Browsing by Author "Altiparmak, N."

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Changes in The Lower Lip Soft Tissue After Bone Graft Harvesting from The Mandibular Symphysis
(2017) Altiparmak, N.; Akdeniz, B. S.; Akdeniz, S. S.; Uckan, S.; https://orcid.org/0000-0002-1988-3195; 27688167; N-1121-2014
Following the surgical release of the mentalis muscle, lip incompetence and/or an increase in lower incisor exposure may be seen due to undesirable attachment of the muscle fibres. The aim of this study was to evaluate the extent of lip ptosis, lower incisor exposure, and other soft tissue changes following bone graft harvesting from the mandibular symphysis when the mentalis muscle is reapproximated precisely to its original position. Seventeen consecutive patients who underwent bone graft harvesting from the mandibular symphysis were included in this study. The mentalis muscle was isolated, identified, marked, and reapproximated precisely during the bone harvesting operation. Digital lateral cephalograms obtained preoperatively and at 6 months postoperative were analyzed and compared by paired samples t-test to determine the horizontal and vertical soft tissue changes in the lower lip and chin. Although the soft tissue thickness at soft tissue point B and at soft tissue pogonion had increased significantly at 6 months after chin bone graft harvesting, there were no significant changes in lower incisor exposure or other positional alterations of the lower lip (P < 0.05). Precise reattachment of the mentalis muscle in its original position helps to avoid significant vertical positional changes in the lower lip. Increases in soft tissue thickness can be observed following bone graft harvesting from the mandibular symphysis.
Comparison of the postoperative stability after repositioning of the maxilla with Le Fort I osteotomy using four-versus two-plate fixation
(2021) Beyler, E.; Altiparmak, N.; Bayram, B.; 32442634
Introduction: Le Fort I osteotomy procedures requires miniplates fixation in both the aperture piriformis and zygomaticomaxillary buttress. Purpose: The purpose of this study was to compare the postoperative stability of the Le Fort I osteotomy using four-plate versus two-plate fixation. Material and methods: This study involved 39 Class III patients who underwent one-piece Le Fort I osteotomy with bilateral sagittal split ramus osteotomy. In group I, four miniplates were placed at the apertura piriformis and the zygomaticomaxillary buttress, whereas, in group II, fixation was achieved with two miniplates bilaterally placed at the piriform apertura with no posterior fixation. Linear and angular measurements included maxillary sagittal and vertical positions. The primary outcome of this study was stability, as recorded by lateral cephalometric measurements of the preoperative, immediately postoperative and late postoperative periods. Results: Significant immediate postsurgical changes were found in both groups. In the late postoperative cephalometric measurements, all skeletal parameters showed significant stability in groups I and II. In terms of vertical and sagittal relapse, there was no significant difference between the four-plate and two-plate groups (p1 = 0.686 and p2 = 0.513, respectively). Conclusion: A good postoperative stability can be obtained with a two-plate fixation after one-piece Le Fort I osteotomy. (C) 2020 Elsevier Masson SAS. All rights reserved.
The Effect of Conventional Surgery and Piezoelectric Surgery Bone Harvesting Techniques on the Donor Site Morbidity of the Mandibular Ramus and Symphysis
(2015) Altiparmak, N.; Soydan, S. S.; Uckan, S.; 25979191
The aim of this study was to evaluate the morbidity following bone harvesting at two different intraoral donor sites, mandibular symphysis and ramus, and to determine the effects of piezoelectric. and conventional surgical graft harvesting techniques on donor site morbidity. Intraoral block bone grafts were harvested from the symphysis (n = 44) and ramus (n = 31). The two donor site groups were divided into two subgroups according to the surgical graft harvesting method used (conventional or piezoelectric surgery). Intraoperative and postoperative pain was assessed using a visual analogue scale (VAS). Donor site morbidity and the harvesting techniques were compared statistically. Of 290 teeth evaluated in the symphysis group, four needed root canal treatment after surgery. The incidence of transient paresthesia in the mucosa was significantly higher in the symphysis group than in the ramus group (P = 0.004). In the symphysis group, the incidence of temporary skin and mucosa paresthesia was lower in the piezoelectric surgery subgroup than in the conventional surgery subgroup (P = 0.006 and P = 0.001, respectively). No permanent anaesthesia of any region of the skin was reported in either donor site group. VAS scores did not differ between the ramus and symphysis harvesting groups, or between the piezoelectric and conventional surgery subgroups. When the. symphysis was chosen as the donor site, minor sensory disturbances of the mucosa and teeth were recorded. The use of piezoelectric surgery during intraoral harvesting of bone blocks, especially from the symphysis, can reduce these complications.
Experimental assessment of histological and biological properties of the induced membrane and the membrane formed around the d-PTFE membrane: A pilot study
(2020) Altiparmak, N.; Akdeniz, S. S.; Akcay, Y. E.; Bayram, B.; Araz, K.; 32145434
Background: The aim of this prospective pilot study is to find answers to the following question: In the treatment protocol of open membrane technique defined by Funakoshi, do the histological and biological properties of the tissue that has already covered the graft surface following the removal of the d-PTFE membrane resemble those properties of induced membrane? Material and methods: 4 male, white Vienna rabbits were used for experiments. Bicortical and 10 mm in diameter four bone defects were created on each calvarial bone. 2 rabbits (8 defects) were accepted as group I and other 2 rabbits (8 defects) were accepted as group II. Bone cement was placed into the all-defect in group I.8 defects were filled with Bi-Oss graft material and covered with d-PTFE membranes in group II. After 8 weeks, sacrifice of the rabbits was performed. In group I, without damaging the formed membrane around it, the bone cement was removed from the defects and the achieved membrane was sent to the pathology department. In group II, the thin film layer that formed under the d-PTFE membrane was sent for histological evaluations. Inflammation, edema, foreign body reaction, synovial-like epithelium existence, thickness, vascularisation (CD31, VEGF), fibrosis were assessed. Results: Inflammation, fibrosis and thickness measurements are significantly different between the groups (P < 0,05) and for these parameters, the mean of d-PTFE group (Group II) is significantly higher than the mean of the induced-membrane group (Group I). There isn't any significant difference for other parameters. Conclusion: The morphological characteristics of membranes of the two groups were similar. There was a cell-rich, vascularised tissue with fibrous structures; fibroblasts, myofibroblast, and collagen, orientated parallel to the cement. (C) 2020 Elsevier Masson SAS. All rights reserved.