The effect of mentoplate application on the condyle.

BACKGROUND: The aim of the study was to investigate the changes occurring in the mandibular condyle by using mentoplate together with rapid maxillary expansion (MP-RME) treatment in the correction of skeletal class III relationship, using fractal analysis (FA). METHODS: The sample consisted of 30 individuals (8-11 years) diagnosed with skeletal Class III malocclusion who underwent MP-RME treatment. Archival records provided cone-beam computed tomography (CBCT) images taken at two intervals: before MP-RME treatment (T0) and after treatment (T1). The CBCT images were obtained using standardized settings to ensure consistency in image quality and resolution. The trabecular structures in the bilateral condyles at both T0 and T1 were analyzed using FA. The FA was performed on these condylar images using the Image J software. The region of interest (ROI) was carefully selected in the condyle to avoid overlapping with cortical bone, and the box-counting method was employed to calculate the fractal dimension (FD). Statistical analysis was conducted to compare the FD values between T0 and T1 and to evaluate gender differences. The statistical significance was determined using paired t-tests for intra-group comparisons and independent t-tests for inter-group comparisons, with a significance level set at p < 0.05. RESULTS: The analysis revealed no statistically significant differences in the trabecular structures of the condyles between T0 and T1 (p > 0.05). However, a significant gender difference was observed in FA values, with males exhibiting higher FA values in the left condyle compared to females at both T0 and T1 (p < 0.05). Specifically, the FA values in the left condyle increased from a mean of 1.09 ± 0.09 at T0 to 1.13 ± 0.08 at T1 in males, whereas in females, the FA values remained relatively stable with a mean of 1 ± 0.09 at T0 and 1.03 ± 0.11 at T1. CONCLUSION: The findings indicate that MP-RME therapy does not induce significant alterations in the trabecular structure of the mandibular condyle. These results suggest the treatment's safety concerning the structural integrity of the condyle, although the observed gender differences in FA values warrant further investigation.

Determination of safety margin of nasal septum osteotomy for sphenoid sinus in cleft lip and palate patients.

BACKGROUND: Nasal septum osteotomy is used for separating the nasal septum and maxilla during a Le Fort I osteotomy. If this osteotomy is applied too high or is tilted into the nasal cavity, the sphenoid sinus and various adjacent vital structures may be damaged, and serious bleeding, neurological complications, blindness or even death may occur. The aim of this study is to determine the safety margin of the nasal septum osteotomy for sphenoid sinus during the Le Fort I surgery in cleft lip and palate (CLP) patients. METHODS: Twenty cleft lip and palate (the CLP group) and 20 healthy individuals (the control group) were included in this study. Three values (two lines and an angle) were measured by cone beam computed tomography (CBCT). The first line is the line passing through the junction of the spina nasalis anterior point and the lower point of the perpendicular lamina of the palatine bone. The undersired line is the line passing through the junction of the spina nasalis anterior point and the lower anterior border of the base of the sphenoid sinus. The osteotomy angle is the angle between these two lines. RESULTS: In the control group; a surgical line of 44.11-61.14 mm (mean 51.91 ± 4.32), an undesired line of 52.48-69.58 mm (mean 59.14 ± 5.08) and an angle of 18.22-27.270 (mean 22.66 ± 2.55) were found, while in the CLP group, a surgical line of 34.53-51.16 mm (mean 43.38 ± 4.79), an undesired line of 46.86-61.35 mm (mean 55.02 ± 3.24) and an angle of 17.60-28.810 (mean 22.60 ± 2.81) were found. CONCLUSIONS: Although the angle to the sphenoid sinus was not significantly affected by CLP, careful planning and consideration of these anatomical differences are crucial to prevent complications and ensure the safety of Le Fort I surgery in CLP patients. Further research with larger sample sizes and subgroup analysis of unilateral and bilateral CLP cases is needed to improve our understanding of these anatomical variations and improve surgical approaches to individuals with CLP undergoing orthognathic procedures.

Evaluation of complications and quality of life of patient after surgical extraction of mandibular impacted third molar teeth.

BACKGROUND: The aim of our study is to evaluate the postoperative complications after the extraction of impacted third molar teeth and to investigate the effects of these complications on the quality of life of patients. METHODS: Demographic, clinical, and radiological evaluations were conducted, covering factors like age, gender, and tooth position. Clinical measurements, pain and edema assessments, and quality of life evaluations through OHIP-14 scores were performed. Preoperative and postoperative mouth opening, trismus, alveolitis and dehiscence were evaluated. RESULTS: A total of 100 patients were included in our study. No significant gender-based differences were found in measurements, pain, or swelling. There was no statistically significant difference between the preoperative and postoperative results of difference A-C, difference B-E, difference A-D, and difference mouth opening. Procedure duration correlated positively with age, alveolar osteitis, trismus, and swelling. Postoperative quality of life, assessed by OHIP-14, demonstrated a negative correlation with age and trismus. It was observed that the gender and the tooth positions of the patients had no effect on the severity of postoperative pain and edema. CONCLUSIONS: As the age of the patients increases and the duration of the procedure increases, the rate of postoperative complications increases and it is concluded that the quality of life decreases significantly.

Determining the safety margin of mandibular lingula in sagittal split ramus osteotomy.

PURPOSE: The anatomical position of the lingula is clinically very important to prevent injuries during sagittal split ramus osteotomy. Our study aims to evaluate the localisation of the lingula by cone beam computed tomography (CBCT) and to compare the localisation of the lingula between malocclusion, gender, and lingula types. METHODS: A retrospective study was conducted to evaluate the shape and location of the lingula using CBCT. A total of 250 CBCT images were included in this study. The lingula was classified as nodular, assimilated, truncated, or triangular type. Six defined distances from the top of the lingula were measured: anterior border of the ramus (L-A), posterior border of the ramus (L-P), internal oblique ridge (L-IOR), mandibular notch (L-N), and distal surface of the mandibular second molar (L-M2) and occlusal plane (L-OP). The measured distances were compared between gender, malocclusion, and lingula types. RESULTS: The most common type of lingula was nodular (32.4%). The L-N, L-P, L-M2, and L-OP distances between genders were statistically higher in male patients than in female patients. The L-IOR, L-M2, and L-OP distances exhibited statistically significant differences found between malocclusions. No statistically significant difference was found when the distances of the lingula to the anatomical points were compared between the lingula types. CONCLUSION: These variations in positioning of the lingula depending on the dysmorphoses are developing towards a systematic 3D examination before any mandibular osteotomy to precisely visualize the position and shape of the lingula.

Comparison of Periodontal Health and Marginal Bone Loss in Mandibular First Molar Single-Crown Dental Implants Placed in Different Positions.

The aim of the present study is to compare the periodontal health and marginal bone loss (MBL) between single-crown dental implants placed interdentally and mesial to the edentulous space. Patients treated with single-crown dental implants between 01/04/2014 and 01/04/2021 were included in the study. The included patients were divided into 2 groups. Group 1 consisted of single implant crowns inserted interdentally with a distal neighboring mandibular second molar and Group 2 consisted of single molar implant crowns inserted distally to the second premolar tooth without a neighboring second molar. The measurements for probing pocket depth, gingival index, and plaque index were made in both groups at the 60-month control session to evaluate periodontal health of the single-crown dental implants. The marginal bone levels of distal and mesial aspects of all implants were measured at the 60-month control session on panoramic radiographs. Forty-six and sixty-one patients were included in Groups 1 and 2, respectively. There was a significantly higher distal MBL in Group 2 compared with Group 1 (P < 0.05). Mesial MBL was higher in Group 1, however, this difference was not significant. The periodontal parameters of probing pocket depth, gingival index, and PI were all significantly higher in Group 1 compared with Group 2 at the 60-month control evaluation (P < 0.05). Single-crown dental implants placed interdentally may show decreased distal MBL and periodontal health compared with single-crown dental implants placed mesial to the edentulous space.

Biomechanical and Histologic Evaluation of Osseointegration of Titanium Dental Implants Modified by Various Combinations of Sandblasting, Acid-Etching, Hydroxyapatite, and Hyaluronic Acid Coating Techniques.

PURPOSE: To compare the osseointegration process of the titanium dental implants with five different surface characteristics-sandblasted, sandblasted and acid-etched, hyaluronic acid-coated (HYA), hydroxyapatite-coated (HA), and machined-in an experimental sheep model at 1- and 3-month examinations. MATERIALS AND METHODS: One hundred sixty dental implants were placed in the left and right tibias of 16 sheep. Five experimental groups were designed. Eight animals (80 implants) were used for biomechanical tests of reverse torque analysis and resonance frequency analysis (RFA). Eight of them (80 implants) were used for the evaluation of bone-to-implant contact (BIC) percentage in histomorphometric analysis. Forty of 80 implants (8 implants for each group) were used at 1-month examinations, and the remaining 40 (8 implants for each group) implants were used at 3-month examinations in the biomechanical test group and histomorphometric examination group, separately. RESULTS: Intergroup analysis at the 3-month followup showed that the increase in the implant stability quotient (ISQ) value was statistically significant for only the HYA group (P < .05). According to ISQ values at 1 and 3 months, group HYA showed statistically higher values at the 1 and 3-month examinations (P < .05). Groups HYA and HA had statistically higher reverse torque values than other groups at the 1-month examination (P < .05). At the 3-month evaluation, the HYA group showed significantly higher reverse torque values compared to other groups (P < .05). The BIC values of the sandblasted and acid-etched, HYA, and HA groups were significantly higher than the sandblasted and machined groups at the 1- and 3-month examinations (P < .05). The BIC value for the HA group showed decreased value at the 3-month examination compared to the 1-month examination (P < .05). CONCLUSION: The RFA, reverse torque, and histomorphometric analysis at 1- and 3-month examinations show that dental implants coated with HYA may have increased potential for osseointegration compared to dental implants with sandblasted, sandblasted and acid-etched, machined, and HA-coated surfaces. Int J Oral Maxillofac Implants 2023;38:583-590. doi: 10.11607/jomi.9935.

Histologic and Immunohistochemical Assessment of the Effect of Various Biomaterials on New Bone Formation in the Maxillary Sinus Floor Augmentation Procedure.

PURPOSE: To assess the effect of different kinds of biomaterials placed with maxillary sinus floor augmentation (MSFA) on bone regeneration. MATERIALS AND METHODS: Thirty-six New Zealand rabbits were used in the study. A standardized method of surgical approach was used for MSFA under anesthesia in all groups. The procedure was performed for each animal. Six separate groups with 12 cases were created. In group 1, no graft was used in MSFA. Advanced platelet-rich fibrin (A-PRF), absorbable collagen cone (ACC), venous blood, the combination of ACC and platelet-rich plasma (PRP), and the combination of ACC and enamel matrix derivative (EMD) were used in groups 2, 3, 4, 5, and 6, respectively. At the end of 4 and 12 weeks, three rabbits from each group were sacrificed by applying high-dose anesthetic, and samples were examined histologically and immunohistochemically. RESULTS: Groups 2 and 5 showed significantly increased new bone formation compared with groups 1 and 4, 4 weeks after MSFA (P < .05). Twelve weeks after sinus floor augmentation, groups 2, 3, 5, and 6 showed significantly higher new bone formation than group 1 (P < .05). Groups 2 and 5 showed significantly higher hard tissue response than groups 1 and 4 at the end of 4 weeks (P < .05). Groups 5 and 6 demonstrated significantly higher hard tissue response than group 1 at the end of 12 weeks (P < .05). Group 5 also showed significantly higher hard tissue response than group 4 at the end of 12 weeks (P < .05). Immunohistochemical analysis showed a significant difference between the osteocalcin scores of groups 2 and 4 and group 1 at the end of 4 and 12 weeks (P < .05). There was also a statistically significant difference between osteocalcin scores at 4 and 12 weeks for groups 1 and 5 (P < .05). When osteopontin scores were compared, there was no significant difference between groups at 4 and 12 weeks (P > .05). Groups 1, 2, and 5 showed significant changes in osteopontin scores between 4 and 12 weeks (P < .05). CONCLUSION: The combination of ACC and PRP and the combination of ACC and EMD showed increased new bone formation and hard tissue response. A-PRF also showed promising results in new bone formation at the end of both 4 and 12 weeks. The usage of ACC as a carrier for liquid-form biomaterials may be more beneficial than the usage of ACC alone.

The Comparison of Dental Anxiety between Patients Treated with Impacted Third Molar Surgery and Conventional Dental Extraction.

BACKGROUND: The aim of the present study is to compare the dental anxiety levels between two outpatient clinics. METHODS: Two hundred and seventy patients treated in two different clinics of minor oral surgery and dental extraction polyclinic in the Dental Faculty of Eskisehir Osmangazi University were included in the study. The impacted third molar surgery group and conventional dental extraction group consisted of 101 and 169 patients, respectively. The Modified Dental Anxiety Scale (MDAS) and Dental Fear Scale (DFS) were used to measure anxiety levels in patients treated in both clinics. Tests were made in an isolated room preoperatively. The differences in anxiety levels according to education status and gender were also evaluated. RESULTS: The impacted third molar surgery group showed a significant increase in dental anxiety measured with DFS questionnaire (p < 0.05). However, MDAS revealed that there was no difference between anxiety levels between the impacted third molar surgery and conventional dental extraction groups (p > 0.05). There was also no difference in anxiety levels between patients with different education status (p > 0.05). Female patients demonstrated higher levels of anxiety in both MDAS and DFS indexes (p < 0.05). CONCLUSION: Dental anxiety may be higher in patients treated with impacted third molar surgery compared with conventional dental extraction. The education status of patients may not affect dental anxiety. Female patients may show increased levels of dental anxiety in conventional dental and impacted third molar extractions.

Two-Dimensional Change in the Cystic Defects after Decompression and Enucleation of Jaw Cysts - A Comparative Study.

Introduction: To compare the treatment methods of enucleation and decompression with regards to reduction of the dimension of the cystic defect with the aid of a software program. Materials and Methods: Thirty patients with regular controls of 3, 6, and 12 months treated between January 1, 2013, and January 1, 2021, were selected and included in the study. Sixteen patients were treated with enucleation and 14 patients with decompression. All preoperative and control radiographic and clinical data were retrieved from the archives. The area measurement of cystic cavities was made on panoramic radiographs taken at preoperative (T0), 3-month (T1), 6-month (T2), and 12-month (T3) control periods with a software program. Intra-group and inter-group analyses were made to compare the reduction of cystic defects between two treatment methods. Results: The mean age of study patients was 45.2 ± 7.3. Eighteen of them were male and 12 of them were female. Statistically, a significant difference was not observed between decompression and enucleation groups at T0, T1, T2, and T3 control periods (P > 0.05). There was a statistically significant difference in the defect dimensions between all control periods in both decompression and enucleation groups (P < 0.05). Discussion: Decompression and enucleation of jaw cysts are both successful in reducing cystic cavities. However, there is no superiority between the two treatment modalities regarding the defect reduction at the 12-month control period.

Comparison of the Crestal Bone Loss Between Implant-Supported Prosthesis With Sinus Augmentation and Distal Cantilevered Implant-Supported Prosthesis Without Sinus Augmentation.

This study aimed to compare the crestal bone loss between a 2-implant-supported, noncantilevered 3-unit fixed partial prosthesis (TUFPP) with sinus augmentation and a 2-implant-supported, distal cantilevered TUFPP without sinus augmentation in the posterior maxilla having insufficient crestal bone. The study subjects were enrolled in 2 groups. Group 1 included patients with 2 implants: an anterior implant placed in the native bone and a posterior implant inserted with simultaneous sinus augmentation using a xenogenic bone graft to support a TUFPP. Group 2 included patients with 2 implants inserted in the native bone to support a distal cantilevered TUFPP. The crestal bone levels at the distal and mesial aspects of each implant were measured at baseline and 6-, 12-, and 24-month follow-up controls on panoramic radiographs. Fifty-two patients and 104 implants were included. There was a significant difference in distal crestal bone loss between anterior and posterior implants in group 1 at 6 months (P < .05) but not at 12 and 24 months (P > .05). Distal crestal bone loss was significantly increased in group 1 posterior implants compared to the group 2 posterior implants at 6 months (P < .05). There was no significant difference in mesial bone loss between the anterior and posterior implants in both groups at all follow-up controls (P > .05). There was also no significant mesial crestal bone loss in relation to the anterior and posterior implants of both groups at all follow-up controls (P > .05). Noncantilevered 2-implant-supported TUFPP with sinus augmentation may have similar medium-term crestal bone loss when compared to cantilevered 2-implant-supported TUFPP without sinus augmentation. Further prospective studies should be designed to compare the performance of the 2-implant-supported cantilevered TUFPP and 2-implant-supported TUFPP with sinus augmentation.

Effects of implant-related variables on the marginal bone loss around dental implants.

OBJECTIVE: Marginal bone loss (MBL), a prognostic parameter for implant success, is associated with implant- and patient-related variables. The purpose of this study was to analyze the effects of the crown-to-implant ratio and independent factors of implant diameter, implant length, implant type, location, and platform switching on distal and mesial MBLs at the 6-, 12-, 24-, and 36-month recall sessions of single crown implant-supported restorations. METHOD AND MATERIALS: Radiographic and clinical data of patients treated with single crown implants were collected. MBL was measured at the baseline and recall sessions on panoramic radiographs. The crown-to-implant ratio was calculated by dividing the length of the crown by that of the dental implant. RESULTS: The crown-to-implant ratio had a moderately positive correlation with distal MBL at the 6-month recall session (P < .05, r = 0.469) and a weakly positive correlation at the 12- (P < .05, r = 0.220), 24- (P < .05, r = 0.214), and 36- (P < .05, r = 0.250) month recall sessions. Distal and mesial MBL did not significantly differ among the four implant types at any recall session (P > .05). The crown-to-implant ratio had no significant correlation with mesial MBL at the 12-, 24-, or 36-month recall session (P > .05), and a moderately positive correlation at the 6-month recall session (P < .001, r = 0.434). CONCLUSIONS: MBL was similar among different implant types in the short and medium terms. There was a positive correlation between distal MBL and the crown-to-implant ratio.

Effects of different polyvinylpyrrolidone iodine concentrations on trismus and swelling following third molar surgery.

OBJECTIVE: To compare the clinical efficacy of different povidone iodine concentrations for the management of postoperative pain and swelling following mandibular third molar surgery. METHODS: The randomised, prospective, double-blind and controlled study was conducted from October 2016 to January 2018 at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Biruni University, Istanbul, Turkey, and comprised individuals aged 18-30 years who underwent surgical removal of pathology-free completely unerrupted mandibular lower third molars. The participants were randomly assigned to four groups: Group I had saline-only controls, Group II was given 0.5% concentration of povidone iodine, Group III had 1% concentration of povidone iodine, and Group IV had 3% concentration of povidone iodine. Facial swelling and trismus were assessed on the 2nd and 7th postoperative days. Data was analysed using SPSS 22. RESULTS: Of the 80 patients, 34(42.5%) were males and 46 (57.5%) were females with an overall mean age of 24.6±3.68 years. Each group had 20 (25%) subjects. All three concentrations of povidone iodine provided significant reduction in postoperative trismus compared to the controls. Trismus was less in Group III and Group IV compared to Group II up to 7 days after surgery. CONCLUSIONS: Irrigation with 3% povidone iodine concentration was found to be more effective in reducing the level of facial swelling after impacted third molar surgery. (Clinical Trials.gov Identifier: NCT03894722).

The Evaluation of the Relationship between Loading Time and Crestal Bone Loss around Dental Implants at 12 Months Control Evaluation after Loading.

The evaluation of the relationship between loading time and crestal bone loss around dental implants 12 months after loading was the objective of this study. All clinical and radiological data of patients treated with posterior mandibular implant-supported fixed dentures between January 4, 2013 and January 3, 2018 were retrieved from the archives. Loading time was recorded as the time between dental implant insertion and loading of the implant-supported restoration. The crestal bone levels of distal and mesial aspects of all implants were measured at postloading 12 months control evaluation on panoramic radiographs. Distal and mesial crestal bone loss values were recorded and averaged to obtain one mean value. The relationship between loading time and crestal bone loss was evaluated with statistical analysis. A total of 89 patients and 238 implants were included in the study. The loading time for each implant was recorded between a range of 0 and 401 days. A linear relationship was observed between loading time and crestal bone loss measured at 12 months control evaluation. The crestal bone loss at 12 months control evaluation after loading was significantly increased with the increase in the loading time after dental implantation (p < 0.05). The range of CBL was narrower between 100 and 200 days of loading time. The increase in loading time may cause increased crestal bone loss after 12 months function. Crestal bone loss at 12 months control evaluation is more predictable in dental implants loaded between 3 to 6 months after dental implant placement.

Evaluation of New Bone Formation in Sinus Floor Augmentation With Injectable Platelet-Rich Fibrin-Soaked Collagen Plug: A Pilot Study.

INTRODUCTION: The objective of this study is to evaluate the new bone formation after sinus floor augmentation with collagen plugs used as carriers for injectable platelet-rich fibrin (i-PRF). MATERIALS AND METHODS: Postoperative immediate and postoperative 6th month panoramic radiographies of patients treated between January 1, 2015, and February 1, 2018, with sinus floor augmentation using i-PRF-soaked collagen plugs were retrieved from the archives, and subantral bone heights of distal and mesial regions of simultaneously inserted implants were measured with a software program. Statistical analysis was performed to understand whether there is a significant change in new bone formation at 6th month follow-up control. RESULTS: A total of 18 implants were inserted in 12 patients. There was significant new bone formation at 6th month follow-up radiography at mesial and distal regions of inserted implants (P < 0.05). CONCLUSION: New bone was regenerated with i-PRF carried by collagen plugs in sinus floor augmentation.

Assessment of the Effect of Clinical Independent Risk Factors on Marginal Bone Loss in 2-Implant-Supported Locator-Retained Mandibular Overdentures.

The objective of this study is to evaluate the effect of clinical parameters of gender, age, implant length, implant diameter, interimplant distance, and locator height on marginal bone loss in 2-implant-supported locator-retained mandibular overdenture prostheses in 6, 12, and 24 recall sessions after loading. Clinical and radiographic data of patients who were treated between January 1, 2014, and January 4, 2018, were retrieved from the archives. The clinical data of gender, age, implant length, implant diameter, and locator height were recorded. The mesial and distal marginal bone levels of all implants and interimplant distances were determined at baseline and at 6-, 12-, and 24-month recall sessions on panoramic radiographs in a computer program. Statistical analysis was used to evaluate the effect of implant length, implant diameter, gender, age, interimplant distance, and locator height on marginal bone loss at the 6-, 12-, and 24-month control evaluations. A total of 57 patients with a mean age of 59.2 ± 9.8 years and 114 implants were included in the study. Among the aforementioned parameters, only the locator height had a major effect on the distal and mesial marginal bone loss (P < .05). A locators with a 4-mm height showed statistically significant distal and mesial marginal bone loss compared with locators with 2- and 3-mm heights in all control periods (P < .05). The locator with a 4-mm height generated more stress compared with locators with 2- and 3-mm heights, leading to marginal bone loss. The absence of oral hygiene evaluation was identified as a limitation of the study. Clinical parameters of gender, age, implant length, implant diameter, and interimplant distance did not seem to affect marginal bone loss in the study population of the current study.

Evaluation of temperature rise following the application of diode and ErCr:Ysgg lasers: an ex vivo study.

PURPOSE: Erbium, chromium: yttrium, scandium, gallium, garnet (ErCr:Ysgg) lasers have been frequently used in oral surgical procedures and are almost seen as alternatives to diode lasers. The aim of this comparative study was to analyze in an animal model the thermal elevation induced by ErCr:Ysgg and diode lasers in soft tissue and bone. MATERIALS AND METHODS: Thirty freshly dissected sheep mandibles containing bone and soft tissue were divided into 120 equal parts. Gallium-aluminum-arsenide (Ga-Al-As) diode laser (λ=940 nm) with 1, 2 and 5 W output powers and ErCr:Ysgg laser (λ=2780 nm) with 2.75, 4.5 and 6 W output powers were used on soft and bone tissues separately for 3 seconds with point application. Mean temperature values before and after application of the lasers were compared in soft tissue and bone. RESULTS: The minimum mean temperature value was observed with 2.75 W ErCr:Ysgg laser while irradiation with 5 W diode laser created the maximum values (p<0.05). CONCLUSION: ErCr:Ysgg laser (λ=2780 nm) with 2.75 W power generates low levels of heat compared to diode lasers and may provide safer surgery in soft and bone tissues without destructive effects of temperature increase.

Histomorphometric Comparison of Bone Regeneration in Critical-Sized Bone Defects Using Demineralized Bone Matrix, Platelet-Rich Fibrin, and Hyaluronic Acid as Bone Substitutes.

AIM: To compare bone regeneration in the critical-sized bone defects grafted with demineralized bone matrix, platelet-rich fibrin, and hyaluronic acid in rats. MATERIALS AND METHODS: Forty Wistar Albino rats allocated into 4 experimental groups: platelet-rich fibrin (PRF) group, noncross-linked hyaluronic acid gel (HA) group, demineralized bone matrix in putty form (DBM) group, and control group. A critical-sized defect of 8 mm was formed involving the sagittal suture for each rat under anesthetic induction. All animals were sacrificed at 21st day after surgery and histomorphometric parameters of total horizontal length (THL) and total vertical length (TVL) of newly produced bone and longest bone trabecula (LBT) were measured in the histologic slides. The difference between experimental groups for these parameters was analyzed. RESULTS: There was statistically significant difference in THL and LBT but not in TVL. Total horizontal length was significantly increased in DBM group compared with control and HA groups (P < 0.05). There was also statistically significant increase in THL in PRF group compared with control group (P < 0.05). Longest bone trabecula significantly increased in DBM group compared with HA group (P < 0.05). There was also statistically significant increase in HA group compared with control group (P < 0.05) and LBT significantly increased in PRF group compared with HA group (P < 0.05). CONCLUSION: The sole usage of HA does not effectively increase bone regeneration when compared with DBM and PRF. The DBM and PRF do not have superiority to each other in the bone regeneration while they are superior to HA.

Histological evaluation of the possible transformation of peripheral giant cell granuloma and peripheral ossifying fibroma: A preliminary study.

AIMS: The objective of this study is to describe shared morphological features of peripheral giant cell granuloma (PGCG) and peripheral ossifying fibroma (POF) in detail and discuss the possible relationship between them. MATERIALS AND METHODS: Ten intermediate cases with features resembling to both POF and PGCG were selected and type 3 and 1 collagen immunostainings were performed for evaluation of the connective tissue maturation. Immunohistochemical staining percentage (SP) for stromal cells in the slides of POF and PGCG counterparts of intermediate lesions was scored as 1 when the SP was above 10%, 2 when the SP was above 25%, 3 when the SP was above 50% and 4 when the SP was above 75%. Staining intensity (SI) of immunuhistochemical staining was graded and scored as 1 - mild, 2 - moderate, and 3 - severe. An immunoreactivity score was calculated by multiplying SP and SI. RESULTS: All intermediate lesions comprised osteoclast type multinucleated giant cells and partly mineralized hard tissue component. Parts of intermediate lesions resembling POF showed higher type 1 collagen immunoreactivity compared to the PGCG counterparts of intermediate lesions (P < 0.05). PGCG counterparts showed higher type 3 collagen immunoreactivity compared to the POF counterparts of the intermediate lesions (P < 0.05). CONCLUSION: POF may be a later stage lesion with morphologically more mature components. A possible transformation may be considered for these two lesions.

Endodontic Outcomes in Mandibular Second Premolars with Complex Apical Branching.

INTRODUCTION: Mandibular premolars that have rare and complex anatomies may have the highest failure rate in nonsurgical endodontic treatment. Awareness of rare and complex anatomies of mandibular second premolars would aid in better outcomes of the treatment. This study aimed to evaluate the success of nonsurgical root canal treatment of mandibular second premolar teeth with complex apical branching. METHODS: Twenty-six mandibular second premolar teeth with complex apical branching treated with multiple-visit nonsurgical root canal treatment or nonsurgical retreatment were retrospectively evaluated. RESULTS: For the clinical outcomes, 9 subjects had complete healing, 1 subject had functional healing, and no subject had no healing scores out of 10 root canal treatment subjects. Six subjects had complete healing, 8 subjects had functional healing, and 2 subjects had no healing scores out of 16 retreatment subjects. For the radiographic outcomes, 7 subjects had complete healing, 3 subjects had incomplete healing, and no subject had no healing scores out of 10 root canal treatment subjects. Six subjects had complete healing, 8 subjects had incomplete healing, and 2 subjects had no healing scores out of 16 retreatment subjects. The clinical outcome of root canal treatment subjects was significantly different than retreatment subjects (P < .05). Similarly, the radiographic outcome of root canal treatment subjects was also significantly different than retreatment cases (P < .05). CONCLUSIONS: The outcome of endodontic treatment of mandibular second premolars may be influenced by treatment type.

The Comparison of the Efficacy of Blue Light-Emitting Diode Light and 980-nm Low-Level Laser Light on Bone Regeneration.

The aim of this study is to histologically compare effects of blue light-emitting diode (LED) light (400-490 nm) and Ga-Al-As low-level diode laser light (980 nm) on bone regeneration of calvarial critical-sized defects in rats. Thirty Wistar Albino rats were included in the study. The experimental groups were as follows: blue LED light (400-490 nm) group (LED); 980-nm low-level laser light group (LL); and no-treatment, control group (CL). A critical-sized defect of 8 mm was formed on calvaria of rats. Each animal was sacrificed 21 days after defect formation. Calvarias of all rats were dissected and fixated for histological examination. Histomorphometric measurements of total horizontal length of the newly produced bone tissue, total vertical length of the newly produced bone tissue, and diameter of the newly produced longest bone trabecula were performed with a computer program in micrometers. There was a statistically significant increase in the total horizontal length and total vertical length in LL and LED groups compared to that in the CL group (P < 0.05), while there was no statistical difference between LED and LL groups (P > 0.05). A statistically significant difference was observed in the longest bone trabecula and LL groups compared to that in CL (P < 0.05), but not between LED-CL and LED-LL groups (P > 0.05). In conclusion, blue LED light significantly enhances bone regeneration in critical-sized defects when compared with CL group, but does not have a statistically significant effect on bone regeneration when compared with 980-nm low-level laser light.