Closure of Oroantral Communication With Plasma-Rich Fibrin Membrane.

Oroantral communication (OAC) is the opening between the maxillary sinus and oral cavity. It may cause oroantral fistula or maxillary sinusitis if left untreated. The surgical closure of the OAC within 48 hours was recommended to avoid the complications like sinus infections. The aim of this study is to evaluate the treatment of OACs with plasma-rich fibrin (PRF) which is safe and easy to implement in the OACs.This study was conducted with the patients, who required the treatment of the OAC, which was developed after the posterior maxillary tooth extraction in the Dental and Maxillofacial Department of the Faculty of Dentistry in Adnan Menderes University.Plasma-rich fibrin membranes were inserted in layers into the tooth socket so that they covered the OAC. Then these membranes were fixated with the sutures to the surrounding gingiva. Antibiotic (amoxicillin/clavulanic acid 1000 mg), analgesic (dexketoprofen trometamol and/or paracetamol), and oral rinse (0.2% chlorhexidine digluconate) agents were prescribed to all patients. The patients were examined in the 3rd and 7th days and 2 months after the operation.All patients tolerated PRF perfectly, and the soft tissue recovery was completed without any problem. Full epithelization was observed in the defect area in all patients. The OAC did not relapse in any patient.Plasma-rich fibrin technique is a simple and effective method, which can be used in the treatment of OACs with a diameter of 5 mm or less with a low risk of complications.

Comparison of ketamine-propofol and ketamine-dexmedetomidine combinations in children for sedation during tooth extraction.

OBJECTIVE: To evaluate the efficiency of ketamine-propofol and ketamine-dexmedetomidine drugs in children for sedation during tooth extraction. METHODS: The randomised, prospective study was conducted at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Kayseri, Turkey, from September to November 2013, and comprised children who were due to undergo tooth extraction. Non-invasive blood pressures (systolic and diastolic), peripheral oxygen saturation, heart and respiratory rates and Ramsay Sedation Scores were assessed at baseline, after applying the drugs and then every 5 minutes thereafter. Further, the ketamine-propofol group received 1mg kg-1 of ketamine and propofol, and the ketamine-dexmedetomidine group received 1mg kg-1 of ketamine + 0.5 µg kg1 of dexmedetomidine. RESULTS: Of the 60 participants, there were 30 (50%) in each group. No statistically significant differences were found in terms of heart rate, non-invasive blood pressures at any time and the number of drug repetitions (p>0.05). Nausea-vomiting was statistically higher in the ketamine-dexmedetomidine group (p<0.05). CONCLUSIONS: Ketamine-propofol might be a better option due to lower vomiting and nausea episodes and higher surgeon satisfaction levels.

New method to increase inter-alveolar height with preservation of crestal cortical bone for implant treatment.

The aim of this technique is to provide adequate interocclusal distance (3 mm) allowing preprosthetic management. A bone block was cut with piezosurgery and extracted, leaving the crestal cortical bone intact. The free crestal alveolar bone was fixed to the maxilla with 2 dental implants. After 3 months of follow-up, abutment surgery was performed and osseointegration was evident with adequate interocclusal height (7 mm) allowing prosthetic management.

Is it possible to shorten the jaws using contraction osteogenesis?

PURPOSE: This study investigated whether shortening of osteotomized jaws is possible. MATERIALS AND METHODS: Nine sheep were used (2 as controls and 7 as experimental subjects). Distraction devices that had previously been activated to 10 mm were fixed to the mandibles of all animals bilaterally and used in reverse as a contraction device. Control and experimental animals were sacrificed at 1 month and 3 months. Bone in the area of contraction was evaluated using radiodensitometry and microscopy. RESULTS: The mandibles were shortened an average of 5.5 mm. Exaggerated bone formation was seen around the osteotomized cortical bone. When histologic slices from experimental animals were examined 1 month after the contraction period, fibrous pseudoarthrosis formation was seen centrally, with hyaline cartilage around it, whereas normal bone formation was seen in the outer part. The hyaline cartilage had turned into normal bone 3 months after the end of contraction. CONCLUSIONS: It is possible to shorten bones using contraction osteogenesis.

Removal of a supernumerary tooth displaced into the infratemporal fossa during extraction.

Accidental displacement of an impacted tooth into the infratemporal fossa (ITF) is a rare but serious complication because of the vulnerability of the surrounding anatomical structures. Here we present the case of a 40-year-old man who reported pain on the right side of his face. Panoramic radiography and cone-beam computed tomography revealed an impacted third molar and a supernumerary tooth positioned immediately below it. Under local anesthesia, the third molar was easily extracted; however, the supernumerary tooth was inadvertently displaced into the ITF. The position of the tooth was confirmed by radiographic examination, and it was immediately removed intraorally by expanding the flap and carefully dissecting the soft tissues. Clinical aspects of this rare complication were evaluated, with special emphasis on the reliability of imaging modalities and surgical techniques.

Gastrointestinal tract metastasis of mandibular diffuse large B-cell lymphoma.

Not only diffuse large B-cell lymphoma is a malignancy, but also is initially and orally diagnosed in early stages. However, it could be misdiagnosed with other oral pathologies. However yet, early diagnosis is still crucial for the prognosis, morbidity, and mortality in such cases. Additionally, whole-body scanning with positron emission tomography/computed tomography should be performed for diagnosis and treatment process.

Comparison of Bovine Bone-Autogenic Bone Mixture Versus Platelet-Rich Fibrin for Maxillary Sinus Grafting: Histologic and Histomorphologic Study.

Numerous grafting materials have been used to augment the maxillary sinus floor for long-term stability and success for implant-supported prosthesis. To enhance bone formation, adjunctive blood-born growth factor sources have gained popularity during the recent years. The present study compared the use of platelet-rich fibrin (PRF) and bovine-autogenous bone mixture for maxillary sinus floor elevation. A split-face model was used to apply 2 different filling materials for maxillary sinus floor elevation in 22 healthy adult sheep. In group 1, bovine and autogenous bone mixture; and in group 2, PRF was used. The animals were killed at 3, 6, and 9 months. Histologic and histomorphologic examinations revealed new bone formation in group 1 at the third and sixth months. In group 2, new bone formation was observed only at the sixth month, and residual PRF remnants were identified. At the ninth month, host bone and new bone could not be distinguished from each other in group 1, and bone formation was found to be proceeding in group 2. PRF remnants still existed at the ninth month. In conclusion, bovine bone and autogenous bone mixture is superior to PRF as a grafting material in sinus-lifting procedures.

Efficacy of dexamethasone on penicillin-induced epileptiform activity in rats: an electrophysiological study.

Corticosteroids are extensively used in treatment of many diseases. In neurosurgery practice, dexamethasone (DEX) is commonly used particularly in cerebral edema secondary to brain tumors, head trauma, and central nervous system infections. There are some uncertainties surrounding the secure use of DEX in patients with epilepsy or seizures induced by diseases of the central nervous system such as head trauma and brain tumors. Despite its extensive use, the effect of DEX on epileptiform activity is unclear. In this study the effect of DEX on epileptiform activity was investigated in rats. The effects of 1, 3, and 10mg/kg DEX on epileptiform activity was compared with effects of antiepileptic drugs commonly employed in treatment of epilepsy, namely phenytoin (PHT) 50mg/kg and levetiracetam (LEV) 50mg/kg that were administered intraperitoneally for 1 week. All groups were administered intracortical penicillin (500IU) to induce epileptiform activity. DEX at the doses of 3mg/kg and 10mg/kg significantly reduced spike frequencies compared to the initial values. In conclusion, we think that DEX can effectively decrease the epileptiform activity.