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    Biomechanical validation of a modified genioplasty distractor
    (Elsevier, 2021) Simsek, Birant; Efeoglu, Candan; Yuce, Meltem Ozden; Akay, Mehmet Cemal; Celen, Serap
    Purpose: Genioplasty is a surgical procedure that is used to enhance the shape and appearance of the chin. It can be performed alone or in combination with other jaw-related surgeries either for medical or cosmetic purposes. Recently many studies have been reported for mandibular reconstruction with distraction osteogenesis. However, these distractors can cause some complications such as incorrect prolongation of hard tissues due to the lack of guiding section. The purpose of this study is to manufacture a novel genioplasty distractor and measure its biomechanical stability and reliability for different activation lengths in mandibular bone. Methods: The modified genioplasty distractor was manufactured from grade 2 and grade 5 (Ti6AI4V) titanium alpha + beta alloy which was biocompatible and adequately rigid for possible in situ application in the future and a sample holder was manufactured for compressive strength testing. Results: Test results showed that our modified genioplasty distractors withstood 300 N compression force for activation lengths from 0 to 11 mm. Recorded stress values were in the range of 0.110 MPa to 0.389 MPa. Conclusion: The modified genioplasty distractor developed and tested here is a promising surgical tool that has the potential to reduce genioplasty related complications especially in demanding cases. (C) 2021 Published by Elsevier Masson SAS.
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    Comparison of Autogenous Block Bone Graft and Screw Tent-Pole Techniques for Vertical Bone Augmentation in the Posterior Mandible: A Split-Mouth Randomized Controlled Study
    (Sage Publications India Pvt Ltd, 2021) Isik, Goezde; Gunbay, Tayfun; Uyanikgil, Yigit; Kisaoglu, Hueseyin; Yuce, Meltem Ozden
    Aim: To evaluate the effect on vertical bone augmentation of the screw tent-pole technique using particulate allograft in combination with injectable platelet-rich fibrin, and to compare this with autogenous block bone graft. Materials and Methods: This split-mouth randomized controlled study involved patients with bilateral partial edentulism and vertical bone loss in the posterior mandible. in each patient, the control side was treated with autogenous block bone graft harvested from the mandibular ramus and, on the test side, the screw tent-pole technique was employed, using particulate allograft in combination with injectable platelet-rich fibrin. All augmented sites were covered by leukocyte and platelet-rich fibrin membrane. The primary outcome variable of this study was the radiographic changes to bone height 6 months after augmentation. The secondary outcome variables were the percentage of newly formed bone and the implant survival rate. The data were analyzed with a significance level of alpha = 0.05. Results: of the 13 patients included, a total of 11 patients (7 females, 4 males; mean age 50.92) completed the study. The mean values of vertical bone gain were 1.72 0.78 mm for the test group and 2.83 +/- 0.89 mm for the control group, which constitutes a significant difference (P = .008). The percentage of newly formed bone was 18.08% +/- 2.17% for the test group and 14.26% +/- 1.76% for the control group. The difference between the groups was statistically significant (P < .001). The implant survival rates were 100% for both study groups. Conclusions: Based on the study results, screw tent-pole can be considered a feasible technique for bone augmentation. Further randomized studies will be necessary to fully evaluate vertical bone augmentation using the screw tent-pole technique, with different graft materials and with larger samples.
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    Does Concentrated Growth Factor Used With Allografts in Maxillary Sinus Lifting Have Adjunctive Benefits?
    (W B Saunders Co-Elsevier Inc, 2021) Adali, Emine; Yuce, Meltem Ozden; Gunbay, Tayfun; Gunbay, Sevtap
    Purpose: Recent studies have shown that the use of platelet concentration products alone, or in combination with variable graft materials, accelerates the new bone formation associated with sinus augmentation. The aim of this study was to measure the adjunctive effects of concentrated growth factor (CGF) used with allograft on new bone formation and augmentation stability in sinus lifting. Materials and Methods: This randomized controlled study included patients who presented for dental implant placement in atrophic posterior maxilla at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University, and who needed maxillary sinus augmentation. All patients were treated with a 2-stage surgical technique using sinus lifting bilaterally and implant placement 6 months later. During sinus lifting surgery, one side was grafted with allograft (group 1) and the other side with allograft mixed CGF (group 2). Cone-beam computed tomography was carried out immediately postoperatively and also 6 months after the augmentation to evaluate vertical bone height and percentage of resorption. Bone specimens were obtained at the time of implant placement and evaluated histomorphometrically to analyze the percentage of new bone formation and residual graft particle. Statistical comparisons were conducted between groups for all these measurements. Results: A total of 10 patients (2 females and 8 males) with a mean age of 57 years (range, 39 to 72) were enrolled in the study. Cone-beam computed tomography analysis revealed a significantly higher percentage of bone height resorption at the sixth month in group 1 (median, 9.32%) compared with group 2 (median, 6.37%) (P < .05). According to the histomorphometric examination, the percentage of new bone formation in group 2 (median, 36.41%) was higher than group 1 (median, 35.49%), but this difference did not reach statistical significance. Conclusions: Using CGF with allografts supports the stabilization of gained vertical bone height after sinus augmentation, but further research is needed to determine the accelerating effects of CGF on new bone formation. (C) 2020 American Association of Oral and Maxillofacial Surgeons
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    The effect of concentrated growth factor (CGF) in the surgical treatment of medication-related osteonecrosis of the jaw (MRONJ) in osteoporosis patients: a randomized controlled study
    (Springer Heidelberg, 2021) Yuce, Meltem Ozden; Adali, Emine; Isik, Gozde
    Objectives The purpose of this present study was to evaluate the efficiency of the growth factors delivered by concentrated growth factor (CGF) on the healing process of osteoporotic patients with medication-related osteonecrosis of the jaws (MRONJ). Methods This randomized controlled study was composed of osteoporotic female patients who were treated with oral bisphosphonates (BPs) and diagnosed with MRONJ. For the CGF group, each patient was treated with a local application of CGF at the surgical site after removing the necrotic bone, while the surgical area was primarily closed as traditional surgical therapy for the control group. The patients underwent clinical examinations for 6 months postoperatively to check the presence of infection and dehiscence. Results Complete healing was achieved in 19 patients of 28 patients (mean age: CGF group, 73.57 +/- 5.1; control group, 73.64 +/- 5.49) diagnosed with MRONJ. There was no significant difference in post-op healing data between groups during healing periods (p > 0.05). in the CGF group (n = 14) in three cases, bone exposure without infection was detected, and one of them showed a recurrent infection. in the control group (n = 14) in six cases, bone exposure without infection was detected, and three of them also showed recurrent infection. Conclusion Although our results were not statistically significant, our findings suggest that the local application of CGF appears to be an effective approach to the surgical treatment of MRONJ in osteoporosis patients by improving tissue regeneration.
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    Effect of concentrated growth factors on frequency of alveolar Osteitis following partially-erupted mandibular third molar surgery: a randomized controlled clinical study
    (Bmc, 2020) Koyuncu, Banu Ozveri; Isik, Gozde; Yuce, Meltem Ozden; Gunbay, Sevtap; Gunbay, Tayfun
    Background the aim of this prospective study was to assess the effectiveness of concentrated growth factors (CGF) in preventing the development of alveolar osteitis (AO) after the extraction of partially-erupted mandibular third molars. Methods Seventy patients (26 men and 44 women) 18 years or older (mean age 25.86; range 18-35) underwent 140 third molar extractions. All the patients presented with bilateral, partially-erupted mandibular third molars and underwent surgical extractions. in each case, one socket received CGF and the other served as a control. the predictor variable was the CGF application and the sides were categorized as 'CGF' and 'non-CGF'. the outcome variable was the development of AO during the first postoperative week. Other study variables included age and gender. Data were analyzed using Cochran's Q test with the significance level set at aPvalue less than 0.05. Results the overall frequency of AO was 11.4% for the control group. the frequency of AO in the CGF group was significantly lower than in the non-CGF group (p < 0.001). Conclusions Based on the results of this study, application of CGF fibrin gel may decrease the risk of AO development after mandibular third molar surgery.
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    Effect of Cone beam Computed Tomography on Treatment Decision of Wisdom Tooth
    (Galenos Yayincilik, 2021) Yuce, Meltem Ozden; Sener, Elif; Isik, Gozde; Adali, Emine; Koyuncu, Banu Ozveri; Baksi, Bedriye Guniz; Gurhan, Ceyda
    Objective: This diagnostic accuracy study aimed to evaluate the relationship between mandibular third molars (M3) and mandibular canal (MC) using panoramic radiographs (PR) and cone-beam computed tomography (CBCT) and to assess the effect of CBCT on treatment decision. Materials and Methods: CBCT scans of 150 patients with close association between MC and M3 on PR were included in the study. The degree of superimposition, Buccolingual position (buccal, central and lingual) and physical relationship (separation, contact and involved) were measured on CBCT images. Fisher's Exact test was used to evaluate differences between PR and CBCT. Results: All M3 were directly superimposed on the MC on PR; however, CBCT showed separation from the canal in 10% of M3 roots. Evaluation of CBCT images revealed that the probability to observe an involvement was significantly higher when the MC was in the lingual position (57.6%) than in other positions. Conclusion: Three-dimensional imaging is very useful to clarify the true relationship between M3 and MC relative to two-dimensional panoramic images, and the clinician may decide to change the treatment plan based on CBCT images in patients with high risk. Nevertheless, PR can be considered an acceptable diagnostic method with low radiation dose compare with CBCT.