Changes in serological bone turnover markers in bisphosphonate induced osteonecrosis of the jaws: A case control study.

BACKGROUND: There are a lot study confirmed the relationship of bone serum markers changes and skeletal irregularities. But there is no sufficient case control studies about the role of these markers on bisphosphonate induced osteonecrosis of jaws (BRONJ). AIMS: The aim of this study is to find out if there is any derangement of bone markers in bisphosphonate-treated patients with ONJ. METHODS: We obtained serum bone markers and other relevant endocrine assays on 20 patients with osteonecrosis of the jaw (ONJ) and 20 randomized healthy volunteers. All of the ONJ group treated with zoledronic acid and had been withdrawn from bisphosphonate for at least 6 months. Diagnostic criteria for ONJ were those formulated by the American Association of Oral and Maxillofacial Surgeons. Serum levels of several indices of bone remodeling were evaluated using commercial enzyme-linked immunosorbent assays. The biochemical assays were performed on N-Telopeptides of type I collagen (NTX), bone-specific alkaline phosphatase (ALP), calcitonin, osteocalcin, intact parathyroid hormone (PTH), T3, T4, TSH, and Vitamin D 25 hydroxy (Vit-D). RESULTS: In ONJ group, PTH level is statistically higher and TSH, Vit-D, osteocalcin and NTX levels statistically lower compared to control group. CONCLUSION: We conclude that these changes in PTH, Vit-D, TSH, osteocalcin and NTX levels maybe have a role in the pathophysiology of BRONJ. But the data need to be confirmed by future studies.

Evaluation of skeletal changes associated with surgically rapid palatal expansion without pterygomaxillary separation.

INTRODUCTION: To evaluate skeletal and nasal volume changes before and after surgery in surgically assisted rapid palatal expansion (SARPE) without pterygomaxillary separation and compare the dental changes by digital model analysis and radiographic analysis. SETTING AND SAMPLE: Population A total of 18 patients (10 females and 8 males) aged 15-33 years and with completed skeletal development, who were referred to Oral and Maxillofacial Surgery Department, Dentistry Faculty, Istanbul University and who had SARPE indication were included in the study. MATERIALS AND METHODS: Skeletal changes, lower nasal volume, transverse diameters of bony nasolacrimal duct and dental changes have been evaluated by using Cone beam computed tomography (CBCT) before and 6 months after the surgery. CBCT data was determined by Mimics v.18.01. Dental changes have been also evaluated by digital model analysis program 'Shape Orthoanalyzer' and the data are compared with those obtained using CBCT. RESULTS: The results obtained from dental measurements made using CBCT and those obtained using scanning three-dimensional (3D) models were consistent with each other. CBCT demonstrated that lower anterior nasal volume and transverse diameters of bony nasolacrimal duct showed statistically significant increase before and after the surgery. CONCLUSIONS: According to the study findings, SARPE without pterygomaxillary separation was noted to be an effective procedure. Lower nasal volumes were increased and the maxilla expanded in the transverse direction in all patients. Dental evaluations that were performed in this digital model analysis also supported our findings in CBCT. Transverse diameters of the bony nasolacrimal duct were shortened at all patients.

The use of reconstruction plates to treat benign mandibular pathological lesions: A retrospective clinical study.

INTRODUCTION: The purpose of this retrospective clinical study was to evaluate the indications for and the utility of reconstruction plates in the management of benign mandibular pathological lesions. The complications associated with plate use were also assessed. PATIENTS AND METHODS: The clinical and radiological data of 23 patients (16 males, 7 females) with large, benign mandibular pathologies were evaluated. During operations, reconstruction plates were used to prevent mandibular fracture or to allow for bone reconstruction after segmental or disarticulation resection. The mean follow-up time was 11.2months. RESULTS: Condylar sag was observed in one patient who had undergone disarticulation resection. A reconstruction plate was removed from one patient because of pain. A plate became exposed in one patient who had undergone a disarticulation resection. Two patients reported slight paraesthesia. Screw-loosening was observed in one patient who had received a non-locking plate. CONCLUSION: Reconstruction plates can be safely used to manage benign mandibular lesions. Preoperative bending of the plates on individualised models is useful for reducing the time required for plate adaptation during operation. Locking reconstruction plates are preferable for preventing screw-loosening. All complications can be managed with careful follow up.

Complications associated with surgically assisted rapid palatal expansion without pterygomaxillary separation.

INTRODUCTION: The purpose of this retrospective clinical study was to evaluate the surgical complications associated with the surgically assisted rapid palatal expansion (SARPE) which does not involve pterygomaxillary separation (PMS). PATIENTS AND METHODS: A total of 40 (25 females, 15 males) skeletally mature patients, who had the diagnosis of maxillary transverse maxillary deficiency (TMD), were treated surgically under local or general anesthesia. The mean follow-up time was 6 months. RESULTS: Recorded perioperative and postoperative complications were discussed within the current literature. No serious complications were observed intraoperatively. Eight patients (20%) showed postoperative complications including neurosensory deficits, maxillary sinus infection, epistaxis, fistula formation and incisional dehiscence. DISCUSSION: Neurosensory deficits were the most common findings. The present findings suggest that minor complications were observed associated with SARPE without PMS. The technique may be performed safely also under local anesthesia.

Intraosseous lipoma of the mandible: a case report and review of the literature.

Intraosseous lipoma is a benign tumor of the bone. It is mostly seen in the metaphyses of the long bones and calcaneus. There are few documented cases of intraosseous lipomas in the jaw. Clinically, the lesion is usually silent and radiologically it appears as a radiolucent area rarely including some radio-opacities. Diagnosis is based on clinical, radiological and histopathological features. Surgical removal of the lesion is the recommended treatment. The authors report a rare case of an intraosseous mandibular lipoma in a 45-year-old female, and review previously documented cases in the English literature. The histopathological and radiological features of the lesion are emphasized.