Extracorporeal Shock-Wave Therapy or Low-Level Laser Therapy: Which is More Effective in Bone Healing in Bisphosphonate Treatment?

OBJECTIVES: Bisphosphonate-related osteonecrosis of the jaw is potential side effect of long-term bisphosphonate therapy. Different treatment modalities have been used in this and investigate the effects of low-level laser therapy (LLLT) and extracorporeal shockwave therapy (ESWT) on socket healing after tooth extraction in rats given long-term bisphosphonates. METHODS: Forty male Wistar-Albino rats were used in this experimental study. About 0.1 mg/kg zoledronic acid was administered intraperitoneally to all animals 3 times per week for 8 weeks. Four groups were made which were control, LLLT, ESWT, and ESWT+LLLT. Upper right first molar teeth extraction was performed in all groups; no treatment was given to the control group after molar tooth extraction. About 810 nm wavelength GaAlAs laser was used in LLLT group. In ESWT group, 1000 pulses, 0.21 mJ/mm ESWT was applied, and the 2 treatment methods were applied to the last ESWT+LLLT group at the same time. All the 4 groups were divided into 2 subgroups according to sacrification time 4 and 8 weeks. Steorologic, histologic, and immunohistochemical examinations were performed. RESULTS: The highest new bone volume was observed in the early LLLT+ESWT. New vessel volume and CD31 expression were found to be high in the LLLT group. matrixmetalloproteinaze (MMP)-2 expression was found increased by the application of LLLT and ESWT. CONCLUSION: The LLLT and ESWT have similar effect on socket healing in the early period and that co-use is more effective upon healing. The LLLT has been shown to increase CD31 expression and increase vascularization and soft-tissue healing.

Efficacy of Extracorporeal Shockwaves Therapy on Peripheral Nerve Regeneration.

PURPOSE: This study was conducted to determine the effects of different doses and methods of extracorporeal shock wave treatment (ESWT) on the sciatic nerve regeneration of rat model using unbiased quantitative stereological techniques and to know which method and dose were effective. METHODS: Twenty-five Wistar albino rats were used in the experiment. All animals were randomly divided into 5 groups. To the first group (control, n = 5) ESWT and surgery were not applied. To 2nd group (E300*2, n = 5), twice doses of 300 impulses uESWs (unfocused) were applied. To 3rd group (E500*2, n = 5), twice doses of 500 impulses uESWs (unfocused) were applied. To 4th group (E300*2, n = 5), twice doses of 300 impulses of fESWs (focused) were applied. To 5th group (E500*2, n = 5), twice doses of 500 impulses of fESWs (focused) were applied. Rats were sacrificed and nerve samples analyzed on the 22nd day following the operation. RESULTS: There is a variable increase in the axon numbers among the shockwave treated groups in compare to the control group. The focused groups showed better improvement and the 300-focused group has shown the highest regeneration rate. CONCLUSION: The authors found that ESWT promotes nerve regeneration, increases the thickness of the myelin sheath and that the most effective result is in the 300 shock wave.

The Effect of Different Doses of Extracorporeal Shock Waves on Experimental Model Mandibular Distraction.

OBJECTIVE: Distraction osteogenesis (DO) is widely used treatment for the bone deformities. In addition extracorporeal shock wave therapy (ESWT) is a new perspective on noninvasive modalities of management of the bone regeneration. We examined the effects of 2 different single doses of ESWT on the consolidation period of DO of the rabbit mandible using stereological, radiological and immunohistochemical methods in the present study. METHODS: DO was performed unilaterally in the mandible of 18 New Zealand rabbits (6 months' old, weighing between 2.5 and 3 kg). The distraction zone of the mandible has received no treatment as controls. Group 2 (ESWT 500) received ESWT (single dose of 500 impulses 0.19 mJ/mm energy flux intensity and 2155 mJ totally) were applied on the first day of the consolidation. Group 3 (ESWT 1000) treated with ESWT (single dose of 1000 impulses0.19 mJ/mm energy flux intensity and 4310 mJ totally) were applied on the first day of the consolidation period. After the sacrification, radiologically bone mineral density, new bone formation, new fibrous tissue, and new vessel formation were analyzed using unbiased stereological methods. RESULTS: It was found a statistically significant difference between the study groups and control group in the bone mineral density measurements and the highest values were in the ESWT1000 group. In terms of stereological analysis, there was a significant difference between the study groups and control group (P = 0.00). The new capillary volume was highest in the E1000 group. Additionally, significant differences were found in point of the capillary volumes between the groups control and ESWT500 (P = 0.001), control and ESWT1000 (P = 0.000), ESWT500 and ESWT1000 (P = 0.040), respectively. CONCLUSIONS: A total of 1000 impulses ESWT may induce the growth factors to enhance the newly formed bone regeneration.

Is it possible to change of the duration of consolidation period in the distraction osteogenesis with the repetition of extracorporeal shock waves?

BACKGROUND: In this study we examined the effects of two different repeated Extracorporeal Shock Waves (ESW) on the consolidation period of the distraction osteogenesis (DO) of the rabbit mandible using stereological, radiological and immunohistochemical methods. MATERIAL AND METHODS: DO was performed unilaterally in the mandible of 18 New Zealand rabbits (six months old, weighing between 2.5-3 kg). In the consolidation period, rabbits were divided into three groups randomly after the distraction period. The distraction zone of the mandible was received no treatment as controls (E0*2). Group 2 (E 500*2) received ESWT (twice 500 impulses at 14 kV and 0.19 mJ/mm2 energy) in the first and fourth days of the consolidation. Group 3 (E1000*2) treated with ESWT (twice 1000 impulses at 14 kV and 0.19 mJ/mm2 energy) in the first and fourth days of the consolidation period. After the sacrification, radiologically bone mineral density, new bone formation, new fibrous tissue and new vessel formation were analyzed by stereological. RESULTS: It was found a statistically significant difference between the study groups and control group in the bone mineral density measurements and the highest value was in the E1000*2 group. In the stereological analysis, new bone formation was highest in the E1000*2 group and there was a significant difference compared to the other groups (E0*2 and E500*2) (p = 0.000). The lowest connective tissue volume was found in the E500*2 and there was a significant difference compared to the other groups (E0*2 and E1000*2) (p = 0.000). The volume of the new vessel was highest in the E500*2 and lowest in the E0*2 group. It was found statistically significant difference between the values of the study and control groups. CONCLUSIONS: Interestingly, we found that repetition of the 1000 impulses ESWT accelerated the consolidation, 500 impulses ESWT extended consolidation period of the DO

Therapeutic Effects of Sildenafil on Experimental Mandibular Fractures.

OBJECTIVES: No previous studies have examined the effect of sildenafil on fracture healing. This study was designed to investigate the effect of sildenafil on the fracture healing process. METHODS: Thirty-six female Sprague-Dawley rats (3-month-old) were used in this study. Animals were randomly divided into 2 groups based on treatment duration (1 week versus 4 weeks) and each group was then divided further into 2 subgroups, control (C) and study (S) groups. Group C (C1, C2) was treated daily with saline solution and group S (S1, S2) was treated daily with 10 mg/kg of sildenafil. Histologic, histomorphometric, radiological, and immunohistochemical analyses were performed at 1 week and 4 weeks after a fracture. RESULTS: The sildenafil group showed a significant increase in fracture healing scores (P = 0.00). The authors observed a transition from fibrous callus to cartilage tissue and immature bone tissue in group S1; and an increased transition of cartilage tissue to completely immature bone tissue in group S2, both of which were administered sildenafil. The strong expression of bone morphogenetic protein 2 and col-1 was observed in the fibrous matrix and osteoblasts within areas of new bone formation, especially in group S1. This group also showed an increase in bone density measurements at 1 week that was statistically significant (P = 0.03). CONCLUSIONS: Sildenafil accelerates fracture healing and can be used as a supporting factor in the improvement of fracture healing under various conditions.

The Radiological and Stereological Analysis of the Effect of Low-Level Laser Therapy on the Mandibular Midline Distraction Osteogenesis.

OBJECTIVE: The aim of this study was to evaluate the effect of low level laser therapy (LLLT) on bone mineral density by using high-resolution computerized tomography (HR-CT) and stereology in patients subjected to mandibular midline distraction. METHODS: Nine patients between the ages of 13 and 16 years with mandibular transverse deficiency (>5 mm) were evaluated. Mandibular midline distraction osteogenesis was performed for all the patients. The patients were divided into 2 groups: the control group (n = 4) and the laser group (n = 5). GaAlAs, 830 nm wavelength, power of 40 mW, energy of 8.4 J/cm2 dose per spot, was directly applied from 2 points on the mandibular midline. The laser was applied in 8 treatment sessions at 48-hour intervals. Bone mineral density and volume of the newly formed bone were analyzed using HR-CT and stereological methods. RESULTS: A higher bone mineral density rate was found in the laser group (P < 0.05). A higher newly formed immature bone rate was found in the control group (P < 0.001). These findings suggest that more mature bone may also have a greater mineral organization than that of immature newly formed bone, which is shown by HR-CT and stereological results. CONCLUSIONS: The retention period can be shortened and mineralization may be increased by using LLLT in mandibular distraction osteogenesis.

Incidence of mandibular fractures in black sea region of Turkey.

BACKGROUND: The aim of this study is to review the incidence of mandibular fractures in the Black Sea Region of Turkey and to present our treatment protocol. MATERIAL AND METHODS: Data were collected regarding age, sex, etiology, time distribution, site of the fracture and the associated injuries and evaluated. These patients were treated at Ondokuz Mayis University Department of Oral and Maxillofacial Surgery between 2003 and 2010. Data were collected from patient files in the archive and were analyzed using SPSS version 20.0 software. RESULTS: A total of 82 patients with 133 mandibular fractures were included in this study. After the follow up period of the patients, the results were achieved from 58 (70.7%) males and 24 (29.3%) females, whose ages ranged from 5 to 72 years and the mean age was 29. Fractures were most seen in 2008 and the busiest month was August. Falls (40.2%) were the major causes of mandibular fractures followed by traffic accidents and violence. The mandibular anatomical sites of higher fracture incidence were: condyle (34.6%), body and symphysis. The number of the fractures and injuries which were seen in other places such as zygomatic arch, alveolar process, tongue, upper and lower lips, orbita, arms was 14. 53 (64.6%) patients were treated by closed reduction, whereas 13 (15.8%) patients were treated by open reduction. CONCLUSIONS: We concluded that our results were widely similar with the studies in developing countries. Socio-economic factors, cultures, geographic conditions and education could affect the etiology of the mandibular fractures and cause different results between the studies conducted in different countries. Key words:Mandibular fractures, etiology, trauma, treatment, complication.

The effect of hemostatic agents and tissue adhesive on injured peripheral nerve healing in rats - Part I. Electrophysiological study.

BACKGROUND: In the practice of maxillofacial surgery, bleeding and nerve injury have common problems. In the control of bleeding, hemostatic agents and tissue adhesives have been frequently used. The effect of these hemostatic agents and tissue adhesives on the injured neural tissues has not been known. OBJECTIVES: In this study, we aimed to investigate the effects of hemostatic agents and tissue adhesive on injured nerve tissues. MATERIAL AND METHODS: Forty-two rats randomly divided into seven groups: Control, Oxidized Regenerated Cellulose (ORC), Gelatine Sponge (GS), Bovine Collagen (BC), Ankaferd BloodStopper (ABS), Glutaraldehyde Surgical Adhesive (BioGlue®) and N-butil-2 cyanoacrylate (Glubran®2). The left sciatic nerves were crushed and surrounded by hemostatic agents and tissue adhesives. At the end of 12 weeks, the surgical site was reopened and electrophysiological recordings were performed. RESULTS: In the ORC, GS, and BC groups, the compound action potential (CAP) values were lower compared to the control group (p < 0.05). Although the values of CAP in the ABS group were higher than in the control group while CAP values in the BioGlue and Glubran®2 groups were lower than the control group, there was no statistical significance between the experimental and control groups (p > 0.05). In the ORC, BC, GS, and Glubran®2 groups, the nerve conduction velocities (NCV) values were lower than in the control group (p < 0.05). In the ABS and BioGlue groups, NCV values were lower compared to the control group but no significant differences were found (p > 0.05). CONCLUSIONS: The present study provides evidence that ABS is the most suitable hemostatic agent due to its favorable effect on the healing of injured neural tissues. BioGlue is also a suitable surgical agent with no adverse effects.

Propolis accelerates the consolidation phase in distraction osteogenesis.

We evaluated the effect of propolis on new bone formation after distraction osteogenesis (DO). This study examined 3 groups: control group, P100, and P200. Rabbits underwent DO of the left mandible after an osteotomy between the first molar and the mental foramen. Bone mineral content and bone mineral density were evaluated using dual-energy x-ray absorption 1 and 4 weeks after the procedure. The volume of connective tissue and new bone and the number of capillaries were measured using stereologic analysis after the subjects were killed. Dual-energy x-ray absorption showed that the bone mineral content and bone mineral density were higher in the groups treated with propolis by week 4, and these parameters were higher in the P200 group. Stereologic analysis showed no significant differences in connective tissue volume and number of capillaries among the groups. New bone volume was lowest in the P200 group. We concluded that propolis accelerates bone formation and may shorten the consolidation phase with DO.

The predominant bacteria isolated from radicular cysts.

PURPOSE: To detect predominant bacteria associated with radicular cysts and discuss in light of the literature. MATERIAL AND METHODS: Clinical materials were obtained from 35 radicular cysts by aspiration. Cultures were made from clinical materials by modern laboratory techniques, they underwent microbiologic analysis. RESULTS: The following are microorganisms isolated from cultures: Streptococcus milleri Group (SMG) (23.8%) [Streptococcus constellatus (19.1%) and Streptococcus anginosus (4.7%)], Streptococcus sanguis (14.3%), Streptococcus mitis (4.7%), Streptococcus cremoris (4.7%), Peptostreptococcus pevotii (4.7%), Prevotella buccae (4.7%), Prevotella intermedia (4.7%), Actinomyces meyeri (4.7%), Actinomyces viscosus (4.7%), Propionibacterium propionicum (4.7%), Bacteroides capillosus (4.7%), Staphylococcus hominis (4.7%), Rothia denticariosa (4.7%), Gemella haemolysans (4.7%), and Fusobacterium nucleatum (4.7%). CONCLUSIONS: Results of this study demonstrated that radicular cysts show a great variety of anaerobic and facultative anaerobic bacterial flora. It was observed that all isolated microorganisms were the types commonly found in oral flora. Although no specific microorganism was found, Streptococcus spp. bacteria (47.5%) - especially SMG (23.8%) - were predominantly found in the microorganisms isolated. Furthermore, radicular cysts might be polymicrobial originated. Although radicular cyst is an inflammatory cyst, some radicular cyst fluids might be sterile.

The effects of zoledronic acid on mandibular fracture healing in an osteoporotic model: a stereological study.

The aim of this study was to evaluate the effect of zoledronic acid (ZA) in the ovariectomized rat on mandibular fracture. Corpus osteotomies were performed on the mandible of ovariectomized rats. Miniplates were placed on these rats, which were randomly divided into 4 groups. After 7 days, groups 3 and 4 were injected with 0.1 mg/kg ZA. Groups 1 and 2 were control groups, so they were injected 0.1 mg/kg saline solution. Animals in groups 1 and 3 were killed at 4 weeks, whereas groups 2 and 4 were killed 8 weeks after operation. The new bone volume of the fracture gap was examined stereologically. Although the difference was not statistically significant compared with the other groups (groups 1 and 3), more bone formation was found in ZA-treated groups (groups 2 and 4) (P < 0.05).

Intraosseous carcinoma arising from an odontogenic cyst: a case report.

Carcinomas from an odontogenic cyst are not common, yet when they occur, squamous cell carcinomas are the most often seen. Among these cysts, the malignancy of keratocysts or dentigerous cysts are most likely. In contrast, a malignant transformation of a radicular cyst to an intraosseous carcinoma is extremely rare. In this case report, an intraosseous carcinoma arising from an odontogenic cyst in a 26-year-old male patient is presented. This case report clearly demonstrates the importance of the clinician's awareness of the malignant potential of apparently innocuous cystic lesions.

In vitro biomechanical evaluation of modified plating techniques for bilateral sagittal split ramus osteotomy in mandibular advancement.

The aim of this study was to compare the biomechanical properties of modified plate techniques using a newly designed three-dimensional test model after sagittal split ramus osteotomy. Fifteen synthetic polyurethane mandibular replicas were used and divided into 3 groups. Self-tapping 6-mm titanium screws with an outer diameter of 2.0 mm and private designed plates produced by 316-L stainless steel were used in the study. After the osteotomy, the distal part was advanced by 5 mm. The jaw models were placed to the three-dimensional test model designed by the authors, and the Instron Lloyd LRX device was used to apply a double-sided tensile force from the mandible angulus region of each group. Resistance forces that caused a displacement of 1.5 and 3 mm were recorded with the Instron program. The mean (SD) of the 3 groups were calculated using analysis of variance and the Tukey test. The results were compared statistically, with values of P < 0.05 determined as statistically significant. On the basis of the results of the Tukey comparison within the groups, there was a statistically significant difference between groups 1 and 2 and between groups 1 and 3 at both 1.5- and 3-mm displacement (P < 0.05). No significant difference was observed between groups 2 and 3 (P > 0.05). This test model was able to identify the most appropriate plate type of 3 different modified plate techniques after sagittal split ramus osteotomy.

Characteristics of 351 supernumerary molar teeth in Turkish population

Objective: The aim of the present study was to evaluate the demographic profile of supernumerary molar (SM) teeth in people in various regions of Turkey. Study Design: A retrospective analysis was carried out on an initial sample of 104,902 subjects drawn from the ortopantographics files from 10 clinics in 7 Turkish cities with documentation of demographic data, the presence of SM teeth, their location, eruption, morphology, and position within the arch. In one region associated pathologies and treatments were also evaluated. Results: Three hundred fifty-one SMs were detected in 288 patients, constituting 0.33% of the study subjects, with a greater frequency in females (56.4%). SMs were found more frequently in the maxilla (87.7%) than in the mandible, and distomolars (62.9%) were more common than paramolars. The SMs encountered were mostly of conical shape (45.7%), impacted (81.1%), and in a vertical position (52.1). The 33% of SM teeth were related to impacted molar teeth. Conclusion: The most common complication involving these teeth was soft tissue irritation. Demographic data from such specific extensive studies are crucial for improved diagnosis of SM teeth. Early detection allows for measures against complications and more successful therapy (AU)

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An evaluation of factors associated with persistent primary teeth.

The aim of the present study was to investigate the reasons for the persistence of primary teeth and also use panoramic radiography to determine the characteristics of persistence teeth. Four-hundred and twenty-six panoramic radiographies, which diagnosed one or more retained primary teeth, were selected from 100,577 panoramic radiographic image files from nine clinics and six different cities in Turkey. The selected radiographies were evaluated to determine the reasons for the persistence of primary teeth; furthermore, this study analyzed the characteristics of the retained primary teeth including tooth type, number, location, and root resorption, and whether, or not, the primary teeth showed evidence of pathological conditions, such as periodontal problems, caries, ankylosis, infra-occlusions, or tipping of the adjacent permanent teeth. Six hundred and seventy-seven retained primary teeth were determined in 426 patients (148 males and 278 females). Retained primary teeth were found most frequently in the mandible rather than the maxilla and the left side was more frequently affected than the right side. Level 1 was found as a most frequently encountered root resorption level. Within the limitation of the present study, the most common type of persistent primary teeth seen on the dental arch were mandibular primary second molars, followed by maxillary primary canines. The most frequent reason for the persistence was the congenital absence of successors to the primary teeth, followed by impaction of the successor teeth.

Characteristics of 351 supernumerary molar teeth in Turkish population.

OBJECTIVE: The aim of the present study was to evaluate the demographic profile of supernumerary molar (SM) teeth in people in various regions of Turkey. STUDY DESIGN: A retrospective analysis was carried out on an initial sample of 104,902 subjects drawn from the ortopantographics files from 10 clinics in 7 Turkish cities with documentation of demographic data, the presence of SM teeth, their location, eruption, morphology, and position within the arch. In one region associated patho-logies and treatments were also evaluated. RESULTS: Three hundred fifty-one SMs were detected in 288 patients, constituting 0.33% of the study subjects, with a greater frequency in females (56.4%). SMs were found more frequently in the maxilla (87.7%) than in the mandible, and distomolars (62.9%) were more common than paramolars. The SMs encountered were mostly of conical shape (45.7%), impacted (81.1%), and in a vertical position (52.1). The 33% of SM teeth were related to impacted molar teeth. CONCLUSION: The most common complication involving these teeth was soft tissue irritation. Demographic data from such specific extensive studies are crucial for improved diagnosis of SM teeth. Early detection allows for measures against complications and more successful therapy.

Retrospective analysis of impacted first and second permanent molars in the Turkish population: A multicenter study

Objectives: The purpose of the present study was to retrospectively analyze 170 case series of patients with 200 impacted first and second permanent molars.Study Design: Records of 104.408 patients were retrospectively screened in this multicenter study. The chosen study population consists of 170 patients who presented with impacted or retained first and second permanent molar.All patients with impacted first or second permanent molar had undergone clinical and radiographic examinations.The following factors were analyzed: age and gender, frequency, distribution, location, position, the number of impacted tooth, primary and secondary retention, degree of infraocclusion, associated pathologic conditions and treatment method.Results: There were a total of 170 patients (male: 91, female: 79, mean ages 22.69±8.99 years ranging from 13 to66 years of age) with 200 retained or impacted permanent molars in 104.408 patients. In this study, 200 impacted teeth which were analyzed were 125 molars (62.5%) vertical position, 17 (8.5%) horizontal, 38 (19%) mesioangular,12 (6%) distoangular, and 7 (3.5%) buccolingual inclination. There were 52 primarily retained (26%) and 32secondarily retained (16%) molars. 137 (68.5%) molars were asymptomatic. Cystic formation was present in 13(6.5%) cases.Conclusions: Although the impactions of first and second permanent molars do not occur frequently, it is important to make an early diagnosis in order to start treatment at the optimal time (AU)

Analysis of different type of transmigrant mandibular teeth

Objective: Until recently, most reports about transmigration have documented that the canine is the only toothwhich can migrate to the opposite side of the arch. The goal of the study was to define the transmigration of differenttypes of teeth in people in various regions of Turkey.Study Design: A total of 112,873 panoramic radiographic files from seven different Turkish cities were inspected.The following data were evaluated according to age, gender, number of transmigrant teeth, localization, eruptionstatus, side, unilaterally or bilaterally and associated pathology or dental abnormalities.Results: Of the 112,873 radiographs included in the study, 90 were seen to present as transmigrant in 87 patients,representing 0.079% of the sample. There were only two (0.0017 %) transmigrant lateral (TML) teeth and onlythree (0.0026%) transmigrant premolar (TMP) teeth encountered. The mean age at the time that the transmigrantmandibular teeth were identified was 29.9 years, with a range from 10 to 66 years. Out of the 87 cases, 51 werefemale and 36 were male, with a male:female ratio of 1:1.41. Transmigrants were more commonly seen unilaterally(96.5%). The most frequent associated pathology was odontoma.Conclusions: Because early detection is vital to prevent complications and ensure more successful treatment, theseextensive studies are crucial. In this extensive study, we indicated cases of transmigration of premolar and lateralteeth as a variant. Demographic variables and properties of all transmigrants (TM) were also presented (AU)

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Retrospective analysis of impacted first and second permanent molars in the Turkish population: a multicenter study.

OBJECTIVES: The purpose of the present study was to retrospectively analyze 170 case series of patients with 200 impacted first and second permanent molars. STUDY DESIGN: Records of 104.408 patients were retrospectively screened in this multicenter study. The chosen study population consists of 170 patients who presented with impacted or retained first and second permanent molar. All patients with impacted first or second permanent molar had undergone clinical and radiographic examinations. The following factors were analyzed: age and gender, frequency, distribution, location, position, the number of impacted tooth, primary and secondary retention, degree of infraocclusion, associated pathologic conditions and treatment method. RESULTS: There were a total of 170 patients (male: 91, female: 79, mean ages 22.69 ± 8.99 years ranging from 13 to 66 years of age) with 200 retained or impacted permanent molars in 104.408 patients. In this study, 200 impacted teeth which were analyzed were 125 molars (62.5%) vertical position, 17 (8.5%) horizontal, 38 (19%) mesioangular, 12 (6%) distoangular, and 7 (3.5%) buccolingual inclination There were 52 primarily retained (26%) and 32 secondarily retained (16%) molars. 137 (68.5%) molars were asymptomatic. Cystic formation was present in 13 (6.5%) cases. CONCLUSIONS: Although the impactions of first and second permanent molars do not occur frequently, it is important to make an early diagnosis in order to start treatment at the optimal time.

Analysis of different type of transmigrant mandibular teeth.

OBJECTIVE: Until recently, most reports about transmigration have documented that the canine is the only tooth which can migrate to the opposite side of the arch. The goal of the study was to define the transmigration of different types of teeth in people in various regions of Turkey. STUDY DESIGN: A total of 112,873 panoramic radiographic files from seven different Turkish cities were inspected. The following data were evaluated according to age, gender, number of transmigrant teeth, localization, eruption status, side, unilaterally or bilaterally and associated pathology or dental abnormalities. RESULTS: Of the 112,873 radiographs included in the study, 90 were seen to present as transmigrant in 87 patients, representing 0.079% of the sample. There were only two (0.0017%) transmigrant lateral (TML) teeth and only three (0.0026%) transmigrant premolar (TMP) teeth encountered. The mean age at the time that the transmigrant mandibular teeth were identified was 29.9 years, with a range from 10 to 66 years. Out of the 87 cases, 51 were female and 36 were male, with a male:female ratio of 1:1.41. Transmigrants were more commonly seen unilaterally (96.5%). The most frequent associated pathology was odontoma. CONCLUSIONS: Because early detection is vital to prevent complications and ensure more successful treatment, these extensive studies are crucial. In this extensive study, we indicated cases of transmigration of premolar and lateral teeth as a variant. Demographic variables and properties of all transmigrants (TM) were also presented.