The micro CT evaluation of crown and root pulp volume versus dentin thickness in teeth in postmortem interval (PMI).

Determining the postmortem interval (PMI) is one of the main study subjects of forensic sciences. The main purpose of this prospective in vitro study that was the Micro-CT evaluation of teeth crown and root pulp volume versus dentin thickness in terms of PMI determination. The study involved 60 female Wistar rats, with weights ranging from 270 to 320 g. These rats were grouped into six different post-mortem period categories. Following the animals' sacrifice, they were subjected to a natural putrefaction period, with a control group, in the grounds of a sheltered garden. Hemi-mandible samples were then extracted and placed in glass tubes for Micro-CT evaluations, following the progression of putrefaction processes. The pulp volume and dentin thickness were assessed using Micro-CT, and the gathered data underwent statistical analysis. Micro-CT was employed to analyze sixty right mandibular second molar teeth in the hemi-mandible. The crown pulp volume exhibited a reduction in group 6, with a value of 0.239 mm3 after a three-month period of natural putrefaction (p < 0.001). There is statistically differences among groups in case of pairwise comparison (p < 0.05). However, the root pulp volume and dentin thickness variables did not display any statistically significant changes. Despite certain limitations associated with this study, the Micro-CT findings concerning teeth pulp volume can serve as an objective parameter, especially for late postmortem investigations and the estimation of time of death.

Effects of modified step Le Fort I advancement surgery on nostril area and inferior nasal structures volume in class III patients: a retrospective clinical study.

OBJECTIVE: The effect of the modified step Le Fort I osteotomy on the inferior nasal structures and the nostril area was evaluated. MATERIALS AND METHODS: This study included 24 patients who had modified step Le Fort I osteotomy. Inferior nasal concha volume (INCV), meatus nasi inferior volume (MNIV), the sum of both structures volume (TV), and nostril area (NA) were evaluated in pre- (T0) and postoperative (T1) periods. RESULTS: For all patients, NA increased both on the right side (p = 0.011) and left side (p = 0.050) after surgery. The INCV and TV values were lower in T1 than those in T0; however, a statistically significant decrease of INCV and TV was found only in the right side of males (p = 0.039 and p = 0.050, respectively). No significant difference was found in MNIV between T0 and T1 measurements (p > 0.05). CONCLUSION: Maxillary advancement with the modified step Le Fort I osteotomy technique increased the NA, which may have a positive effect on breathing function. On the other hand, although TV tended to decrease, MNIV did not change after surgery as the same decreasing tendency also existed in INCV. CLINICAL RELEVANCE: Step Le Fort I advancement surgery technique usually affects nasal structures positively regarding the nasal airway.

Comparison of the effect of therapeutic elastic bandage, submucosal dexamethasone, or dexketoprofen trometamol on inflammatory symptoms and quality of life following third molar surgery: a randomized clinical trial.

OBJECTIVES: We aimed to compare the effects of preoperative single-dose submucosal corticosteroid injection and postoperative elastic therapeutic bandage application with postoperative non-steroid anti-inflammatory drug therapy on postoperative inflammatory symptoms and quality of life following mandibular third molar surgeries. MATERIALS AND METHODS: A single-center, randomized, clinical trial was conducted with 52 patients (36 female, 16 male) who expected severe postoperative sequelae as a result of the extraction of impacted mandibular third molars. The patients were randomized into three groups. In the preoperative submucosal corticosteroid injection group (n = 16), 8 mg/2 ml dexamethasone 21-phosphate was administered near operated sites. In the postoperative therapeutic elastic bandage application group (n = 19), Kinesio tapes were applied to operated sites. Paracetamol 500 mg was prescribed for the patients in the corticosteroid and elastic bandage application groups. In the postoperative non-steroid anti-inflammatory drug group (n = 17), 25 mg dexketoprofen trometamol was prescribed. Maximal mouth opening, swelling, pain, and Oral Health Impaction Profile scores were quantified preoperatively and postoperatively on the second and seventh days. Additionally, all patients were asked to evaluate the postoperative period by the Postoperative Symptom Severity Scale. RESULTS: Analysis of the obtained data revealed that on the second postoperative day, postoperative edema and trismus were significantly lower in the submucosal corticosteroid (p = 0.025, p = 0.03) and therapeutic elastic bandage (p = 0.032, p = 0.014) groups, and the patients in these groups had a more comfortable postoperative period than the group prescribed a postoperative non-steroid anti-inflammatory drug (p = 0.016). CLINICAL RELEVANCE: In oral surgery, postoperative elastic bandage application can provide results similar to those of preoperative submucosal corticosteroid injection with respect to inflammatory symptoms and quality of life. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04200885. Date of Registration: December 2019 (retrospectively registered).

The micro-CT evaluation of enamel-cement thickness, abrasion, and mineral density in teeth in the postmortem interval (PMI): new parameters for the determination of PMI.

OBJECTIVE: The estimation of time of death or the determination of the postmortem interval (PMI) is one of the most important issues in forensic medicine and odontology. However, evaluation of bone and dental hard tissues in PMI could be challenging due to the lack of objective methods with high accuracy. In this respect, micro-CT analysis which has not been used for postmortem evaluation would be beneficial in evaluating hard tissues such as bones and teeth. Therefore, the aim of the present study was to determine the alterations in the hard dental tissue, mineral density of enamel, and the surface abrasion of hard dental tissues of rats in the PMI period with a relatively novel method, micro-CT. METHODS: The present study included 60 female Wistar rats which were divided into six study groups. The rats were sacrificed at the baseline and were left into nature putrefaction process. The study groups were created based on the PMI period as week-0, week-1, week-2, week-4, week-8, and week-12, which included 10 rats in each group. All hemi-mandibles were collected in the determined timelines and the micro-CT analysis was carried out on each group. Mineral density of enamel and the surface abrasion of hard dental tissues were determined. RESULTS: The enamel and cement thickness remained the same in the examined PMI periods. Mineral density of the enamel tissues were also similar until the 8th week but the decrease was significant at 12th week (2.313 gHAp cm3). Surface abrasion of the dental tissues on weeks 4, 8, and 12 were 0.006, 0.024, and 0.024 mm, respectively. CONCLUSION: The present study indicated that surface abrasion and enamel mineral density evaluation via micro-CT can be considered as objective and precise parameters in PMI evaluation in forensic medicine and odontology.

Can Resorbable Fixation Screws Replace Titanium Fixation Screws? A Nano-Indentation Study.

PURPOSE: The aim of this study was to compare the nano-hardness and elastic modulus of titanium and resorbable screws and determine whether resorbable screws could completely replace titanium screws. MATERIALS AND METHODS: The mechanical properties (nano-hardness and decreased elastic modulus) of TriMed titanium, resorbable Inion CPS, and Synthes RapidSorb samples were measured using a nano-indentation technique. In this study, a Hysitron TriboIndenter TI 950 with a resolution less than 1 nN and a displacement resolution of 0.04 nm was used for the nano-indentation tests. The unloading segments of the nano-indentation curves were analyzed using the method of Oliver and Pharr (J Mater Res 7:1564, 1992). RESULTS: Statistical analysis showed that the values of the elastic modulus and nano-hardness of the TriMed titanium screws were significantly higher than those of the resorbable Inion CPS and Synthes RapidSorb screws (P < .05). A statistical difference was not observed between the values of the elastic modulus and the nano-hardness of the Inion CPS and Synthes RapidSorb screws (P > .05). CONCLUSIONS: In this study, the resorbable screws were found to be soft and flexible compared with the titanium screw. According to the results of this nano-indentation study, resorbable and titanium screws cannot be used interchangeably.

Readiness for clinical practice: Self-perceived confidence of final year dental students in Turkey - A multi-institutional study.

Introduction: The primary aim of undergraduate dental education is to prepare dental students for independent dental practice and to enable them to provide safe and effective dental care. This study aimed to investigate the self-perceived preparedness of senior dental undergraduate students in Turkey. Methods: Purposive sampling was used to recruit final-year dental students from 10 dental institutions offering undergraduate dental programs in Turkey. Student preparedness was assessed using a previously validated dental preparedness assessment scale based on 50 items encompassing core clinical skills, cognitive attributes, and behavioral skills. The research instrument was then translated into Turkish. The R statistical environment for Windows was used for the data analysis. Results: Responses were provided by 272 students (156 women and 116 men; 57% and 43%, respectively) across 10 different universities. The mean score of the participants was 75.68 with slightly higher scores for men compared to women (77.35 vs. 74.46 respectively). However, independent t-tests showed that the scores did not differ significantly between women and men. Conclusions: This study evaluated the self-perceived preparedness for dental practice of final-year students from 10 universities in Turkey. Although the results showed several areas of weakness, the scores of self-perceived preparedness of Turkish students were comparable to those reported in Europe and Asia. These findings can be used to inform future curriculum development to support students in consolidating their learning in perceived areas of weakness.

Cleft Palate Repair with Orbicularis Oris Plus Buccal Mucosal Flap: A New Double Layered-Technique.

Recurrent oronasal fistula closure is a challenging phenomenon that has been managed with many surgical or flap techniques, such as local, regional, and distant flaps, with various modifications. Despite these options, the ideal method to repair this kind of chronic fistula has not yet been established. It is difficult to repair because recurrent surgical repairs or interventions cause this region to become more fibrotic with less vascular tissue, which considerably reduces the likelihood of closing this kind of fistula. For this reason, surgeons and researchers continue to work to overcome these obstacles by using more regional, vascular, and neighboring tissue. Classic cleft palate repair techniques use double-layered, nasal, and oral side closure and even a three-layered technique (e.g. plus levator veli palatini and tensor veli palatini muscular repair) in the soft palate region. Hence, we used partial orbicularis oris muscle with enough vascular supply to repair the nasal side and cheek mucosal flap to repair the oral side as a double-layered repair technique. Two years later, during routine patient follow-up, no complications were identified, and the patient's satisfaction with this treatment was acceptable.

Evaluation of bony changes observed in mandibular osteotomy lines and mandibular condyles following bilateral sagittal ramus osteotomy by fractal analysis.

OBJECTIVES: This study aimed to evaluate the surgically impacted trabecular changes in mandibular osteotomy lines and mandibular condyles after bilateral sagittal split ramus osteotomy using the fractal analysis method. MATERIALS AND METHOD: The study population consisted of 30 patients (9 male, 21 female) diagnosed with mandibular prognathism and operated with bilateral sagittal split ramus osteotomy under general anesthesia. Fractal analyses observed the alterations on the trabecular structure of osteotomy lines, and mandibular condyles on panoramic radiographs obtained preoperatively, postoperatively, 1st week, 6th month, and 12th month. The box-counting method was used to evaluate the changes in trabecular structure by fractal analysis. P-values of less than 0.05 were considered significant. RESULTS: The fractal dimension values in both osteotomy lines and mandibular condyles were significantly decreased on postoperative 1st week regarding preoperative values. However, fractal dimension values commenced increasing in the following postoperative period. The fractal dimension values of the horizontal and vertical osteotomy lines reached their preoperative values on postoperative 6th and 12th month, respectively. The decreased fractal dimension values observed in the early postoperative period in the right and left condyles reached their preoperative values at the 6th postoperative month. CONCLUSION: Fractal analyses performed postoperatively can provide information about trabecular changes and bone healing of structures such as osteotomy lines directly affected by bilateral sagittal split ramus osteotomy and indirectly affected mandibular condyles. The results support that fractal analysis can be used together with clinical data in the evaluation of bone healing process.

Ultrasonographic evaluation of changes in the thickness, width, elasticity index and echogenic pattern of the masseter muscle after mandibular set-back surgery.

INTRODUCTION: The masseter muscle is one of the structures that undergoes significant changes following jaw movements in orthognathic surgery. This study aims to investigate the effects of mandibular setback surgery, performed in patients with skeletal class III deformity, on the thickness, width, elasticity index, and echogenic pattern of the masseter muscle. MATERIAL AND METHODS: This prospective case-control study enrolled patients with class III deformity who underwent mandibular setback surgery, while the control group consisted of class I patients. The predictor variable was the time measured at two different points: preoperative (T1) and postoperative 6 months (T2). The primary outcome variable focused on changes in the internal echogenic pattern of the masseter muscle. Secondary, tertiary, and quaternary outcome variables included changes in the thickness, width, and elasticity index of the masseter muscle, respectively. Gender, age, type of operation, and amount of movement were considered as covariates. Ultrasonography was employed to evaluate the outcome variables. RESULTS: The study group comprised 31 patients, including 17 females (mean age 22.24 ± 3.52 years) and 14 males (mean age 23.14 ± 2.65 years). The control group consisted of 16 females (mean age 23.34 ± 1.22 years) and 15 males (mean age 23.12 ± 1.76 years). Masseter muscle thickness increased significantly after mandibular setback surgery (p = 0.015). However, there was no statistically significant difference in masseter muscle width before and after surgery (p = 0.627), nor in the elasticity index (p = 0.588). Furthermore, a statistically significant transformation from Type I to Type II was observed in the internal echogenic pattern of the muscle (p = 0.039). Additionally, there was no statistically significant correlation between the amount of mandibular movement performed and the changes in the masseter muscle. CONCLUSIONS: Mandibular setback surgery leads to changes in both the physical and structural properties of the masseter muscle.

Emotional effect of the Covid-19 pandemic on oral surgery procedures: a social media analysis.

BACKGROUND: This study aimed to analyze Twitter users' emotional tendencies regarding oral surgery procedures before and after the coronavirus disease 2019 (COVID-19) pandemic worldwide. METHODS: Tweets posted in English before and after the COVID-19 pandemic were included in the study. Popular tweets in 2019 were searched using the keywords "tooth removal", "tooth extraction", "dental pain", "wisdom tooth", "wisdom teeth", "oral surgery", "oral surgeon", and "OMFS". In 2020, another search was conducted by adding the words "COVID" and "corona" to the abovementioned keywords. Emotions underlying the tweets were analyzed using CrystalFeel - Multidimensional Emotion Analysis. In this analysis, we focused on four emotions: fear, anger, sadness, and joy. RESULTS: A total of 1240 tweets, which were posted before and after the COVID-19 pandemic, were analyzed. There was a statistically significant difference between the emotions' distribution before and after the pandemic (p < 0.001). While the sense of joy decreased after the pandemic, anger and fear increased. There was a statistically significant difference between the emotional valence distributions before and after the pandemic (p < 0.001). While a negative emotion intensity was noted in 52.9% of the messages before the pandemic, it was observed in 74.3% of the messages after the pandemic. A positive emotional intensity was observed in 29.8% of the messages before the pandemic, but was seen in 10.7% of the messages after the pandemic. CONCLUSION: Infectious diseases, such as COVID-19, may lead to mental, emotional, and behavioral changes in people. Unpredictability, uncertainty, disease severity, misinformation, and social isolation may further increase dental anxiety and fear among people.

Evaluation of the detectability of early mandible fracture healing findings in terms of vitality aspect by using micro-CT technology in postmortem interval.

The purpose of the present study was to investigate the vitality aspect of mandibular fractures using micro-CT in the analysis of bone mineral density and other bone microstructure trabecular parameters in the postmortem interval. This study included 72 female Wistar rats. In the study groups, the rats' mandibles were first fractured and after three days of living, the rats were sacrificed. In the control groups, the rats were sacrificed first and then the mandibles were fractured. All rats were left for a natural putrefaction period according to their group's time as week-0, week-1, week-2, week-4, week-8, and week-12. All fractured hemi-mandibles were scanned by micro-CT and analyzed in terms of BMD and other bone trabecular microstructures. BMD and the other bone trabecular microstructures, such as bone volume, percent bone volume, trabecular separation, and trabecular pattern factor, showed statistically significant differences in both the study and control groups (p ≤ 0.05). There were statistically significant differences between the study and control groups in comparisons of BMD in groups 1, 2, 3, 4 and 5, bone volume and percent bone volume in groups 1 and 3, bone surface and bone surface density in group 6, trabecular separation in group 1, and trabecular number, trabecular pattern factor, and structural model index in group 6. Micro-CT scanning and analysis of BMD and other bone trabecular microstructure parameters for evaluation of vitality aspects of mandible fractures in the PMI has various valuable results that should provide guidance for possible studies in the future.

Surgical Extrusion of Anterior Teeth with Intrusion Traumatic Injury: A Report of two Cases.

Intrusion is the most severe luxation injury type, which results in both soft and hard tissue damage. In severe intrusions, the crown must be re-positioned in the arch to avoid periapical pathology and marginal bone loss. There is minimal information about the effect of treatment delay on pulpal and periodontal healing in intrusion trauma. The present paper reports on two cases of severe intrusive luxation applied late at different times treated with surgical extrusion. The first patient, an 11-year-old female, referred to Tokat GOP pediatric dentistry clinic three days after the intrusion tooth 21. The second patient, a 13-year-old male, referred to our clinic fifteen days after a traffic accident. The intruded teeth were positioned surgically and splinted. Surgical extrusion should be preferred as soon as possible to initiate root canal treatment in teeth, the crown of which is fully embedded in the alveolar bone.

Does the Angulation of an Impacted Mandibular third Molar Affect the Prevalence of Preoperative Pathoses?

STATEMENT OF THE PROBLEM: The removal of a third molar tooth associated with a pathological condition is usually an easy decision. However, it is necessary for clinicians to know about the prevalence of preoperative pathologies associated with impacted mandibular third molars to the identification of the prophylactic approach to be applied to symptom-free impacted third molars. PURPOSE: The objective was to investigate the effect of the angulation of impacted mandibular third molars on the prevalence of associated pathologies. MATERIALS AND METHOD: In this retrospective study, we examined the panoramic radiographs of 954 patients referred for impacted third molar surgery. A total of 1598 impacted mandibular third molar teeth were included in the study. Pathological conditions included the caries on distal surface of the adjacent second molar, caries on impacted mandibular third molars, bone loss distal to the adjacent second molar, the radiolucent area distal to the impacted mandibular third molar were determined. RESULTS: Caries were observed more in the impacted third molar (18.9%) compared to the adjacent second molar (15.8%). The radiolucent area on distal surface of the impacted mandibular molar was 11%, while the periodontal bone loss distal to the adjacent second molar was 4.9%. Mesioangular-impacted mandibular third molars had high risk of caries development on second and third molar. The prevalence of periodontal tissue damage to the adjacent second molar was higher in horizontal and mesioangular angulation. Vertical and distoangular-impacted mandibular third molars had high risk for bone loss at distal aspect. CONCLUSION: The prevalence rate of pathological conditions in mesioangular impacted teeth was higher.

Radiographic characteristics of mesiodens in a non-syndromic pediatric population in the Black Sea region.

AIM: A mesiodens is the most frequent type of supernumerary tooth. They can be related to several complications, such as ectopic eruption and midline diastema. The aim of the present study was to assess the radiographic properties of mesiodens by analyzing the associated age, sex distribution, number of mesiodens per patient, shape, direction of eruption, and their association with complications. METHODS: The present study was performed using panoramic radiographs of 14 400 pediatric patients (4-14 years old) who visited the Department of Pediatric Dentistry at Gaziosmanpasa University for a variety of dental complaints from 2015 to 2018. RESULTS: There were 82 mesiodens diagnosed in a total of 71 patients. Among the 82 mesiodens, 51 (62.1%) were conical in shape, which was the most commonly seen shape, followed by 14 supplemental (17.07%), and 12 (14.6%) tuberculate. Of the 82 mesiodens, 65 (79.2%) were aligned vertically, nine (10.9%) were inverted, and eight (9.7%) were horizontally placed. Clinical complications were observed in 76.8% of patients. CONCLUSION: The management of mesiodens can be performed using three methods: (a) spontaneous eruption; (b) early intervention; and (c) delayed intervention. However, the management of mesiodens should be evaluated on an individual basis to determine the best treatment method. Mesiodens-associated complications should be addressed prior to the lateral incisors erupting.

Effects of pain catastrophizing and anxiety on analgesic use after surgical removal of impacted mandibular third molars.

BACKGROUND: In dentistry, pain is a factor that negatively affects treatments and drug use. The aim of this study was to evaluate the correlations of the postoperative analgesic use with pain catastrophizing and anxiety in patients who underwent removal of an impacted mandibular third molar. METHODS: We recruited 92 patients who underwent the extraction of impacted mandibular third molar. In this study, the Pederson index was used to preoperatively determine the difficulty of surgical extraction. Patients were asked to note the number of analgesics used for 7 postoperative days. Patients were divided into two groups based on the Pain Catastrophizing Scale: low and high score groups. State-Trait Anxiety Inventory-trait and State-Trait Anxiety Inventory-state questionnaires were used to determine the anxiety levels of the patients. The obtained data were examined to evaluate the correlations of pain catastrophizing and anxiety with the postoperative analgesic use. RESULTS: In this study, 92 patients, including 60 women and 32 men, were recruited. The analgesic use was higher in women than in men but with no significant difference (P > 0.05). Pain Catastrophizing Scale scores were higher in women than in men but with no significant difference (P > 0.05). The analgesic use was higher in patients with high pain catastrophizing than in those with low pain catastrophizing but with no significant difference (P > 0.05). State-Trait Anxiety Inventory-trait scores were higher in women than in men but with no significant difference. However, state-Trait Anxiety Inventory-state scores were significantly higher in women than in men (P < 0.05). CONCLUSION: The postoperative analgesic use may be higher in patients who catastrophize pain than in others. Knowing the patient's catastrophic characteristics preoperatively would contribute to successful pain management and appropriate drug selection.

Evaluation of the 3 mm Thickness Splint Therapy on Temporomandibular Joint Disorders (TMDs).

Objective. This study aimed at finding out whether the 3 mm thickness of stabilization splints has positive or negative effects on all temporomandibular disorder (TMD) symptoms. Materials and Methods. The statistical calculation included 25 (22 females; 3 males) TMD patients who received 3 mm thickness stabilization splint therapy. They were evaluated according to follow-up treatment period, TMD pain, muscle pain, mouth opening, diet score, and splint usage time per day. Results. There was important treatment success that 22 (88%) of patients were totally healed. There was not any remarkable effect or advancement of splints on total healings of TMDs in first 3 months' period (11/25 patients, 44%). The mouth opening mean reached 38, 67 mm at 6 months and 41 mm at 12 months with remarkable success. Except one (4%) patient, other 24 (96%) patients had a normal diet score of 3 at the end of splint therapy. There was no correlation between splint usage duration a day and total healing of TMDs. Conclusion. We conclude that 3 mm splint therapy should maintain at least 6 months to achieve remarkable results. Splint should be used at least 12 h a day consistent with our results. Finally, diet score should be incorporated with TMD pain and amount of mouth opening; hence, we advise to use in one term as "total healing."

The effect of Hypericum Perforatum on wound healing of oral mucosa in diabetic rats.

PURPOSE: This study aims to investigate the histopathological and biochemical effects of the topical application of Hypericum perforatum on the healing of surgical wounds created in the oral mucosa of rats with experimentally induced diabetes mellitus. MATERIALS AND METHODS: The study was carried out on 48 adult male Wistar albino rats. The animals were divided into two main groups as control and study groups. Two main groups were divided into three subgroups according to the sacrification days. All rats were given streptozotocin 60 mg/kg, after 72 hours, and those having blood glucose levels above 200 mg/dL were included in the study. Mucosal defects were created in the palatal area of the rats. H. perforatum oil was applied topically twice a day to the wounds of the rats in the study group. Animal were sacrificed on the 3rd, 7th and 10th days and samples taken from the palatal wounds were examined histologically and biochemically. RESULTS: On the 7th day, ulceration, necrosis, epithelialization, polymorphonuclear leucocytes and hydroxyproline variables showed statistically significant differences (p<0.05). Ulceration, necrosis and polymorphonuclear leukocytes values were higher in the control group, whereas epithelialization and hydroxyproline values were found to be higher in the H. perforatum group. Among 10th-day groups, there was only a statistically significant difference between the values of hydroxyproline, whereas H. perforatum-treated group showed high hydroxyproline levels (p<0.05). CONCLUSION: Topically applied H. perforatum did not create any difference on the 3rd day, but it has positively affected the wound healing on the 7th and 10th days in diabetic rats.

To what extent does hyaluronic acid affect healing of xenografts? A histomorphometric study in a rabbit model.

Among the many graft materials that have been used for the treatment of bone defects in oral and maxillofacial regions is xenograft. To improve osteoconductive effects of xenografts, they have been combined with various biocompatible materials, such as hyaluronic acid and bone morphogenetic protein. To determine bone-healing capacity of high molecular weight hyaluronic acid (HA) combined with xenograft in rabbit calvarial bone defects. Ten adult male New Zealand rabbits (mean weight 3 kg) were included in the study. Three 6-mm-diameter bicortical cranial defects were created on calvarial bone of all rabbits. These defects were filled as follows: a) xenograft; b) HA+xenograft; c) autograft. One month after the first operation, rabbits were sacrificed. Specimens were evaluated histomorphometrically. Considering multiple comparisons, differences regarding new bone were statistically significant between all groups (p<0.05). The volume of residual graft was significantly decreased in HA group compared to xenograft group (p=0.035). Marrow space, trabecular thickness (TbTh), trabecular width (TbWi), trabecular separation (TbSp), and number of node: number of terminus (NNd:NTm) in the autograft group were significantly better than xenograft and HA groups (p<0.05). However, regarding marrow space, TbTh, TbWi, TbSp, and NNd:NTm values, xenograft and HA groups showed similar results and the difference were not significant (p>0.05). These results support that high molecular weight hyaluronic acid could contribute to the healing of xenograft by improving the percentage of new bone formation and reducing the percentage of residual graft. However, HA did not significantly affect the quality of newly formed bone assessed by microarchitectural parameters.

An Asymptomatic and Overelongated Styloid Process.

Elongation of the styloid process is a rare condition. Only 4% of patients have clinical symptoms where elongated styloid process (ESP) occasionally irritates or disrupts adjacent anatomical structures, which is called Eagle syndrome. This present report was aimed at reporting an asymptomatic ESP with unusual width and length.

Management of obstructive sleep apnea in a Treacher Collins syndrome patient using distraction osteogenesis of the mandible.

In this study, we present the surgical treatment of obstructive sleep apnea in a child with Treacher Collins syndrome. A 10-year-old girl with a past history of Treacher Collins syndrome presented to our clinic with her parents for respiratory distress and insomnia. The patient was referred to a sleep laboratory where she was diagnosed with obstructive sleep apnea, which was a consequence of her Treacher Collins syndrome. The patient underwent mandibular distraction osteogenesis under general anesthesia. The mandible was expanded by 15 mm using internal bilateral distractors. After distraction osteogenesis, the patient's respiratory problems resolved, and she was able to sleep comfortably. Distraction osteogenesis was an effective method of advancing the mandible, increasing the upper airway space and ultimately preventing obstructive sleep apnea syndrome in patients with Treacher Collins syndrome.