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Öğe Alveolar ridge splitting versus autogenous onlay bone grafting: Complications and implant survival rates(Lippincott Williams & Wilkins, 2017) Altıparmak, Nur; Akdeniz, Sıdıka Sinem; Bayram, Burak; Gülsever, Serap; Uçkan, SinaPurpose:To compare the complications and implant survival rates of localized alveolar ridge deficiencies in the horizontal dimension reconstructed by alveolar ridge splitting (ARS) or autogenous onlay bone grafting (OBG).Materials and Methods:Twenty-eight ARS and 28 OBG were performed. The survival rate of the all included implants was evaluated using the clinical and radiographical evaluation criteria of Misch et al. Temporary exposure of graft, mild infection, temporary paresthesia, and bad split were defined as minor complications; permanent exposure of graft, loss of graft, and permanent paresthesia were defined as major complications. Major and minor complications of ARS and OBG groups were statistically compared.Results:When the minor and major complication rates are considered, there was not any statistically significant difference between OBG (P = 0.099) and ARS (P = 0.241) groups. The satisfactory survival rate of OBG group was 92% and was 100% in the ARS group, and the difference was not statistically significant (P = 0.116).Conclusion:When reconstructing vertically sufficient but horizontally insufficient alveolar ridges, ridge splitting technique could shorten the treatment period, decrease postoperative swelling and pain, eliminate the need for a second surgical site, reduce the treatment cost, and ease the patient cooperation to the surgery.Öğe Changes in difficult airway predictors following mandibular setback surgery(Churchill Livingstone, 2015) Soydan, Sıdıka Sinem; Bayram, Burak; Akdeniz, Baki Serkan; Kayhan, Zeynep; Uçkan, SinaThe aim of this study was to determine the effect of surgical mandibular backward movements on the predictors of a difficult airway. Thirty-seven skeletal class III patients were included in this study. The Mallampati score, body mass index (BMI), maximal inter-incisal distance, and thyromental and sternomental distances of these patients were evaluated preoperatively and at 6 months and 2 years postoperatively. A sagittal split ramus osteotomy (SSRO) without genioplasty was performed in all patients by the same surgical team, and anaesthesia was provided by the same anaesthesiologist using nasotracheal intubation. The paired samples t-test and Wilcoxon signed-rank test were used for statistical comparisons of the data. There were no statistically significant changes in BMI or sternomental and thyromental distances after SSRO. The maximal inter-incisal distance was significantly reduced at 6 months postoperatively (P < 0.05), but no statistical difference was found between the values obtained preoperatively and at 2 years postoperative. A statistically significant increase in Mallampati score was observed postoperatively (P < 0.05). Both the patient and practitioner should be aware of the risks associated with an increased postoperative Mallampati score in mandibular setback patients. The amount of mandibular setback in skeletal class III patients with a high preoperative Mallampati score should be limited to prevent potential postoperative airway problems.Öğe Comparison of success rate of dental implants placed in autogenous bone graft regenerated areas and pristine bone(Lippincott Williams & Wilkins, 2020) Altıparmak, Nur; Akdeniz, Sıdıka Sinem; Diker, Nurettin; Bayram, Burak; Uçkan, SinaAutogenous bone grafting still has been considered as the "gold standard" and wildly used in the case of alveolar bone reconstruction. The aim of the present study is to evaluate the success rate of implants placed in autogenous block augmented ridges and implants placed in pristine bone (PB). This study included 113 patients. Fifty-three patients were treated with autogenous block grafts and particulate bone, after 6 months of healing implant placements were performed in autogenous bone augmented (ABA) areas. In 60 patients implant placement was performed, with no need for grafting and implants were placed into the PB. Follow-up data (pain, mobility, exudation from peri-implant space, success rate, marginal bone resorption) were collected after 5 years of prosthetic loading. The cumulative implant success rate at the 5-year examination was 92.45% for the ABA group and 85% for PB group. There were 3 failed implants in the ABA group and 3 in PB group. Average marginal bone loss was 1.47?mm on ABA group and 1.58?mm on PB group. No statistically significant differences for pain, exudation from peri-implant space, implant mobility, implant success, peri-implant bone loss parameters, and patient satisfaction level were found between groups. The obtained data demonstrated that the success rate of implants placed in regenerated areas are very similar to the success rate of implants those placed in PB.Öğe Comparison of tunnel and crestal incision techniques in reconstruction of localized alveolar defects(Quintessence Publishing Co Inc, 2017) Altıparmak, Nur; Uçkan, Sina; Bayram, Burak; Soydan, SıdıkaPurpose: The aim of this study was to compare the complication rates of recipient sites prepared using two incision techniques: crestal and tunnel. Materials and Methods: In this prospective study, patients underwent augmentation procedures (68 patients; 75 sites) by the same surgeon that were performed consecutively using the crestal incision technique (27 horizontal, 10 vertical; crestal group) or the tunnel incision technique (27 horizontal, 11 vertical; tunnel group). Autogenous bone block grafts were harvested with a piezoelectric surgical device, and the grafts were fixed at the recipient sites by two titanium screws in both groups. The authors evaluated minor exposure, transient paresthesia, major exposure, permanent paresthesia, gingival recession at adjacent teeth, surgery time, and visual analog scale pain scores. Results: Soft tissue dehiscence and graft failure were significantly lower in patients undergoing the tunnel technique. Conclusion: The tunnel incision technique significantly decreased soft tissue exposure, the most common complication of augmentation procedures with autogenous onlay bone grafts. This technique should be considered an alternative to the crestal incision technique for preparation of the recipient site.Öğe Ortognatik cerrahide kullanılan titanyum miniplakların söküm prevelansı: Uzun dönem takipli retrospektif çalışma(Yeditepe Üniversitesi Rektörlüğü, 2022) Çubuk, Seçil; Kaya, Burçak; Bayram, Burak; Uçkan, SinaAmaç: Bu çalışmanın amacı ortognatik cerrahi uygulanmış hastalarda miniplak ile ilişkili gelişen komplikasyonların uzun dönemli takip sürecince değerlendirilmesidir. Materyal ve Metod: Araştırmaya 2004-2017 yılları arasında ortognatik cerrahi uygulanmış hastalar dahil edilmiştir. Miniplak söküm nedeni, miniplak sökümü uygulanan bölge, ortognatik cerrahi ile miniplak söküm işlemi arasında geçen süre ve miniplak sökümü sonrasında bulgu ve semptomlarda iyileşme durumu değerlendirilmiştir. Bulgular: Araştırmaya dahil edilen 70 hastanın 11’inde (%15,7) toplam 19 adet miniplak söküm işlemi uygulanmıştır. Ortalama takip süresi 7,65+2,81 (3,5-15,3 yıl) yıl olup; ortognatik cerrahi ile miniplak çıkartılma işlemleri arasında geçen süre ortalama 1.52 yıldır (4 ay-6 yıl). Miniplak söküm nedenleri enfeksiyon (%45,5), soğuk hassasiyeti (%18,2), miniplağın palpe edilebilir hale gelerek hastada rahatsızlık oluşturması (%9), miniplağın bulunduğu bölgeye başka bir cerrahi uygulama yapılacak olması (%18,2) ve hasta isteği olarak sıralanabilir (%9). Toplam 13 adet (%11,6) miniplak mandibuladan çıkartılmış; 6 adet (%3,06) miniplak ise maksilladan çıkartılmıştır. Çene ucunda miniplak söküm işlemi uygulanmamıştır. Enfeksiyon nedeniyle mandibuladan miniplak sökülme oranının %69, maksilladan miniplak sökülme oranının ise %16,6 olduğu görülmüştür (p<0,05). Miniplak bulunan bölgeye uygulanacak başka bir cerrahi işlem nedeniyle maksilladan toplam 3 adet (%50) miniplak sökülmüş, mandibulada ve çene ucunda ise bu nedenle miniplak söküm işlemi uygulanmamıştır (p<0,05). Sonuç: Kliniğimizde 13 yıllık bir süreçte ortognatik cerrahi uygulanmış hastalarda miniplak söküm prevelansının %15,7 olduğu görülmüştür. Miniplak ile ilişkili komplikasyonlar ortognatik cerrahiden ortalama 1,5 yıl sonra gelişmiş, postoperatif 5. yıldan sonra miniplaklar ile ilişkili herhangi bir komplikasyon görülmemiştir.Öğe Preventive and therapeutic effects of relaxin on bisphosphonate-related osteonecrosis of the jaw: An experimental study in rats(Universidade Estadual Paulista, Institute of Science and Technology of Sao Jose dos Campos, 2020) Develi, Tuba; Uçkan, Sina; Bayram, Burak; Deniz, Kağan; Erdem, Şaban Remzi; Özdemir, Binnaz Handan; Başçıl Tütüncü, Neslihan; Bacanlı, DidemObjective: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a challenging complication of chronic bisphosphonate (BP) use. The hormone relaxin is able to induce the multistep differentiation process of human osteoclastogenesis, exhibits anti-fibrotic and anti-inflammatory actions, and promotes vasodilatation, wound healing, and angiogenesis. The present study aimed to evaluate the effects of relaxin in the prevention and management of BRONJ. Material and Methods: Thirty-six male Sprague Dawley rats were randomly divided into four groups. Rats in group 1 (n = 10) received relaxin and BP simultaneously for 12 weeks. Rats in group 2 (n = 10) received injections of BP for 12 weeks, followed by relaxin for another 12 weeks. Rats in group 3 (n = 10) received only BP injections, and those in group 4 (control, n = 6) received only saline. Necrosis and inflammation in the rats’ mandibles were evaluated as indicators of BRONJ. Results: Necrosis and inflammation were not detected in group 1 (BP + relaxin). In group 3 (BP only), incidence rates of necrosis and inflammation were 90% and 60%, respectively. Conclusions: Our findings suggest that relaxin may be potently effective in preventing BRONJ and have some benefit in the treatment of existing BRONJ.Öğe The influence of bilateral sagittal split ramus osteotomy on submental-cervical aesthetics(Wiley-Blackwell, 2014) Soydan, Sıdıka Sinem; Uçkan, Sina; Üstdal, Ayça; Bayram, Burak; Bayrak, BurcuThe effect of orthodontic-surgical treatment on submental-cervical region was evaluated in a very limited number of studies. The aim of this study was to evaluate submental-cervical soft tissue contour changes following mandibular advancement and set-back procedures via bilateral sagittal split ramus osteotomy. Sixty-seven patients were included in this study. Group 1 consisted of 27 skeletal Class II patients who underwent mandibular advancement surgery, whereas Group 2 consisted of 40 skeletal Class III patients who underwent mandibular set-back surgery. Various linear and angular measurements were performed on pre-operative and sixth month post-operative cephalometric radiographs. A new method was used to evaluate the amount of sagging at submental region. The submental length did not change in Group 1; however, it decreased significantly in Group 2 (P<005). The angle between submental plane and facial plane decreased to 959 degrees from 988 degrees in Group 1(P<005), whereas it increased to 931 degrees from 882 degrees in Group2 (P<005). The change of submental soft tissue sag was almost stable in Group 1, while 034mm increase of sag was observed in Group 2. This increase was not statistically significant (P>005). Mandibular set-back and advancement procedures do not remarkably change the submental sag following approximately 6mm jaw movement. Although mandibular advancement did not significantly effect submental length, soft tissue followed mandibular set-back with a ratio of 1:1 at C-point to projection of soft tissue pogonion and 1:07 at C-point to soft tissue menton distances.
