetik Anabilim Dalı’nda oklüzal splintleri hazırlanmıştır. Klinik olarak ağrı ve dejeneratif eklem hastalığı tespit edilen bireylere 1-3 ay arası splint kullanımından sonra M.Ü.D.F. Ağız-Diş-Çene Hastalıkları ve Cerrahisi Anabilim Dalı’nda diagnostik TME artroskopisi ile beraber lavaj ve lizis yapılmıştır. Çalışmamızda postoperatif 3. ayda alınan PDUSG görüntüleri ile artroskopi sonrasında sinoviyal mikrovaskülarizasyon da anlamlı derecede azalma olduğu tespit edilmiştir. Anahtar Kelimeler:Temporomandibuler eklem,sinovitis,mikrovaskülarizasyon, power doppler ultrasonografi, artroskopi EVALUATION OF SYNOVIAL MICROVASCULARIZATION USING POWER DOPPLER ULTRASONOGRAPHY IN ARTHROSCOPICALLY TREATED PATIENTS WITH DEGENERATIVE TEMPOROMANDIBULAR JOINT DISEASE SUMMARY The aim of this study is to evaluate the affect of TMJ arthroscopy on synovial microvascularization by comparing the grades of synovial microvascularization which were measured by power doppler ultrasonography scans in preoperative and postoperative period for patients with TMJ synovitis. Radiologic and clinical examinations were performed by magnetic resonance imaging and manuel palpation for internal derangements .The PDUSG scans were obtained preoperatively to assess the presence of synovial microvascularization. The postoperative PDUSG scans were taken in a period of 3 months following the arthroscopic surgery to demonstrate any change in synovial microvascularization. This study was conducted on symptomatic patients with degenerative TMJ disease in Marmara University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery. After the first clinical examinations , which were held in the Department of Oral and Maxillofacial Surgery; the patients were referred for MRI and PDUSG scans to Department of Radiology, School of Medicine, Marmara University. Occlusal TMJ splints were fabricated in M.U. Faculty of Dentistry, Department of Prosthodontics. Patients used occlusal splints for period of 1 – 3 months . Diagnostic TMJ arthroscopy with lavage and lysis was performed after failed comprehensive conservative treatment for internal derangements of TMJ patients. After two months of postoperative period , the PDUSG scans confirmed significant decrease in the levels of synovial vascularization. Key words: Temporomandibular joint,synovitis,microvascularization,power doppler ultrasonography,arthroscop