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Öğe Analysis of gull in flight appearance and related parameters following le fort i osteotomy(Lippincott Williams & Wilkins, 2021) Süzen, Muazzez; Dilaver, Emrah; Uçkan, SinaThe present study aimed to investigate how "Gull in Flight" appearance and alar-columellar relationship change following maxillary surgery. Thirty-three patients who underwent Le Fort I osteotomy with or without mandibular osteotomy were included in this retrospective study. Measurements which were angle of columella triangle, alar-rim angle, columella lobular angle, and distance of points forming "Gull in Flight" appearance were evaluated on pre and postoperative frontal and lateral photos of patients. Data was submitted to statistical analysis and significance level was determined as 0.05. Following Le Fort I surgery, distance of points forming "Gull in Flight" appearance with respect to canthus was decreased significantly (P < 0.05). Positions of these points to each other were not changed (P > 0.05). Every 1 mm maxillary impaction led to 0.58 mm reduction in y3 (the distance from the point that illustrates Gull's body) (P = 0.032). There was a decrease in angle of columella triangle, alar-rim angle and increase in columella lobular angle. However, these changes were not found significant (P > 0.05). Angle of columella triangle was increased 2.51 degree for every 1 mm maxillary advancement (P = 0.028). In conclusion, maxillary surgery had an impact on nasal region from frontal view. However, "Gull in Flight" appearance which is one of the aesthetic parameters in nose was not changed following maxillary surgery.Öğe Analysis of inferior nasal morphology and nostrils following Le Fort I osteotomy(Lippincott Williams and Wilkins, 2022) Süzen, Muazzez; Dilaver, Emrah; Ak, Kıvanç Berke; Uçkan, SinaObjective: This study aimed to investigate the soft tissue parameters related to inferior nasal morphology and nostril shape and investigate the change at nostril types according to the Modified Topinard System following maxillary surgery. Materials and Methods: Thirty-five patients who underwent Le Fort I osteotomy with or without mandibular osteotomy were included in this retrospective study. Presurgery (T1) and postsurgery (T2) measurements which were the angle between the longitudinal axis of left and right nostril, nostril length, nostril width, alar width, alar base width, columella length, and columella width, were measured on computed tomography images. Nostril types according to Modified Topinard System and nostril shapes were also examined. Results: Following Le Fort I surgery, there was a significant increase in alar base width, alar width, and angle between the longitudinal axis of the left and right nostril (P<0.05). Nasal tip protrusion was decreased with significance (P=0.022). Multiple linear regression analysis showed that every 1 mm maxillary impaction amount leads to a 3.34 degrees increase in the angle between the longitudinal axis of the left and right nostrils (P=0.03, adjusted R (2)=0.21). Nostril type classification according to Modified Topinard System was changed significantly (P=0.000). Conclusion: Surgeons should be aware of the risk of postoperative nonaesthetic results in Modified Topinard System's borderline cases. Modified Topinard classification may be included in preoperative orthognathic planning from the bottom view.Öğe Analysis of relationship between haller cells and schneiderian membrane thickness(2021) Dilaver, Emrah; Akbulut, Aslıhan; Delilbaşı, Barış ÇağrıObjective: This first aim of this study was to determine whether there is a relationship between the presence of Haller cells and Schneiderian membrane thickness (SMT) by considering factors such as age and gender. The second aim of this study was to investigate correlation between the visibility of Haller cells on cone beam computed tomography (CBCT) and digital panoramic radiographs. Materials and Methods: Seventy-eight edentulous patients were included in the study. Cross-sectional views obtained from CBCTs were used to determine the mean sinus membrane thickness. Parameters such as gender and age were also investigated. Results: The difference in SMT at the base of the maxillary sinus was significant between those with and without Haller cells (p <0.05). A correlation was found between the detection of Haller cells on CBCT and digital panoramic radiographs (p <0.01). Although SMT was higher in men than in women, this difference was not significant (p> 0.05). Conclusion: Considering the results of our study, the presence of Haller cells may cause sinus membrane thickness at base of maxillary sinus. Since Haller cells can also be seen in digital panoramic radiographs, digital panoramic view taken prior to sinus lift surgery can provide clinicians with preoperative hint about SMT.Öğe Assessment of surgical complications related to dentalimplant surgery using Clavien-Dindo Classification(Selcuk University Faculty of Dentistry, 2021) Dilaver, Emrah; Ak, Kıvanç Berke; Süzen, Muazzez; Uçkan, SinaBackground: The aim of this study is to evaluate the surgicalcomplications encountered in the implants performed by the same surgeon between 2016-2019 using the Clavien-Dindoclassification used to grade the severity of surgicalcomplications. Methods: This retrospective study includes a total of 1171implants performed in 368 cases undergoing dental implantsurgery. Complications related to the operation were recordedand these complications were evaluated according to theClavien-Dindo Classification system. Possible effects of otherfactors such as age, gender, smoking, Diabetes mellitus andimmediate implant placement on complications were alsoevaluated. Results: A total of 98 complications have been reported,including flap dehiscence, numbness, infection, the apical part ofthe dental implant in the maxillary sinus, lack of primary stability,and cortical bone perforation. Smoking and immediateimplantation were found to be risk factors for flap dehiscence (p<0.05). 54.8% of the complications were in Clavien-Dindo Class Iand 28.5% in Class IIIa. According to the Clavien-Dindoclassification, gender, age, smoking and Diabetes Mellitus didnot increase the severity of the complications encountered. Conclusion: The Clavien-Dindo classification could serve as auseful in dental implant surgery both for standardization ofcomplications and to help clinicians understand theconsequences of complications. Wide range of using theClavien-Dindo classification system would allow comparisons ofdifferent techniques’ outcome in implant surgery among differentsurgeons and centers.Öğe Changes of stress distributions around pterygomaxillary junction with different osteotome angulations(Lippincott Williams & Wilkins, 2020) Dilaver, Emrah; Süzen, Muazzez; Demir, O?uzhan; İriç, Sedat; Ayhan, Ali Osman; Uçkan, SinaThe aim of this study was to investigate how the alteration of the angulation of osteotome at pterygomaxillary junction affects lateral pterygoid plate, maxillary tuberosity, palatal surface of maxilla, palatine bone and body of sphenoid bone. Following reconstruction of 3D modelling of maxilla, Osteotomes' tip was angulated 45 and 90 to sagittal plane to simulate pterygomaxillary osteotomy. Finite element analyses (FEA) was performed and Von Misses stress distributions were analyzed for two different angulations. Independent sample t test was used to compare differences between 45 and 90 angulations. Von Misses stress values on lateral pterygoid plate were higher in 45 angulation (0.71?±?0.21 MPa) than 90 angulation (0.54?±?0.28 MPa). This difference was statistically significant (P?Öğe Closure of a persistant oroantral fistula with nasoseptal cartilage as a complication of lateral sinus lifting: A case report(2017) Gürler, Gökhan; Dilaver, Emrah; Soylu, Erkan; Develi, Tuba; Delilbaşı Barış ÇağrıOroantral fistula may develop due to tooth extraction, infection or surgical interventions in the posterior maxilla. Several surgical techniques have been described for oroantral fistula closure. All these techniques have different advantages and disadvantages. This report presents an oroantral fistula case, which occurred, following lateral sinus lifting procedure. Traditional surgical techniques (buccal advancement flap, palatal flap, and Bichat's buccal fat pad) were performed to close the oroantral fistula, but could not to be managed. Finally, closure was succeeded with septal cartilage graft placed over the bony defect.Öğe Conservative surgical treatment of the jaw cysts in children: Case study of five patients(Medknow Publications & Media Pvt Ltd, 2017) Gürler, Gökhan; Yılmaz, S.; Delilbaşı, Barış Çağrı; Dilaver, Emrah; Yüzbaşıoğlu, Emir; Patır Münevveroğlu, AslıAims: Conservative treatment of jaw cysts establishes low surgical complication risk and protects vital anatomical structures such as inferior alveolar nerve, maxillary sinus and permanent tooth germs. Marsupialization and decompression have been widely used in children. The aim of this study was to evaluate the results of the conservative treatment of jaw cysts in five children. Materials and Methods: This article presents case series of marsupialization in jaw cysts associated with impacted teeth in five children. A total of nine impacted teeth within the cystic lesions were observed. Results: Complete resolution of all cystic lesions and simultaneous eruption of six impacted teeth within the cyst were managed. The other two teeth were erupted orthodontically and one had to be extracted. Conclusions: Marsupialization is effective for the treatment of cystic lesions in growing patients as it preserves vital anatomical structures and enables eruption of the impacted teeth within the cyst.Öğe Correlation between prevelance of haller cells and postoperative maxillary sinusitis after sinus lifting procedure(Churchill Livingstone, 2019) Akbulut, Aslıhan; Dilaver, EmrahOur aim was to investigate the prevalence of Haller cells in a group of patients listed for sinus lifting, and to assess the correlation between postoperative maxillary sinusitis and their presence. A total of 102 patients (150 sides) were evaluated retrospectively on cone-beam computed tomography (CT). The presence and dimensions of Haller cells were noted on the scans. The development of postoperative maxillary sinusitis was recorded. Fisher's exact test was used for statistical evaluation and probabilities of less than 0.05 were considered significant. Maxillary sinusitis developed after sinus lifting in five patients, and Haller cells were found in three of them. However, there was no correlation between the presence of Haller cells and postoperative maxillary sinusitis (p = 0.638). The cells were larger in patients with postoperative maxillary sinusitis, and the greater dimensions may be a potential risk factor for developing it after a sinus lift.Öğe Does low gonial angle affect the amount of bone loss around implant in the posterior mandible?(Selcuk University Faculty of Dentistry, 2021) Dilaver, Emrah; Süzen, Muazzez; Ak, Kıvanç Berke; Uçkan, SinaBackground: The purpose of this study was to investigatewhether there is a role of the low gonial angle on marginal boneresorption around the implants placed in the posterior mandible. Methods: This retrospective study, including 20 patients with 46implants followed 36 months were inserted in the mandibularedentulous posterior area. Patients without systemic diseasewere included in this study. The gonial angle was measured on apanoramic x-ray; Patients with a gonial angle of more than1250were classified as high gonial angle, and those with lessthan 1200 were classified as a low gonial angle group. Mesialand distal marginal bone resorption and implant angulation withthe occlusal plane were measured via Image J software (National Institutes of Health; version 1.5i, USA). Independent samples t test was used to compare measured variables between high andlow gonial angle groups. Results: The mean marginal bone resorption (MBL) was0.27±0.16 mm for the mesial side and 0.27±0.13mm for thedistal side in the LGA group. In the HGA group, MBL was0.77±0.28mm for the mesial side and 0.71±0.27mm for thedistal side. There was no statistical significance between HGAand LGA groups regarding marginal bone resorption. However,implant angulation with the occlusal plane was correlated withmarginal bone resorption in the HGA group. Conclusion: The result of this study is that a low gonial angle isnot directly a risk factor for marginal bone resorption around thedental implant. However, implants should be placedperpendicular to the occlusal plane as possible in the HGAgroup.Öğe Effect of V-Y plasty on lip lengthening and treatment of gummy smile(Churchill Livingstone, 2018) Dilaver, Emrah; Uçkan, İbrahim SinaThe aim of this study was to assess the effect of isolated V-Y plasty on lip lengthening and the treatment of gummy smile. An isolated V-Y plasty was performed on 14 patients with a gummy smile. In each case, measurements of upper lip length and gingival display were recorded from posed-smile photographs taken preoperatively and at 1, 3, and 6 months postoperatively. Gingival display decreased significantly and lip length increased significantly over all intervals investigated. Applying this technique after Le Fort I surgery may be beneficial; however, as with other injection or surgical lip lengthening methods, its stand-alone application should be questioned.Öğe Evaluation of internal nasal valve using computed tomography after le fort ı osteotomy: A cross-sectional study from a tertiary center(Galenos Publishing House, 2021) Dilaver, Emrah; Ak, Kıvanç Berke; Süzen, Muazzez; Altın, Gökhan; Uçkan, SinaAim: Internal nasal valve, which has been the most resistant region of the nasal airway, is affected by Le Fort I osteotomy. This study aimed to investigate the changes in the internal nasal valve (INV) after Le Fort I osteotomy. Methods: A retrospective computed tomography (CT) data of thirty-two patients who underwent Le Fort I surgery alone or combined with mandibular surgery from 2018 to 2020 were evaluated. INV area, INV angle, external nasal valve area, and interalar width were measured at preoperative (T1) and postoperative period (T2) on CT images. Results: CT assessment showed that the INV area was increased for both the right and left side (p1=0.005, p2=0.007). Right and left INV angle was increased from 16.15±3.240 to 19.63±5.210 and from 15.93±3.260 to 19.17±4.430 respectively (p1=0.000, p2=0.007). Interalar width was increased at the postoperative period (p=0.000). Also, the correlation between interalar width and INV area was found borderline significant (p=0.051, r=0.814). Right and left external nasal valve areas were increased after surgery (p1=0.000, p2=0.003). Conclusion: Maxillary surgery and surgical procedures affecting interalar width have an impact on the internal nasal valve.Öğe Evaluation of parameters related with upper lip aesthetics and dynamic smile following Le Fort I osteotomy(Elsevier, 2022) Dilaver, Emrah; Süzen, Muazzez; Uçkan, SinaObjective: The present study aimed to investigate how upper lip aesthetic and dynamic smile parameters are changed following a Le Fort I osteotomy.Methods: Twenty-seven patients who underwent Le Fort I osteotomy with or without mandibular osteotomy were included in this retrospective study. Upper lip aesthetic parameters which were Cupid's bow angle, lip angle, lip length, lip width, philtrum width and lip corners were evaluated on pre and postoperative rest photos using Image J software. Lip corner movement direction, buccal corri-dor area with respect to canine and last visible tooth were also measured on posed smile photos with respect to dynamic smile evaluations. Measured variables were submitted to statistical analysis and significance level was determined as 0.05.Results: There was a significant reduction in buccal corridor area according to last visible teeth for right and left side at postoperative period. However, buccal corridor area with respect to canine for the right and left side was not significant. The angle between the lip corner movement direction and Y-axis of the face for the right and left sides was not significant between pre and postoperative period. The changes in this angle were not also correlated with the changes in buccal corridor area and maxillomandibular movements. Not only the Cupid's bow angle, lip angle but also lip length, lip width, philtrum width and lip corner have not been changed significantly. Conclusion: Buccal corridor area investigated in dynamic smile shows significant improvement after orthog-nathic surgery especially in the means of maxillary impaction. Lip corner movement during smile was not associated with the changes in buccal corridor area. Landmarks around perioral area in static state were affected clinically with no statistical significance following the surgery.Öğe Evaluation of prevalence and dimension of pineal gland calcification by cone-beam computed tomography (CBCT)(Cumhuriyet University Faculty of Dentistry, 2022) Süzen, Muazzez; Dilaver, Emrah; Uçkan, SinaObjectives: This study aimed to investigate the prevalence and dimensions of pineal gland calcification on cone-beam computed tomography (CBCT) in patients undergoing dental treatment. Materials and Methods: We retrospectively examined CBCT scans in which the pineal gland appeared in the field of view and noted the presence of pineal gland calcification (PGC). Anteroposterior, lateral, and area measurements of the PGCs were made by the same observer. Variables such as age and gender were recorded for each patient from previous clinical examination data. Results: Among 220 patients (135 females, 85 males), the prevalence of pineal gland calcification was 33.6%. There was no significant difference between males and females (p>0.05). PGC was strongly associated with older age (p<0.001). The PGCs had mean anteroposterior and lateral dimensions of 2.56±0.98 mm and 3.39±1.29 mm, respectively, and the mean total calcified area was 5.45±3.75 mm2. Conclusions: This study showed no correlation between age, gender, and PGC size. However, the average calcified area was found to be significantly larger in men than women.Öğe Evaluation of quality and reliability of websites about orthognathic surgery using Google Trends (TM) application(Scientific Scholar LLC, 2020) Dilaver, Emrah; Kılınç, Delal DaraObjectives: Orthognathic surgery is the only treatment option for some cases in orthodontics. livo main goals were aimed in this study. The first goal was to determine the top three keywords that Google searchers look for "orthognathic surgery" using the Google Trendsmi application. The second was to assess the quality and reliability of the webpages yielded by searching those four keywords on Google.Materials and Methods: Google Trends was searched using the keyword "Orthognathic Surgery" Then, Google was searched using keywords: "Orthognathic surgery" and the other first three keywords. An oral surgeon and an orthodontist analyzed the quality and reliability of the websites using the DISCERN assessment tool.Results: The correlation between evaluators was low. Forty-six of the 70 websites were the websites of different oral and maxillofacial clinics and orthodontic clinics. The percentage of websites was 11% for personal doctor websites, 10% for academic journals, 7% for institutes, 6% for orthodontic clinics, and 1.4% for denial clinics. Overall rating scores of the websites for researchers were 2.41 +/- 1.35 for oral surgeon and 1.99 +/- 1.49 for orthodontist.Conclusions: The reliability and quality of the information in all of the websites was very low. The data on the websites did not have any scientific review processes such as review-peer review.Öğe Evaluation of soft tissue projection on axial cone beam computed tomography images after surgically assisted rapid maxillary expansion(Galenos Yayıncılık, 2021) Kılınç, Delal Dara; Dilaver, EmrahObjective: Surgically assisted rapid maxillary expansion (SARME) is one of the major treatment objectives in orthodontics. It is very obvious that SARME has non-negligible clinical impacts on the facial soft tissues of patients. This study aimed to investigate the correlation between hard tissue expansion and soft tissue projection after SARME on axial cone beam computed tomography (CBCT).Materials and Methods: Sixteen patients (9 women, 7 men) with a mean age of 22.18 +/- 1.64 years and having a transverse maxillary deficiency were enrolled in this retrospective study. A tooth borne Hyrax maxillary expander was applied to the patients and CBCT images were taken before (T0) and 6 months after (T1) SARME. Soft and hard tissue changes were superimposed and evaluated digitally on presurgical and post-surgical axial CBCT images by using In Vivo Dental Software.Results: The mean value of the hard tissue expansion was 4.50 +/- 1.38 mm for the anterior region and 3.92 +/- 1.31 mm for the posterior region. The difference between these values was not significant (p>0.05). There was no correlation between soft tissue projections (p=0.509; r=0.178) and anterior and posterior hard tissue expansion values (p=0.424; r=0.102) on both sides.Conclusion: There was no correlation between soft tissue projection and hard tissue expansion values after SARME. In addition, the difference between the anterior and posterior hard tissue expansion values was not statistically significant.Öğe Is 2 mm a safe distance from the inferior alveolar canal to avoid neurosensory complications in implant surgery?(Medknow Publications, 2017) Tüfekçioğlu, Şükran; Delilbaşı, Barış Çağrı; Gürler, Gökhan; Dilaver, Emrah; Özer, NaciAim: The aim of the present study was to compare the neurosensory complications related to implants inserted closer than 2 mm to the inferior alveolar canal (IAC) with those inserted further than 2 mm. Materials and Methods: A total of 474 implants in 314 patients placed posterior to mental foramen area were evaluated retrospectively on panoramic radiographs. Patients were divided into two groups regarding implant proximity to the IAC (Group 1, distance ?2 mm, Group 2, distance >2 mm). Postoperative neurosensory complications (pain and paresthesia) were recorded. Chi-square test was used for statistical comparison and P ? 0.05 was considered significant. Results: One hundred and fifty-three implants (32.2%) were inserted closer than 2 mm to the IAC whereas 321 implants (67.8%) were inserted further than 2 mm. Three implants which had a distance of 0 mm to the IAC (0.63%) caused paresthesia after surgery. Implant distance to IAC did not show a significant difference regarding pain and paresthesia (P = 0.06 and P = 0.08, respectively). Conclusion: When 2 mm is considered as a safety distance, the distance of the implants to the IAC did not yield any statistical difference regarding postoperative neurosensory complications.Öğe Unilateral complex syngnathia of the maxilla, mandible, and zygomatic complex in a newborn baby(Churchill Livingstone, 2017) Özel, Abdullah; Şenol Güven, Gamze; Dilaver, Emrah; Uçkan, SinaSyngnathia is a rare congenital fusion of the hard and softtissues of the jaw. Early intervention after birth is essential because without it the baby cannot feed, and facial growthand function will be severely affected.Öğe V-Y plasti tekniğinin dudak uzatma ve diş eti gülümsemesini tedavi etmedeki etkinliğinin değerlendirilmesi(İstanbul Medipol Üniversitesi Diş Hekimliği Fakültesi, 2016) Dilaver, Emrah; Uçkan, İbrahim SinaGülme esnasında diş etlerinin 3mm'den fazla görünmesine gummy smile (diş eti gülümsemesi) denilmektedir. Diş eti gülümsemesinin nedenleri arasında; üst çene ön bölgesinin dik yönde aşırı gelişimi, ağız çevresi kaslarının gülme esnasında dudağı normalden fazla yukarıya taşıması, üst kesicilerin okluzal düzlemden aşağıya sarkmış olması ve kısa kron boyu sayılmaktadır. Le Fort I osteotomisi ile maksillayı yukarı almak, kron boyu uzatmak, maksiller kesicilerin intrüzyonu, botulinum toksin uygulaması, myektomiler ve dudak uzatma operasyonları diş eti gülümsemesinin tedavi yöntemleri arasındadır. V-Y plasti, diş eti gülümsemesini azaltmak için uygulanan bir cerrahi teknik olmakla beraber bu teknik hemen her zaman maksilla cerrahisi ile birlikte uygulanmaktadır. Bu nedenle maksilla hareketlerinin ve V-Y plastinin dudak uzunluğunu hangi oranda etkilediği değerlendirilememektedir. Bu çalışmada diş eti gülümsemesi şikayetiyle kliniğe başvuran 14 hastaya izole V-Y plasti yapılmıştır. Gingival hiperplazisi, değişmiş pasif erüpsiyonu, kısa kron boyu olan ve maksiller cerrahiyle beraber V-Y plasti yapılan hastalar çalışma dışı kabul edilmiştir. Hastaların preoperatif ve postoperatif 1., 3. ve 6. aydaki poz gülüşünde fotoğrafları çekilerek bu fotoğraflar üzerinde dudak uzunluğu ve anterior dişlerin gingival marjinindeki görünen diş eti miktarları ölçüldü. V-Y plasti sonrasında dudak uzunluğunda her üç kontrol döneminde istatistiksel olarak anlamlı bir artış olduğu ve görünür diş eti miktarının anlamlı derecede azaldığı belirlendi. Anterior dişetlerin görünürlüğünde 1.ayda ortalama olarak % 43'lük bir azalma sağlanmışken bu oran 3.ayda %29, 6.ayda ise %21'e düşmüştür.
