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    Is Autogenous Abdominal Fat Transplantation Into a Large Temporomandibular Joint Defect Following Removal of Failed Alloplastic Prosthesis a Definitive Treatment?
    (W B Saunders Co-Elsevier Inc, 2014) Tekin, Umut; Keller, Eugene E.; DeLone, David R.
    Purpose: To evaluate the long-term clinical outcome after the removal of failed major alloplastic temporomandibular joint (TMJ) implants and the placement of an autologous abdominal fat graft. Materials and Methods: A long-term clinical follow-up was performed in 4 patients who underwent removal of a failed alloplastic implant and insertion of an autologous abdominal fat graft under 1-stage surgical management. Postsurgical use of pain medication was documented and the vertical interincisal opening measurement was obtained at the follow-up visit. Long-term computed tomographic (CT) scans were available for 3 of 4 patients and evaluated for fat graft retention by a radiologist. Hounsfield units were used. Results: The study showed long-term(average, 4.7 years) clinical success, including normal jaw function (>= 30-mm vertical opening) and freedom from the use of pain-relieving medication. Long-term CT scans (average, 5 years after surgery) documented fat graft retention in 3 patients (-80 HU). Conclusion: Autogenous fat graft placement alone, after major TMJ alloplastic removal, provides excellent long-term clinical success. (C) 2014 American Association of Oral and Maxillofacial Surgeons
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    Pharyngeal airway space changes and stability following an extended LeFort-I osteotomy advancement in cleft lip and palate and non-cleft lip and palate patients: A long term comparison study
    (Elsevier, 2022) Tekin, Umut; Akdeniz, Berat Serdar; Keller, Eugene E.
    Purpose: The aim of this study was to evaluate effects of extended maxillary advancement osteotomy on pharyngeal airway space (PAS) in mid-facial deficient cleft lip and palate (CLP) patients and mid-facial deficient non-CLP patients. Methods: Pharyngeal airway space (PAS) of 10 CLP and 10 non-CLP patients with the mean age of 19 years 10 months was measured on digitized lateral cephalograms taken shortly before maxillary advancement operation with Quadrangular Le Fort I osteotomy (QLF-I) (T0), early post-operative, (T1) and long term post-operative (T2). Two way repeated analysis of variance, independent samples t-test and correlations tests were used for statistical analysis of airway and skeletal changes. Results: Total PAS depth and area was significantly increased after the advancement and was stable in long term post-operative period for CLP and non-CLP patients. Nasopharyngeal and velopharyngeal airway space depth and area was statistically increased at T1 and T2 for both groups. Oropharyngeal airway depth and area showed no significant statistical difference at any of the time points. The effect of QLF-I osteotomy on (PAS) was similar in both CLP and non-CLP patients. Conclusions: Nasopharyngeal, velopharyngeal, and total pharyngeal airway space depth and area increased after maxillary advancement with the QLF-I osteotomy; this increase was stable in long term follow up. Maxillary advancement with the QLF-I technique had no significant effect on oropharyngeal airway space depth and area in both CLP and non-cleft patients. (C) 2021 Elsevier Masson SAS. All rights reserved.
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    Superoxide dismutase activity in synovial fluids in patients with temporomandibular joint internal derangement
    (W B Saunders Co-Elsevier Inc, 2007) Güven, Orban; Tekin, Umut Saracoglu; Durak, Ker; Keller, Eugene E.; Hatipoglu, Murat
    Purpose: To measure the activity of superoxide dismutase (SOD) in the synovial fluid of patients with temporomandibular joint internal derangement and to show the relationship between the activity of SOD and the severity of the disease. Materials and Methods: Twenty patients with internal derangement were classified according to Wilkes by clinical radiological examinations. SOD activity was measured by the method based on nitrobluetetrazolium reduction rate. Results: The activity of SOD seemed to be progressively decreased as the stage of the disease increased. Conclusion: The reduction of SOD activity observed may result from insufficient scavenging capacity of free radicals. Further investigation and longitudinal studies are required to determine the role of antioxidants that scavenge the free radicals in temporomandibular joint disorders. (c) 2007 American Association of Oral and Maxillo/acial Surgeons.