Stafne Bone Cavity Complicated By Periapical Infection.

Stafne bone cavity (SBC) is an uncommon lesion of the mandible; and generally found incidentally on routine radiographic examinations. The radiographic differential diagnosis of SBC includes a variety of lesions including odontogenic cysts, benign tumors, or bone metastases. In the present case, a 22-year female patient was admitted with chief complaint of pain in the right mandibular molar area. On panoramic radiographic examination, a non-specific large radiolucent lesion related to mandibular molar teeth was detected and extra-oral surgical intervention was planned. However, on examination with cone-beam CT(CBCT), a SBC was suspected due to lack of lingual cortical plate; and intraoral surgical exploration confirmed the diagnosis showing a cavity with small inflamed salivary gland tissue. Examination with CBCTon suspicious jaw lesions helps avoid unnecessary extraoral surgical interventions.

Dental patients' knowledge and awareness about transmission ways of acquired immune deficiency syndrome (AIDS).

PURPOSE: The aim of this study was to evaluate the patients' attitude, knowledge and awareness about HIV/AIDS. And secondary aim was to assess the need for further education about HIV/AIDS. MATERIALS AND METHODS: A questionnaire of 39 items was used to evaluate the patients' knowledge. 301 patients were included (mean age 37.12±7.85 years, 41.5% male, 58.5% female) in the study. Results were calculated by Students t-test, Chi-square test, Fisher's exact test. RESULTS: Most of the patients had accurate knowledge about transmission ways, however transmission through breastfeeding (31.6%), public restrooms (44.9%), and insects and mosquitos bite (47.2%) were less recognized. Saliva (32.2%), urine (36.9%), tears (58.5%), sweat (54.5%), breast milk (30.6%), feces (36.9%) and cerebrospinal fluid (7.3%) were less recognized body fluids. Generally university and postgraduate educated patients had more accurate knowledge than other groups. 63.1% of patients thought that they need further education about HIV/AI DS. CONCLUSION: The results of this study showed that the knowledge level about HIV/AIDS was almost agreeable. However, the patients had deficiencies with respect to their knowl-edge. Therefore the authors of this study believe that there must be education programs related to HIV/AIDS.

Correlation of Fractal Dimension Values with Implant Insertion Torque and Resonance Frequency Values at Implant Recipient Sites.

PURPOSE: Fractal analysis is a mathematical method used to describe the internal architecture of complex structures such as trabecular bone. Fractal analysis of panoramic radiographs of implant recipient sites could help to predict the quality of the bone prior to implant placement. This study investigated the correlations between the fractal dimension values obtained from panoramic radiographs and the insertion torque and resonance frequency values of mandibular implants. MATERIALS AND METHODS: Thirty patients who received a total of 55 implants of the same brand, diameter, and length in the mandibular premolar and molar regions were included in the study. The same surgical procedures were applied to each patient, and the insertion torque and resonance frequency values were recorded for each implant at the time of placement. The radiographic fractal dimensions of the alveolar bone in the implant recipient area were calculated from preoperative panoramic radiographs using a box-counting algorithm. The insertion torque and resonance frequency values were compared with the fractal dimension values using the Spearman test. RESULTS: All implants were successful, and none were lost during the follow-up period. Linear correlations were observed between the fractal dimension and resonance frequency, between the fractal dimension and insertion torque, and between resonance frequency and insertion torque. CONCLUSION: These results suggest that the noninvasive measurement of the fractal dimension from panoramic radiographs might help to predict the bone quality, and thus the primary stability of dental implants, before implant surgery.

Clinical Evaluation of the Use of Tibial Bone Grafting in Dentoalveolar Reconstructive Surgery.

OBJECTIVE: The aim of this study was to evaluate the efficacy of tibial autogenous bone grafting in the treatment of patients with alveolar bone defects. MATERIALS AND METHODS: The study subjects consisted of 12 patients (10 male, 2 female, age: 19-51 years) who underwent reconstructive autogenous bone-grafting procedures. The medial approach to the tibial bone was used to harvest autogenous cancellous bone grafts in all the patients. Clinical parameters (complications at the donor and recipient sites, resorption and volume of the grafts) were evaluated retrospectively. RESULTS: The mean age of the patients was 36.25 ± 0.9 years. Of the 12 patients, 5 (41.7%) received bone grafts for sinus augmentation, 3 (25%) for cyst cavity reconstruction and 4 (33.3%) for alveolar cleft reconstruction procedures. The average follow-up period was 28.4 months (range: 21-40 months). An average of 5.2 cm3 of cancellous bone was harvested for grafting procedures. All the grafting procedures were successful, and there were no surgical complications during the harvesting protocol. In all cases, pain and gait disturbance lasted less than 2 weeks. CONCLUSION: The results of this study suggest that the use of tibial autogenous bone graft harvested using a medial approach was a safe, simple and effective method for grafting various alveolar bone defects where high amounts of cancellous bone grafts were needed with low morbidity.

Finite-Element Analysis of a New Designed Miniplate which is Used via Intraoral Approach to the Mandible Angle Fracture: Comparison of the Different Fixation Techniques.

The mandible is the largest facial bone as well as the most commonly fractured bone in the maxillofacial region. Despite numerous studies conducted to identify optimal treatment modalities and plates configurations for intraoral and transoral approaches, no definitive conclusion has been reached. This study used finite element analysis (FEA) to assess 4 scenarios for treatment of an angle fracture (6-hole noncompression miniplate; 6-hole single plate/Champy's technique, 3D strut plate; 2 parallel 4-hole noncompression miniplates). Analysis included segmental displacement and Von Mises Stress evaluations of a 3D reconstruction of a human mandible. Von Mises Stress values for plates did not vary significantly among treatment groups. Moreover, no significant differences were observed in cumulative displacement of segments subjected to vertical and horizontal loads, with all treatment configurations demonstrating clinical acceptability.

Preservation of a tooth related with central giant cell granuloma with non-invasive curettage: 7 years followed-up case report.

Central Giant Cell Granuloma (CGCG) is defined by the World Health Organization as an intraosseous lesion consisting of cellular fibrous tissue containing multiple foci of hemorrhage, aggregations of multinucleated giant cells, and occasionally trabeculae of woven bone. An 8-year-old patient presented with painless swelling and bleeding in his upper right canine region was referred to our clinic. Incisional biopsy was confirmed that this was a CGCG. The patient was treated with non-invasive curettage and secondary intention healing. Seven-year follow-up of the patient revealed a complete resolution of the lesion and uneventful eruption of the permanent canine tooth. In this case report, a successful long-term outcome of the conservative treatment of the CGCG was presented.

Effects of the hyperbaric oxygen on de novo bone formation during periosteal distraction.

OBJECTIVE: The purpose of this study was to investigate the effect of hyperbaric oxygen (HBO) therapy on de novo bone formation during periosteal distraction (PD). MATERIALS AND METHODS: Periosteal distraction was performed in 24 mature male New Zealand rabbits using a custom-designed device placed on the lateral surface of the mandibular corpus. Twelve rabbits (group H) were given adjunctive HBO treatment, whereas 12 rabbits (group N) were kept in a normal environment (normobaric oxygen). After a 7-day latency period, the same distraction protocol was applied to both groups. However, the rabbits in group H were treated with pure oxygen at 2.4 atm absolute for 25 times. Both groups were further divided into 2 subgroups and killed after consolidation periods of 4 and 8 weeks. Photodensitometric and histologic analyses were performed to evaluate the newly formed bone. RESULTS: There was no significant difference between the 4-week consolidated HBO group and the 8-week consolidated normobaric oxygen subgroup (P = 0.229). Moreover, there was better bone formation in the 8-week HBO group than in the 8-week control group. CONCLUSION: The results of this study indicate that PD with HBO could be used to increase the quality and the quantity of the bone newly formed by PD.

Iatrogenic displacement of impacted mandibular third molar into the pterygomandibular space: a case report.

Accidental displacement of an impacted lower third molar into the pterygomandibular space during extraction is a rare complication. The purpose of this article is to report the case of a lower third molar displaced into the pterygomandibular space during an unsuccessful surgical intervention. A 26-year-old male patient presented with infection and trismus was referred to our clinic. The patient's history revealed that he undergone an unsuccessful impacted third molar removal performed by dentist two years ago. The patient was not referred to oral surgeon after the incident, although, the doctor noticed the iatrogenic displacement. On radiological examination, panoramic radiograph and Computed Tomography (CT) scans showed that the displaced tooth was migrated in the pterygomandibular space over the two-year time. Infection and trismus were controlled by antibiotic therapy and physiotherapy before the surgery and the displaced tooth was recovered under local anesthesia. The post-operative period was uneventful and the patient recovered without any sequel.

One-and-a-half-barrel vascularized free fibular flap for the reconstruction of segmental mandibular defect.

We designed one-and-a-half-barrel vascularized free fibular flap which is a further modification of the double-barrel technique, and we tried to overcome the discrepancy between mandible and fibula flap. We used this flap in case of a segmental mandibular defect that occurred as a result of a giant cell reparative granuloma excision. This new modification eliminated volume insufficiency of the classical technique and volume excess of the double-barrel technique.A segmental mandibular defect that occurred as a result of giant cell reparative granuloma excision was reconstructed using one-and-a-half-barrel vascularized free fibular flap. The size discrepancy between mandible and free fibula flap is a well-known problem, and this new modification of free fibular flap eliminated volume insufficiency or excess problems of the other techniques.

The evaluation of the effects of hyperbaric oxygen therapy on new bone formation obtained by distraction osteogenesis in terms of consolidation periods.

OBJECTIVE: The aim of this study was to evaluate the effect of hyperbaric oxygen therapy on new bone formation obtained by distraction osteogenesis in long- or short-term consolidation periods. MATERIALS AND METHODS: Twenty-four rabbits were used. The animals were divided into two groups of 12 animals each, and vertical mandibular distraction osteogenesis was performed. Hyperbaric oxygen therapy was administered in the first group. Each group was subdivided into two subgroups according to the 30- and 60-day consolidation period. The acquired bone amounts were compared according to their radiographic density and histopathology. RESULTS: Histopathologically, in the experimental group, callus formation was increased and the new bone was more mineralized. According to the radiographic densitometry analyses, there were no statistically significant differences between the 30-day consolidated subgroups of the experimental group and the 60-day consolidated subgroup of the control group (p = 0.873). CONCLUSION: Hyperbaric oxygen therapy can be used to increase the quality and the quantity of bone and to decrease the maturation time which may shorten the consolidation period of vertical distraction osteogenesis. CLINICAL RELEVANCE: The effect of hyperbaric oxygen therapy on vertical distraction osteogenesis procedure according to consolidation periods has been determined. Hyperbaric oxygen therapy may increase the quality and the quantity of bone and shorten the consolidation period.

Vertical distraction osteogenesis of fibula transplant for mandibular reconstruction: a case report.

Bone continuity defects in the mandible are caused by tumor surgery, trauma, infection, or osteoradionecrosis. Today, reconstruction of long-span mandibular defects with a free fibular flap is a routine procedure. However the bone height of the mandible after reconstruction is about half that of the dentulous mandible. Therefore, the deficiency in bone height makes implant placement impractical. In our case, because it was necessary to restore the mandibular height, a vertical distraction osteogenesis was performed on the grafted mandible of the patient who was referred to our clinic with a reconstructed mandible owing to a gunshot injury. As a result, the vertical discrepancy between the fibula and the native hemimandible of the patient was corrected. And the placement of dental implants was performed without any complications. In conclusion, we believe that the vertical distraction osteogenesis of free vascularized fibula flaps is a reliable technique that optimizes implant positioning for ideal prosthetic rehabilitation.