Evaluation of accessory mental foramen and accessory infraorbital foramen with cone-beam computed tomography in Turkish population.

It was aimed to evaluate the frequency of accessory mental foramen (AMF) and accessory infraorbital foramen (AIOF) and analyse the correlation between these two foramina using cone-beam computed tomography (CBCT). The retrospective study reviewed the CBCT images of 1020 patients. The rates of AMF and AIOF were evaluated according to sex and age distributions. Correlations between the localizations of AMF and AIOF in the right and left jaws and the correlations between the occurrences of these foramina were evaluated. In the CBCT images of the 1020 patients, AMFs were detected in 48 patients, among which 14 were in the right half jaw, and 34 were in the left half jaw. AIOFs were detected in 143 patients, among which 65 were in the right half jaw, and 78 were in the left half jaw. Recognising and detecting AMF and AIOF with CBCT is important in terms of preventing complications that may occur in surgical procedures.

Asporin levels in patients with temporomandibular joint disorders.

BACKGROUND: Understanding the pathogenesis of temporomandibular joint disorder (TMD) is important for diagnosis and treatment planning. Thus, biochemical analysis is usually used for the detection of tissue damage. OBJECTIVE: In this study, we aimed to investigate the serum asporin levels in patients with TMD. METHODS: Our study was planned to be performed on 43 healthy individuals (control group) without any joint problems and 43 patients with temporomandibular joint internal derangement (TMJ-ID; patients group) according to the Wilkes classification (stages 3, 4 and 5). Serum asporin levels were determined by the enzyme-linked immunosorbent assay (ELISA) method and compared between groups. Asporin levels were analysed according to the demographic and clinical characteristics of the patients, and the differences between them were demonstrated. RESULTS: Asporin levels were found to be significantly increased in the patients group compared to control group (p = .0303). The age and gender distributions of the samples in the control and patients groups were homogeneous, and there was no statistically significant difference between the groups. In addition, while there was no significant change in asporin levels in females in the patients group compared with the control group, the asporin levels were significantly increased in males in the patients group (p = .0403). CONCLUSIONS: Consequently, asporin seems to be an important biomarker in the pathobiology of TMJ-ID as it is significantly upregulated in these patients.

Comparison of Dexmedetomidine and Ketamine for Managing Postoperative Symptoms After Third-Molar Surgery.

PURPOSE: Lower-impacted third-molar surgery is the most common oral-maxillofacial surgery procedure and involves a considerable degree of soft- and bony-tissue trauma. This study measured and compared postoperative sequalae between patients receiving dexmedetomidine or ketamine after third-molar surgery. PATIENTS AND METHODS: This study was a randomized double-blind prospective trial. The patients were divided into 2 groups: ketamine and dexmedetomidine. Pain, swelling, and trismus outcomes were evaluated before and 2 and 7 days after surgery. In addition, patients were asked to record the number and timing of oral analgesic tablets they required during the postoperative period. Data were analyzed using the Mann-Whitney U test and a repeated-measures general linear model. The significance level was set at P < .05. RESULTS: The study included 66 patients (38 women and 28 men) undergoing extraction of impacted mandibular third molars. Significant differences were found between the groups in visual analog scale pain scores at 1, 6, and 12 hours after surgery (P < .001, P = .010, and P = .030, respectively). Trismus and swelling did not differ significantly between the 2 groups (P > .05). CONCLUSIONS: Ketamine resulted in less postoperative pain than dexmedetomidine during the first 12 hours after third-molar surgery.

Assessment of Effect of Submucosal Injection of Dexmedetomidine on Postoperative Symptoms.

PURPOSE: Embedded third molar surgery is the most frequent oral-maxillofacial surgical procedure performed. The purpose of this study was to assess the clinical effect of submucosal dexmedetomidine (dex) on decreasing postoperative edema, trismus, and pain after surgical molar extraction. MATERIALS AND METHODS: We carried out a double-blind, randomized, prospective study including patients undergoing surgical bilateral embedded mandibular molar extraction. Patients were divided into 2 groups: those receiving saline solution and those receiving dex. The main outcome measures of pain, facial swelling, and trismus were assessed on days 2 and 7 after surgery. In addition, patients were requested to record the time rescue analgesics were taken, as well as the total number taken. The variables were analyzed using the Student t test and a repeated-measures general linear model. P < .05 was considered statistically significant. RESULTS: The study included 40 patients (9 women and 11 men per group; mean age, 23.40 years) undergoing surgical bilateral embedded mandibular molar extraction. On day 2, a statistically significant difference in edema was found between the groups (P = .004). On days 2 and 7, statistically significant differences in the severity of trismus were found between the groups (P = .001 and P < .001, respectively). In addition, statistically significant differences were found between the groups in visual analog scale pain scores at 1, 6, 12, 24, and 48 hours (P = .161, P = .038, P = .110, P = .136, and P = .007, respectively) and in the number of analgesic tablets taken (P < .001). CONCLUSIONS: Preoperative submucosal dex is an efficient, safe, and beneficial therapeutic strategy to decrease edema, trismus, and pain after surgical molar extraction.

WhatsApp messaging improves communication in an oral and maxillofacial surgery team.

OBJECTIVE: Smartphones have become very popular among oral and maxillofacial surgeons. WhatsApp is an application that enables users to send voice, text, and multimedia messages using the group communication feature. The purpose of this study was to evaluate the efficiency of WhatsApp messaging as a mode of consultation within an oral and maxillofacial surgery team. MATERIALS AND METHODS: A retrospective study on WhatsApp group conversations amongst oral and maxillofacial surgeons was performed between July 2015 and July 2016. A WhatsApp group consisting of senior and junior surgeons was created, and many consultations were recorded. Seven hundred fifty-six consultations were included in the study. In this study, the arrival and response times of messages, types of cases, timing of consultation's end, consultant locations, contents of multimedia messages, and the categories/types of messages were evaluated. During consultations, some cases were discussed with text messages via WhatsApp, and some cases with voice and image messages via WhatsApp, with or without WhatsApp text messages. In addition, several cases were discussed with video messages via WhatsApp. Thus, a total of 1747 messages reflecting four different message types were included in this study: 754 (43%) were text messages, 752 (43%) were photographic images, 213 (12%) were videos, and 28 (nearly 2%) were voice messages. RESULTS: The most frequent consultations concerned impacted teeth (n = 363, 48.01%). Most consultations were resolved using WhatsApp (n = 306, 64.4%), and consultants were often not in the hospital during these consultations (n = 411, 54.3%). Most messages sent by consultants were conclusive (n = 306, 74.4%). CONCLUSION: We conclude that WhatsApp is a simple, free, and practical application, which allows efficient consultation when consultants are not in the hospital.

Clinical Evaluation of Complications in Implant-Supported Dentures: A 4-Year Retrospective Study.

BACKGROUND Implants that can be used in the prosthetic rehabilitation of full and partial edentulous patients are now frequently used due to advances in dentistry. Despite advanced methods of applications, failures and complications can still be seen. The aim of our study was to evaluate clinical prosthetic values and complications that occurred during 4-year follow-up in implant-supported restorations. MATERIAL AND METHODS This retrospective study included 40 patients who received oral rehabilitation with an implant-supported prosthesis. A total of 162 implants were placed: 99 in the maxilla and 63 in the mandible. The prosthetic and surgical data were recorded. Data including prosthetic complications and implant loss were recorded and statistically analyzed using Cox proportional hazard regression analysis. RESULTS In total, 159 implants (98.14%) survived, 3 implants (1.86%) failed, and 100% of the protheses were successful. There were 62 dental implants used as abutments for removable dentures and 97 for fixed dentures. The most frequent prosthetic complications after placement of an implant-supported prosthesis were loss of retention, mucositis, abutment screw loosening, and fracture. Patient satisfaction after prosthesis use was also evaluated, showing that satisfaction was systematically increased. CONCLUSIONS To minimize the frequency of complications, protocols must be established from diagnosis to the completion of treatment and follow-up of implant-supported prostheses, especially in terms of adequate technical steps and careful radiographic evaluation of the components.

Effects of Potentilla fulgens as a Prophylactic Agent in Tibial Defects in Rats.

OBJECTIVE: To investigate the effects of Potentilla fulgens as a prophylactic agent on tibial defects in the rat. STUDY DESIGN: Twenty-eight male Wistar albino rats weighing 200-215 g each were divided into 3 experimental groups. The tibial bone defect group served as the control group. The experimental groups were Potentilla fulgens with tibial defect (14 days) and Potentilla fulgens with tibial defect (28 days). Extract of Potentilla fulgens was mixed with water (400 mg/kg/day) and given to groups 14 and 28 as drinking water. The histopathological and immunohistochemical characteristics of each tibial bone cavity within each group were observed. The trabecular new bone formation was evaluated by expression rate of osteonectin and osteopontin. RESULTS: In the Potentilla fulgens + tibial defect group (14 days), trabecular bone had started combining extensive new bone formation, osteocyte cells were evident, and lamellar bone was formed. Osteoblasts showed a positive reaction with osteonectin. Osteopontin expression was positively observed between fibrous structures and in the osteoblast and osteocyte cells. This can be considered indicative of new bone formation. In the Potentilla fulgens + tibial defect group (28 days), an increase in expansion in trabecular bone and myeloid tissue was observed. Osteoblastic activity and osteocyte cells began to be observed in new bone fragments. CONCLUSION: In our study we show that Potentilla fulgens extract provided a protective effect on new bone formation and aided in the development of osteocytes and secretion of matrix in osteoblasts. Additionally, we show the inductive effect of the extract on new bone formation. In particular, the expression of osteopontin and osteonectin was also supported with the Western blot technique on the development of osteoblasts and osteocytes, showing a similar trend with our results.

Effect of Zoledronic Acid Application on Different Graft Materials in Calvarial Bone Defect Models. An Experimental Analysis.

OBJECTIVE: To determine the effect of zoledronic acid on graft materials in bone calvarial defects. STUDY DESIGN: Eighty adult (12 weeks) Sprague-Dawley male rats weighing from 300-350 g were divided into groups: calvarial defect, calvarial defect + synthetic graft, and calvarial defect + xenograft. All groups received zoledronate intravenously for a week after surgery and were sacrificed at either 6 or 12 weeks after their operation. The rat calvariae were fixed in 10% neutral buffered formalin before decalcification in 10% ethylenediaminetetraacetic acid for 20 days. Calvarial bone samples were then dehydrated and processed for embedding in paraffin wax. Sections 5 µm thick were stained with hematoxylin and eosin and examined by light microscopy. RESULTS: The effects of zoledronic acid, a third-generation nitrogen-containing bisphosphonate, on different graft materials in rats with critical-size calvarial defects were analyzed and compared. Significantly less graft resorption was identified in zoledronic acid-treated rats that had received a xenograft than in either the untreated rats or those with a synthetic graft. In the xenograft group primary ossification was visible at week 12, and the graft had entered the bone to a greater extent than in the other experimental groups or in the control group. Osseous structures were also observed more clearly in this group than in the others. CONCLUSION: Zoledronic acid histopathologic bone graft stimulates bone formation. Zoledronic acid may be considered among the therapeutic methods available to improve the bone formation process in calvarial bone formation.

Evaluation of calcified carotid atheroma on panoramic radiographs and Doppler ultrasonography in an older population.

AIM: The aim of this study is to determine the reliability of panoramic radiograph (PR) as a screening tool for the detection of calcified carotid atheroma (CCA) by comparing it with Doppler ultrasonography (DU) examination. A second aim was to evaluate the relationship among CCA, systemic diseases, smoking, and body mass index in an older population. MATERIALS AND METHODS: A total of 1,650 PRs of patients aged over 45 years (736 males and 914 females) were randomly selected. All the patients had been referred to the Faculty of Dentistry, Afyon Kocatepe University, Afyonkarahisar, Turkey, during 2013-2014 for routine PR screening. Medical data were collected from the archival records of the dental school. The patients were divided into two groups: Group A (study group), CCA findings were confirmed by DU (n=59); and Group B (control group), CCA findings were not confirmed by DU (n=34). RESULTS: Of the 1,650 individuals, 93 (5.63%) were detected to have CCA on PR. The population consisted of 43 males and 50 females with mean age of 59.84±10.92 years. No difference was determined in respect of CCA between the sexes (P=0.745). There was a significant difference between Group A and Group B in respect of hypertension (P=0.004). But there was no difference between Group A and Group B in respect of age (P=0.495), BMI (P=0.756), diabetes (P=0.168), and smoking (P=0.482) distribution. CONCLUSION: Although PR cannot be used as an initial diagnostic method when searching for CCA, dentists should be aware of CCA on a routine PR, particularly in older patients who may also have the risk factors of obesity, diabetes mellitus, hypertension, and smoking. Recognizing of CCA especially in hypertensive patients could potentially increase the length and quality of life for individuals.

Alterations in maxillary sinus volume among oral and nasal breathers.

BACKGROUND: Oral breathing causes many changes in the facial anatomical structures in adult patients. In this study we aimed to determine the effects of long-term oral breathing (>5 years) on the maxillary sinus volumes among adult male patients. MATERIAL/METHODS: We accessed medical records of 586 patients who had undergone cone beam computed tomography (CBCT) for any reason between September 2013 and April 2014. Patients who had undergone cone-beam dental volumetric tomography scans for any reason and who had answered a questionnaire about breathing were screened retrospectively. Cone beam dental volumetric tomography (I-Cat, Imaging Sciences International, Hatfield, PA, USA) was used to take the images of the maxillo-facial area at a setting of 120 kVp and 3.7 mA. This study involved male patients older than 21 years of age. RESULTS: The study included a total of 239 male patients, of which 68 were oral breathers and 171 were nasal breathers. The mean age of the oral breathers was 48.4 years and that of the nasal breathers was 46.7 years and the difference was not statistically significant (p>0.05). The mean maxillary sinus volumes of the oral and nasal breathers were 9043.49±1987.90 and 10851.77±2769.37, respectively, and the difference in maxillary sinus volume between the 2 groups was statistically significant (p<0.001). CONCLUSIONS: The volume of maxillary sinus in oral breathers (>5 years) was significantly lower than in nasal breathers, but it remains unclear whether this is due to malfunctioning of the nasal cavity or due to the underlying pathological condition.

A comparison of the effects of methylprednisolone and tenoxicam on pain, edema, and trismus after impacted lower third molar extraction.

BACKGROUND: The aim of the present study was to compare the effects of preemptive intravenous tenoxicam and methylprednisolone administrations on extraction of impacted third molars. MATERIAL AND METHODS: This was a placebo-controlled, randomized, double-blind, clinical trial. A total of 60 adult patients ages 18-40 years with the complaints of impacted third molar teeth were included in the study. RESULTS: The postoperative swelling ratios (p<0.05) and pain scores (p<0.05) were significantly better in both study groups than in the control group and there was no statistically significant difference between methylprednisolone and tenoxicam groups with regards to the edema and pain relief. CONCLUSIONS: Preoperative administration of 80 mg methylprednisolone achieves better control of trismus than tenoxicam without any significant differences in edema and pain control in impacted third molar teeth extraction.