Browsing by Author "Uckan, Sina"

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Combined use of alveolar distraction osteogenesis and segmental osteotomy in anterior vertical ridge augmentation
(2015) Oncu, Elif; Isik, Kubilay; Alaaddinoglu, E.Emine; Uckan, Sina; 0000-0001-6718-3882; 25661636
INTRODUCTION: Vertical defects of the anterioral veolar ridge are challenging cases in implant dentistry. Various techniques, such as onlay bone grafting, segmental osteotomy (SO) oral veolar distraction osteogenesis (ADO), have been suggested to manage those situations. ADO has an advantage of being capable of enhancing both hard and soft tissue simultaneously. PRESENTATION OF CASE: One of the possible complications of ADO is rotation ortilting the transport segment (TS). In this report, we present a 30-year old woman who had a severe anterior vertical deficiency. ADO was started to manage the case, but advancement of the TS lagged on the left side and the segment rotated. A SO was planned and the lagged side was corrected. Two years after the surgery, hard and soft tissue gains were found to be preserved. DISCUSSION: Vertical alveolar bone deficiencies are challenging cases for dental implantology. Alveolar DO promotes soft tissue along with hard tissue, and the bone regeneration process and shows lower infection rates and greater stability over the long term. However, the technique has some disadvantages and can lead to complications, such as breaking of the distraction device, nerve injury or paresthesia, fracture of transport bone, hematoma, wound dehiscence, severe bleeding, and even jaw fractures. Deviation of the TS from the distraction path is another undesired situation. The rigidity of the device, the width of the mucosa, the volume of the transport and anchor segments, and the amount of augmentation can affect vector deviation. CONCLUSION: We suggest that SO can be used in similar cases in which TS could not be distracted on a straight vector line. (C) 2015 Published by Elsevier Ltd. on behalf of Surgical Associates Ltd.
Comparative Evaluation of Simultaneous Maxillary Sinus Floor Elevation and Implant Placement with Residual Bone Heights Greater or Less than 5 mm
(2015) Soydan, Sidika Sinem; Cubuk, Secil; Bayrak, Burcu; Uckan, Sina; 25265126
Purpose: Implants can be inserted simultaneously during sinus floor elevation (SFE), or 6 months later, for posterior maxillary rehabilitation. The residual bone height (RBH) is a major factor that affects the type of surgical procedure that will be performed. The aim of this study was to compare the survival rates of implants inserted during one-stage SFE with two different RBHs (< 5 mm and >= 5 mm). Materials and Methods: This study consisted of implants inserted into an RBH of either < 5 mm or >= 5 mm, and the survival of the implants was assessed according to the clinical symptoms of the patients: pain or tenderness during function (or spontaneously), mobility, depth of probing, exudation history, and radiographic bone loss at the final follow-up appointment. The survival rates of the two groups were statistically compared using the Fisher exact test. Results: Fifty-nine consecutive patients (29 women and 30 men) undergoing a onestage sinus elevation procedure simultaneously with implant insertion were included in this study. Fifty-one implants were placed in the study group (RBH: 1 to 4.9 mm), and 31 implants were placed in the control group (RBH: 5 to 8 mm). The survival rate of the implants in the study group was 94.2% at the 5.4-year follow-up and 95.8% in the control group at the 7.9-year follow-up. There was no statistically significant difference between the groups in terms of the implant survival rate (P = .785). Conclusion: The results of this study suggest that SFE with simultaneous implant placement in patients with an RBH < 5 mm can be accomplished, and that the survival rate is similar to that of the one-stage SFE protocol with an RBH of > 5 mm.
Comparison of Success Rate of Dental Implants Placed in Autogenous Bone Graft Regenerated Areas and Pristine Bone
(2020) Altiparmak, Nur; Akdeniz, Sidika Sinem; Diker, Nurettin; Bayram, Burak; Uckan, Sina; 32282668
Autogenous 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.
Comparison of Tunnel and Crestal Incision Techniques in Reconstruction of Localized Alveolar Defects
(2017) Altiparmak, Nur; Uckan, Sina; Bayram, Burak; Soydan, Sidika; 28520823
Purpose: 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.
Dentofacial Effects of Skeletal Anchored Treatment Modalities For The Correction of Maxillary Retrognathia
(2014) Sar, Cagla; Sahinoglu, Zahire; Ozcirpici, Ayca Arman; Uckan, Sina; https://orcid.org/0000-0003-4966-9779; https://orcid.org/0000-0002-9250-3689; 24373654
Introduction: The aim of this clinical study was to investigate the skeletal, dentoalveolar, and soft-tissue effects of 2 skeletal anchorage rationales for Class III treatment compared with an untreated Class III control group. Methods: Fifty-one subjects who were in the prepubertal or pubertal growth period were included in the study. In group 1 (n = 17), facemasks were applied from miniplates placed in the lateral nasal walls of the maxilla, and intermaxillary Class III elastics were applied from symphyseal miniplates to a bonded appliance on the maxilla in group 2 (n = 17). These skeletal anchored groups were compared with an untreated control group (n = 17). Lateral cephalometric radiographs were obtained at the beginning and the end of the observation periods in all groups and analyzed according to the structural superimposition method. Differences between the groups were assessed with the Wilcoxon signed rank test or the paired-samples t test. Results: The treatment periods were 7.4 and 7.6 months in groups 1 and 2, respectively, and the untreated control group was observed for 7.5 months. The maxilla moved forward by 3.11 mm in group 1 and by 3.82 mm in group 2. The counterclockwise rotation of the maxilla was significantly less in group 1 compared with group 2 (P < 0.01). The mandible showed clockwise rotation and was positioned downward and backward in the treatment groups, and it was significantly greater in group 2 compared with group 1 (P < 0.01). Changes in the maxillary incisor measurements were negligible in group 1 compared with group 2. A significant amount of mandibular incisor retroclination was seen in group 1, and a significant proclination was seen in group 2. The maxillomandibular relationships and the soft-tissue profiles were improved remarkably in both treatment groups. Conclusions: The protocols of miniplates with facemasks and miniplates with Class III elastics offer valid alternatives to conventional methods in severe skeletal Class III patients. However, the 2 maxillary protraction protocols demonstrated significant skeletal and dentoalveolar effects. The miniplate with facemask protocol is preferred for patients with severe maxillary retrusion and a high-angle vertical pattern, whereas in patients with a decreased or normal vertical pattern and retroclined mandibular incisors, miniplates with Class III elastics can be the intraoral treatment option. Therefore, the exact indication of the procedure should be considered carefully.
Is The Incidence of Temporomandibular Disorder Increased in Polycystic Ovary Syndrome?
(2014) Soydan, Sidika Sinem; Deniz, Kagan; Uckan, Sina; Unal, Asli Dogruk; Tutuncu, Neslihan Bascil; https://orcid.org/0000-0002-3798-7326; https://orcid.org/0000-0002-1816-3903; 25124832; ABG-5027-2020
The prevalence of temporomandibular disorders is higher among women than men (ratio 3:1 -9:1). Polycystic ovary syndrome(PCOS) is the most common endocrine disorder in women, which is characterised by chronic low-grade inflammation and excess of androgenic hormones that lead to metabolic aberrations and ovarian dysfunction. Increased activities of various matrix metalloproteinases (particularly MMP-2 and 9) in the serum of these patients has been reported, and it has been hypothesised that high activities of MMP may contribute to loss of matrix and chronic inflammation of the fibrocartilage in temporomandibular disorders. Our aim was to evaluate the incidence of temopormandibular dysfunction in women with PCOS compared with an age-matched, disease-free, control group. We studied 50 patients with previously diagnosed PCOS and 50 volunteers who had normal menstrual cycles. We made a comprehensive clinical examination of the temporomandibular joint (TMJ) and muscles of mastication in both groups and recorded the Visual Analogue Scores (VAS) for pain. There were significant differences (p<0.001) in the incidence of temporomandibular disorders (n=43 (86%) in the PCOS group compared with n=12 24% in the control group), muscle tenderness(n=32 (64%) in the PCOS group compared with n=14 (28%) in the control group) and pain in the TMJ (mean (SD) VAS 2.9 (2.61) compared with 0.3 (1.56). We confirm the higher incidence and severity of disorders of the TMJ in patients with PCOS and suspect that chronic low-grade inflammation may play a part in the aetiology of the disease. Copyright (C) 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Lactobacillus rhamnosus could inhibit Porphyromonas gingivalis derived CXCL8 attenuation
(2016) Mendi, Aysegul; Kose, Sevil; Uckan, Duygu; Akca, Gulcin; Yilmaz, Dervis; Aral, Levent; Gultekin, Sibel Elif; Eroglu, Tamer; Kilic, Emine; Uckan, Sina; 27008259
An increasing body of evidence suggests that the use of probiotic bacteria is a promising intervention approach for the treatment of inflammatory diseases with a polymicrobial etiology. P. gingivalis has been noted to have a different way of interacting with the innate immune response of the host compared to other pathogenic bacteria, which is a recognized feature that inhibits CXCL8 expression. Objective The aim of the study was to determine if P. gingivalis infection modulates the inflammatory response of gingival stromal stem cells (G-MSSCs), including the release of CXCL8, and the expression of TLRs and if immunomodulatory L. rhamnosus ATCC9595 could prevent CXCL8 inhibition in experimental inflammation. Material and Methods G-MSSCs were pretreated with L. rhamnosus ATCC9595 and then stimulated with P. gingivalis ATCC33277. CXCL8 and IL-10 levels were investigated with ELISA and the TLR-4 and 2 were determined through flow cytometer analysis. Results CXCL8 was suppressed by P. gingivalis and L. rhamnosus ATCC9595, whereas incubation with both strains did not abolish CXCL8. L. rhamnosus ATCC9595 scaled down the expression of TLR4 and induced TLR2 expression when exposed to P. gingivalis stimulation (p<0.01). Conclusions These findings provide evidence that L. rhamnosus ATCC9595 can modulate the inflammatory signals and could introduce P. gingivalis to immune systems by inducing CXCL8 secretion.
Management of Bisphosphonate-Related Osteonecrosis of the Jaw With a Platelet-Rich Fibrin Membrane: Technical Report
(2014) Soydan, Sidika Sinem; Uckan, Sina; 24075235
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a challenging complication resulting from the long-term application of bisphosphonates. In most cases, BRONJ occurs after a surgical procedure involving the jawbone. Currently, the management of BRONJ remains controversial, and there is no definitive treatment other than palliative methods. Platelet-rich fibrin (PRF) represents a relatively new biotechnology for the stimulation and acceleration of tissue healing and bone regeneration. This technical note describes the total closure of moderate bone exposure in persistent BRONJ in 2 weeks with a double-layer PRF membrane. PRF may stimulate gingival healing and act as a barrier membrane between the alveolar bone and the oral cavity. PRF may offer a fast, easy, and effective alternative method for the closure of bone exposure in BRONJ. (C) 2014 American Association of Oral and Maxillofacial Surgeons
Psychosocial and Functional Outcomes of Orthognathic Surgery: Comparison with Untreated Controls
(2015) Sar, Cagla; Soydan, Sidika Sinem; Ozcirpici, Ayca Arman; Uckan, Sina; 0000-0002-9250-3689
Objectives: Orthognathic surgery is a procedure for patients with dentofacial deformities and provides dramatical dentofacial and psychological alterations. The aim of this controlled study was to evaluate how orthognathic surgery affects patients' psychosocial well-being and compare them with patients having dentofacial discrepancies and with individuals who do not have any skeletal discrepancies. Methods: Hundred and sixty-three adult individuals were included in this study as three groups: patients who underwent orthognathic surgery, patients having skeletal discrepancies and individuals who do not have any skeletal discrepancies. Patients in all groups were asked to fill out two questionnaires concerning the psychological and physical status of the patients at that moment and additional questions were asked to patients in post-surgical phase regarding post-surgical satisfaction. Categorical variables were statistically evaluated by Fisher Exact and chi-square tests. Results: Patients who were going to seek orthognathic surgery were significantly concerned about their dentofacial appearance, body image and psychosocial status when compared with patients in the post-surgical phase and the individuals who did not have skeletal discrepancies. The results of the patients who underwent orthognathic surgery were approximated to the results of non-patient control group and had high degrees of satisfaction with improvement in appearance brought about by surgery at 6-month post-operatively. Conclusion: Following orthognathic surgery, patients had better psychosocial status when compared to patients without skeletal deformities. Patients in the pre-surgical phase were not only functionally but also psychosocially the least satisfied group of individuals. (C) 2014 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI. Published by Elsevier Ltd. All rights reserved.
Radiological and Histological Evaluation of the Effects of Cortical Perforations on Bone Healing in Mandibular Onlay Graft Procedures
(2016) Dayangac, Emre; Araz, Kenan; Oguz, Yener; Bacanli, Didem; Caylak, Berrin; Uckan, Sina; 24889104
BackgroundPerforations of the cortical bone may be an advantage for the success of the autogenous bone graft procedure, but whether this perforation has a positive effect on the bone remains controversial. PurposeThis study evaluates the effects of cortical perforation of the autogenous bone block graft radiologically and histologically. Materials and MethodsSeven adult pigs were used for this study. On the experimental side, cortical perforation at the host site was prepared, while no perforation was done on the control side. The specimens were evaluated, and the Wilcoxon signed-rank test was used for statistical analysis. ResultsIn the radiological evaluation, the Wilcoxon signed-rank test indicated no significant differences in densities among the grafts (p=.23) with a mean of 4.290.951 for the unperforated graft side and 3.57 +/- 0.976 for the decorticated graft side. In histological evaluation, there was a significant difference in the thickness of the grafts between the groups (experimental group 3.71 +/- 1.286, control group: 4.71 +/- 0.488; p=.033). However, when the remodeling and osteoblastic activity in the grafts were measured, no significant differences were observed between the groups (p=1 and p=.133, respectively). ConclusionIn augmentation with mandibular onlay bone grafts, cortical perforations in the recipient site make no distinct contribution to bone healing within 12 weeks.
Sagittal skeletal correction using symphyseal miniplate anchorage systems: Success rates and complications
(2019) Cubuk, Secil; Kaya, Burcak; Sahinoglu, Zahire; Ates, Ufuk; Ozcirpici, Ayca Arman; Uckan, Sina; 30413832
ObjectivesAim of this study is to evaluate success rates and complications related with symphyseal miniplate anchorage systems used for treatment of Class2 and Class3 deformities.MethodsAtotal of 58miniplates applied to 29growing patients were evaluated. The first group comprised 24symphyseal miniplates applied to 12patients and Forsus Fatigue Resistant Devices were attached to the head of the miniplates for mandibular advancement. The second group consisted of 34symphyseal miniplates applied to 17patients and intermaxillary elastics were applied between acrylic appliances placed on the maxillary dental arch and the symphyseal miniplates for maxillary protraction. Success rate and complications of the symphyseal plate-screw anchorage system were evaluated.ResultsThe overall success rate of symphseal miniplates was 87.9%. Six miniplates showed severe mobility and 2miniplates broke during orthodontic treatment. Infection, miniplate mobility and mucosal hypertrophy were statistically different between the two groups.ConclusionsSymphyseal miniplates were generally used as successful anchorage units in most patients. Infection, mobility, and mucosal hypertrophy occurred more frequently in Class2 deformity correction. However, the success rates regarding the two treatment modalities were comparable. ZusammenfassungZieleZiel der vorliegenden Studie ist es, Erfolgsraten und Komplikationen im Zusammenhang mit symphysealen Miniplattenverankerungssystemen zur Behandlung von Klasse-II- und -III-Anomalien zu bewerten.MethodenAusgewertet wurden insgesamt 58Miniplatten, die bei 29Patienten im Wachstum inseriert wurden. In der ersten Gruppe wurden 24symphyseale Miniplatten bei 12Patienten inseriert. Zur Korrektur der Unterkieferrucklage wurden Forsus-Apparaturen an den Miniplatten verankert. In der zweiten Gruppe wurden 34symphyseale Miniplatten bei 17Patienten inseriert. Zur Protraktion des Oberkiefers wurden intermaxillare Elastics verwendet, die zwischen Acrylgeraten im Oberkiefer und den symphysealen Miniplatten eingehangt wurden. Untersucht wurden Erfolgs- und Komplikationsraten des symphysealen Platten-Schrauben-Verankerungssystems.ErgebnisseDie Gesamterfolgsrate der symphsealen Miniplatten betrug 87,9%. Bei 6Miniplatten zeigte sich eine hohe Mobilitat, 2frakturierten wahrend der kieferorthopadischen Behandlung. Das Auftreten von Infektion, Miniplattenmobilitat und Schleimhauthypertrophie war zwischen den beiden Gruppen statistisch unterschiedlich.SchlussfolgerungenSymphyseale Miniplatten wurden in der Regel bei den meisten Patienten als erfolgreiche Verankerungseinheiten eingesetzt. Infektion, Mobilitat und Schleimhauthypertrophie traten haufiger bei Klasse-2-Korrekturen auf, die Ergebnisse beider Behandlungsmethoden unterschieden sich jedoch nur geringfugig.
Short-Term Evaluation of Nasal Changes After Maxillary Surgery
(2014) Yilmaz, Alev; Polat-Ozsoy, Omur; Arman-Ozcirpici, Ayca; Uckan, Sina
Objective: To determine the nasal soft-tissue profile changes in skeletal Class III patients who underwent maxillary or bimaxillary orthognathic surgery. Materials and Method: This clinical retrospective study consists of 40 patients (19 male and 21 female) who had undergone orthognathic surgery. All patients received single jaw maxillary (9 patients) or bimaxillary surgery (31 patients). Standardized lateral cephalograms obtained before operation and at least 6 months after the operation were used. Twelve measurements (4 skeletal and 8 soft-tissue measurements) were made. The distributions of the variables were checked by Shapiro-Wilk test. Paired-samples t test was used for parametric data and Wilcoxon sign rank test for nonparametric data, to analyze the differences between pre- and postoperative measurements. Results: After orthognathic surgery, SNA and ANB increased; SNB decreased significantly. A significant reduction in nasofrontal angle, TH-Prn, and nasal tip projection and a significant increase in nasofacial angle were found. In addition, superior movement of the nasal tip was found, and as a result, the nasal hump decreased. The N-Sn/Pr ratio, nasal tip angle, and nasolabial angle did not show any significant changes. Conclusion: It can be concluded that more vertical nasal changes rather than sagittal nasal changes are observed after maxillary surgery.
Stress Distribution on Short Implants at Maxillary Posterior Alveolar Bone Model With Different Bone-to-Implant Contact Ratio: Finite Element Analysis
(2016) Yazicioglu, Duygu; Bayram, Burak; Oguz, Yener; Cinar, Duygu; Uckan, Sina; 26867093
The aim of this study was to evaluate the stress distribution of the short dental implants and bone-to-implant contact ratios in the posterior maxilla using 3-dimensional (3D) finite element models. Two different 3D maxillary posterior bone segments were modeled. Group 1 was composed of a bone segment consisting of cortical bone and type IV cancellous bone with 100% bone-to-implant contact. Group 2 was composed of a bone segment consisting of cortical bone and type IV cancellous bone including spherical bone design and homogenous tubular hollow spaced structures with 30% spherical porosities and 70% bone-to-implant contact ratio. Four-millimeter diameter and 5-mm-height dental implants were assumed to be osseointegrated and placed at the center of the segments. Lateral occlusal bite force (300 N) was applied at a 25 degrees inclination to the implants long axis. The maximum von Mises stresses in cortical and cancellous bones and implant-abutment complex were calculated. The von Mises stress values on the implants and the cancellous bone around the implants of the 70% bone-to-implant contact group were almost 3 times higher compared with the values of the 100% bone to -implant contact group. For clinical reality, use of the 70% model for finite element analysis simulation of the posterior maxilla region better represents real alveolar bone and the increased stress and strain distributions evaluated on the cortical and cancellous bone around the dental implants.