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Öğe Allogenic versus Autogenous Bone Rings in Dental Implant Surgery: Guidance of Stress Analysis-Part II(Amer Scientific Publishers, 2018) Ozgul, Ozkan; Altay, Berkan; Atil, Fethi; Onder, M. Ercument; Tekin, Umut; Yilmaz, Seda; Kocyigit, Ismail DorukObjective The aim of this study is to compare the stress distribution along the alveolar bone following the allogenic and autogenous bone ring assisted immediate dental implant surgery using three dimensional finite element analyses Material and Methods Finite element models of maxilla and mandible that augmented with autogenous and allogenic bone ring graft with dental implant were created Vertical force of 100 N and oblique force of 100 N at 45(degrees) angle were applied to root formed design dental implant and abutment Results The highest calculated values of VonMisses (VM) stresses were observed in oblique loaded mandible model which augmented with allogenic graft In all models the highest VM stress values were greater for oblique loading compare to vertical loadings Allogenic bone ring grafts contribute the stresses more evenly through the implant, as for the autogenous grafts stresses are concentrated in the neck area of the implant Discussion Allogenic and autogenous grafts applied with implant placement create different stress distributions Stress distributions should be considered when choosing type of biomaterial.Öğe Choosing Implant Type for Using with Allogeneic Bone Ring Graft: Guidance of Stress Analysis-Part I(Amer Scientific Publishers, 2018) Ozgul, Ozkan; Kocyigit, Ismail DorukObjective: The aim of this study is to compare the stress distribution of three different implant macro design applied with allogeneic cancellous bone rings using three dimensional finite element analyses. Material and Methods: Finite element models of maxilla and mandible that augmented with allogeneic bone ring graft with implants were created. Vertical force of 100 N and oblique force of 100 N at 45 degrees angle were applied to three different (variable thread, cylindrical, standard thread) macro design implants. Results: Stress concentrations in the conjunction of neck of the implant and allogeneic bone ring were higher than other areas. The highest calculated values of Von Misses stresses were observed in standard thread implant with oblique loading in mandible model. In all models the highest stress values were greater for oblique loading compare to vertical loading. Discussion: Implant macro designs shows different distributions to implanted bone or graft. It should be considered when choosing an implant in the cases augmented with allogeneic cancellous bone ring.Öğe Clinical Evaluation of the Use of Tibial Bone Grafting in Dentoalveolar Reconstructive Surgery(Karger, 2016) Atil, Fethi; Kocyigit, Ismail Doruk; Suer, Berkay Tolga; Alp, Yunus Emre; Yazan, Murude; Tekin, Umut; Tuz, Hakan H.Objective: The aim of this study was to evaluate the efficacy of tibial autogenous bone grafting in the treatment of patients with alveolar bone defects. Materials and Methods: The study subjects consisted of 12 patients (10 male, 2 female, age: 19-51 years) who underwent reconstructive autogenous bone-grafting procedures. The medial approach to the tibial bone was used to harvest autogenous cancellous bone grafts in all the patients. Clinical parameters (complications at the donor and recipient sites, resorption and volume of the grafts) were evaluated retrospectively. Results: The mean age of the patients was 36.25 +/- 0.9 years. Of the 12 patients, 5 (41.7%) received bone grafts for sinus augmentation, 3 (25%) for cyst cavity reconstruction and 4 (33.3%) for alveolar cleft reconstruction procedures. The average follow-up period was 28.4 months (range: 21-40 months). An average of 5.2 cm(3) of cancellous bone was harvested for grafting procedures. All the grafting procedures were successful, and there were no surgical complications during the harvesting protocol. In all cases, pain and gait disturbance lasted less than 2 weeks. Conclusion: The results of this study suggest that the use of tibial autogenous bone graft harvested using a medial approach was a safe, simple and effective method for grafting various alveolar bone defects where high amounts of cancellous bone grafts were needed with low morbidity. (C) 2015 S. Karger AG, BaselÖğe Clinical Performance of Zygomatic Implants-Retrospective Multicenter Study(Mdpi, 2020) Davo, Ruben; Bankauskas, Simonas; Laurincikas, Remigijus; Kocyigit, Ismail Doruk; Sanchez de Val, Jose Eduardo MateThe main objective of this analysis was to evaluate (1) implant survival, (2) biologic complications, and (3) demographics associated with zygomatic implants placed according to the zygomatic anatomy-guided approach (ZAGA). This retrospective multicenter study reviewed data from the charts of 82 consecutive patients who had received 182 zygomatic implants. Patients were fully edentulous (62.2%), partially edentulous (22.0%), or had failing dentition (15.9%). Most patients (87.5%) did not have previous sinusitis and 11.3% had been previously treated for it. Additionally, about half of the patients (53.8%) did not present periodontal pathology, and one-third (36.3%) did, but were subsequently treated. Most implants (93.8%) were loaded immediately, i.e., within 48 h of placement. Implants were followed for 10.5 +/- 7.2 months, and all were recorded as surviving and stable at last follow-up. Post-operative complications were infrequent and included sinusitis (10.1%) and peri-implant hyperplasia (0.8%). The low complication rate and 100% implant survival and stability indicate that zygomatic implants offer a viable treatment option when performing graftless restoration of severely resorbed maxilla, including immediate loading protocols.Öğe Correction of Postsurgical Alveolar Ridge Defect With Vertical Alveolar Distraction of the Onlay Block Graft(Lippincott Williams & Wilkins, 2012) Kocyigit, Ismail Doruk; Tuz, Hakan H.; Alp, Yunus Emre; Atil, Fethi; Tekin, Umut; Coskunses, Fatih MehmetAlveolar bone augmentation for dental implant rehabilitation is one of the greatest challenges for oral and maxillofacial surgeons. Bringing out an inadequate quantity of vertical bone during augmentation compromises correct implant positioning and the resulting prosthetic restoration. Alveolar distraction osteogenesis is now generally used in correcting alveolar ridge atrophy due to trauma, congenital defects, or periodontal defects. Onlay block grafting is a suitable method for restoring the alveolar bony defects. However, it sometimes can become a complicated procedure to repair the horizontal defect accompanying a vertical defect using only bone blocks. This clinical report presents a successful reconstruction of a severe anterior mandibular alveolar bony defect as a result of impacted teeth extraction and periodontal problem in a 50-year-old healthy female patient. The defect was reconstructed with symphysis graft and platelet-rich fibrin in the first step. Vertical alveolar distraction was performed on the grafted site to maintain the suitable bony height 3 months later. Grafted bony segment distraction and the treatment options in similar cases were also discussed in this clinical report among with the literature.Öğe Effect of Locally Administered Alendronate on Onlay Grafts(Amer Scientific Publishers, 2017) Tekin, Umut; Ozgul, Ozkan; Tuz, Hakan; Korkusuz, Petek; Kocyigit, Ismail Doruk; Atil, Fethi; Onder, M. ErcumentObjective: The present study compared the effects of local alendronate application on the osteogenesis of autogenous and xenogenous onlay grafts implanted in rabbit mandibles. Material and Methods: 28 New Zealand rabbits were used in this experimental animal study. The animals were randomly divided into 4 groups according to graft material as follows: D1: autogenous graft-saline; D2: 60% autogenous graft-40% alendronate D3: xenogenous bone graft-saline; D4: 60% xenogenous graft-40% alendronate. 3 histologic parameters were evaluated: the ratio of new bone formation to the total defect area, the active osteoblast-lined bone length, and the ratio of osteocyte-filled lacunae to total lacunae. At the same time, the grafted zones were evaluated using dual-energy X-ray absorptiometry (DEXA) and the Bone mineral density scores were measured. Results: The present study showed better results for the group receiving alendronate applied to autogenous graft when compared to other groups. Discussion: The administration of alendronate increases the resistance of autogenous graft; it may also enhance new bone formation and increase the viability of xenograft. Further animal studies supported with biomechanical tests are required prior to human studies.Öğe Effect of Locally Applied bFGF on Implant Stability: Biomechanical Evaluation of 2 Different Implant Surfaces in Rabbits(Lippincott Williams & Wilkins, 2014) Kartal, Yasemin; Ucok, Cahit; Ozgul, Ozkan; Kocyigit, Ismail Doruk; Suer, Berkay TolgaObjectives: The aim of this study was to evaluate the implant stability with the addition of local application of basic fibroblast growth factor (bFGF) during the osseointegration of 2 different dental implant surfaces using rabbit tibia model. Materials and Methods: Fifty-six dental implants, 28 of hydrophilic surface (SLActive) and 28 of hydrophobic surface (OsseoSpeed), were placed in 14 mature New Zealand rabbits. The rabbits each received both SLActive and OsseoSpeed implants per tibia, and bFGF was applied locally on 1 randomly selected tibia. Half of the subjects were killed at the fourth week of healing period, and the other half were killed at the twelfth week. Stabilization was assessed using resonance frequency analysis (RFA) and removal torque value (RTV). Results: The local application of bFGF was found to enhance osseointegration, especially at the fourth week of healing period after application (P = 0.046). RFAs and RTVs were found to be higher in bFGF-treated implant with hydrophilic surfaces when compared with both bFGF-treated hydrophobic implants and nontreated hydrophilic controls. Conclusion: Local application of bFGF seems to increase the stabilization values in implants with hydrophilic surfaces and those with hydrophobic surfaces.Öğe Effect of Systemic Oxytocin Administration on New Bone Formation and Distraction Rate in Rabbit Mandible(W B SAUNDERS CO-ELSEVIER INC, 2020) Altay, Berkan; Dede, Eda Ciftci; Ozgul, Ozkan; Atil, Fethi; Kocyigit, Ismail Doruk; Orhan, Kaan; Tekin, UmutPurpose: The main disadvantage of distraction osteogenesis is the prolonged treatment protocol. Recently, oxytocin (OT) has been found to have anabolic effects on bone metabolism. In this experimental study, the effects of OT on the mandibular distraction gap in rabbits at 2 different distraction rates were evaluated. Materials and Methods: This experimental study was conducted on 28 male New Zealand white rabbits. The animals were divided into 3 experimental groups and 1 control group. Group A (control group, n = 7) consisted of animals with distraction at a rate of 1 mm/day, and group B (n = 7) consisted of animals with a distraction rate of 2 mm/day; groups A and B received postoperative saline solution injection. Group C (n = 7) consisted of animals with distraction at a rate of 1 mm/day, and group D (n = 7) consisted of animals with a distraction rate of 2 mm/day; postoperative OT injection was performed in groups C and D. Results: Both histomorphologic and micro-computed tomography evaluations showed increased bone healing in the OT-treated groups. Conclusions: On the basis of the evaluation of both the histomorphometric and micro-computed tomographic data, systemic OT administration was found to increase new bone formation and bone healing with distraction osteogenesis. (C) 2020 American Association of Oral and Maxillofacial SurgeonsÖğe Effects of Local Low-Dose Alendronate Injections Into the Distraction Gap on New Bone Formation and Distraction Rate on Distraction Osteogenesis(Lippincott Williams & Wilkins, 2017) Alp, Yunus Emre; Taskaldiran, Alper; Onder, Mustafa Ercument; Karahan, Siyami; Kocyigit, Ismail Doruk; Atil, Fethi; Tekin, UmutBisphosphonates that constrain bone resorption have a direct effect on osteoclast function. In this experimental study, the effects of low-dose local alendronate injections on the distraction gap (DG) in rabbit mandible at 2 different rates were evaluated. The experimental study was conducted on 20 male, New Zealand white rabbits. The animals were divided into 3 experimental groups and 1 control group. Group 1 consisted of animals with distraction at the rate of 1 mm/day, receiving postoperative local low-dose alendronate local injections into the DG. Group 2 consisted of animals with distraction at the rate of 2 mm/day, receiving postoperative 0.75 mu g/kg of alendronate local injections into the DG. Group 3 consisted of animals with distraction at the rate of 2 mm/day, receiving postoperative 0.2 mL local saline injections into the DG. Group 4 consisted of animals with distraction at the rate of 1 mm/day, receiving postoperative 0.2 mL local saline injections into the DG. All the injections were performed immediately postoperatively and for all groups at 1, 2, 3, and 4 weeks following surgery. The distraction zones were evaluated using dual-energy X-ray absorptiometry and histological analysis. Histologically, bone healing was found to be significantly accelerated in Groups 1 and 4 compared with Groups 2 and 3 (P<0.05). Bone healing was superior in Group 1 and the difference was statistically significant compared with Group 4. There was a significant increase in mean bone mineral density in the 1 mm daily rate groups (Groups 1 and 4) compared with the 2 mm daily rate groups (Groups 2 and 3) (P<0.05). Local low-dose alendronate injections could be an effective way for improving bone formation in distraction osteogenesis. Furthermore, the results of this study did not support the hypothesis that injections of local low-dose alendronate may allow 2 mm/day instead of 1 mm/day of elongation in the rabbit mandible.Öğe Evaluation of Advanced Platelet Rich Fibrin (A-PRF) on Bone Healing. Is It Better than Old Version? A Histological Animal Study(Amer Scientific Publishers, 2017) Titirinli, Kubra; Tekin, Umut; Atil, Fethi; Onder, M. Ercument; Senguven, Burcu; Ozgul, Ozkan; Kocyigit, Ismail DorukObjective: This study aims to evaluate the effect of fibrin, which is formed with an alteration to the standard PRF centrifugation protocol, on the bone formation. The study additionally aims to assess cell-distribution, and to evaluate the effects of alterations in the speed and duration of centrifugation on the changes in cell-distribution and the formation of hard tissue, by making histological investigations. Materials and methods: Ten New Zealand rabbits were used in this experimental animal study. PRF (2700 rpm, 12 min) and APRF (1500 rpm, 14 min) were placed in the standard bone defects that formed in the right corpus of the mandible randomly. No additional material was placed in the left mandible defect, as a control group. Rabbits were sacrificed after two months, the histological evaluation was performed. Results: There were no marked differences between groups in regard to the quantity of bone formation and bone quality. The quantities of new bone formation were (mean) 56.9%, 55%, 42.5%. Discussion: It may be considered that PRF and its variations have positive effects on the new bone tissue and cell number, and may lead to more rapid ossification compared to the unprocessed bone defects.Öğe Evaluation of Preoperative Model Surgery and the Use of a Maxillary Sinus Surgical Template in Sinus Floor Augmentation Surgery(Lippincott Williams & Wilkins, 2013) Kocyigit, Ismail Doruk; Coskunses, Fatih Mehmet; Ozgul, Ozkan; Tuz, Hakan Hifzi; Kartal, Yasemin; Polat, Muhlis; Orhan, KaanMaxillary sinus augmentation is an accepted technique for dental implant placement in presence of insufficient maxillary bone. There are various techniques in the literature, either by crestal or lateral approach in maxillary sinus augmentation that have high percentage of success, while all have complications. Schneiderian membrane perforation is the most common complication encountered during surgery. The aim of this study was to evaluate the benefits of preoperative model surgery and the ease of use of a maxillary sinus surgical template (MSST) during maxillary sinus augmentation surgery with a lateral approach. Ten patients included in the study needed rehabilitation of a partially or totally edentulous maxilla with an implant-supported fixed prosthesis and requiring sinus augmentation. A questionnaire was asked to performing surgeons, and study results showed the use of an MSST was found to be effective in terms of adaptation (62.5%), window preparation (87.5%), ease of elevation (95.9%), ease of grafting (95.9%), reduction of perforation risk (91.7%), and achieving immobility during the procedure (62.5%); however, the use of an MSST was also found to prolong the surgical procedure (100%) and restrict the view of the surgical area (79.2%). Maxillary sinus augmentation appears to be a useful tool for locating an appropriate entrance to the sinus cavity, allowing for safe elevation of the sinus membrane and effectively grafting the sinus floor.Öğe Finite-Element Analysis of a New Designed Miniplate which is Used via Intraoral Approach to the Mandible Angle Fracture: Comparison of the Different Fixation Techniques(Lippincott Williams & Wilkins, 2015) Coskunses, Fatih Mehmet; Kocyigit, Ismail Doruk; Alil, Fethi; Tekin, Umut; Suer, Berkay Tolga; Tuz, Hakan Hifzi; Yagiz, AyberkThe mandible is the largest facial bone as well as the most commonly fractured bone in the maxillofacial region. Despite numerous studies conducted to identify optimal treatment modalities and plates configurations for intraoral and transoral approaches, no definitive conclusion has been reached. This study used finite element analysis (FEA) to assess 4 scenarios for treatment of an angle fracture (6-hole noncompression miniplate; 6-hole single plate/Champy's technique, 3D strut plate; 2 parallel 4-hole noncompression miniplates). Analysis included segmental displacement and Von Mises Stress evaluations of a 3D reconstruction of a human mandible. Von Mises Stress values for plates did not vary significantly among treatment groups. Moreover, no significant differences were observed in cumulative displacement of segments subjected to vertical and horizontal loads, with all treatment configurations demonstrating clinical acceptability.Öğe Oral rehabilitation with implant-supported fixed dental prostheses of a patient with cleidocranial dysplasia(Mosby-Elsevier, 2018) Atil, Fethi; Culhaoglu, Ahmet; Kocyigit, Ismail Doruk; Adisen, Zahit; Misirlioglu, Melda; Yilmaz, BurakThis clinical report describes the oral rehabilitation with implant-supported fixed dental prostheses in the maxilla and mandible of a patient with cleidocranial dysplasia. Cone-beam computed tomography and a tilted implant protocol in the mandible helped to establish a conservative approach for bone preservation, prevent surgical complications, enable proper implant positioning to avoid anatomic structures, and support the fixed dental prostheses.Öğe Piezosurgery Versus Conventional Surgery in Radicular Cyst Enucleation(Lippincott Williams & Wilkins, 2012) Kocyigit, Ismail Doruk; Atil, Fethi; Alp, Yunus Emre; Tekin, Umut; Tuz, Hakan H.Objective: This study compared the use of piezosurgery and conventional surgery in radicular cyst enucleation. Study Design: The study was conducted with 29 patients who were radiologically and cytologically prediagnosed with radicular cysts in the jaw region. Nineteen patients were treated using piezosurgery, and 10 were treated using conventional surgical procedures. Surgical procedures were evaluated according to the following criteria: hemorrhage, soft-tissue damage, manipulation complexity, major perforation areas on the enucleated cyst tissue, and approximate operation duration. Patients were monitored postoperatively and evaluated for hemorrhaging at 24, 48, and 72 hours following surgery. Follow-up was conducted to check for recurrences and ranged from 5 to 24 months. Results: No complications were observed in any of the 20 patients treated using piezosurgery, although the duration of surgery was longer than expected. Of the 10 patients treated using conventional methods, hemorrhaging that affected the operation occurred in 3 cases, perforation of the cyst epithelium and difficulties in enucleation occurred in 5 cases, postoperative hemorrhage occurred in 2 cases, and recurrence was observed in 2 cases. Conclusions: Piezosurgery may be considered effective in procedures such as enucleation that require sensitive manipulation, despite the increase in the length of the overall surgical procedure. Given the results of the present study and the current lack of information in the literature regarding postoperative pain, infection, and long-term success rates associated with the use of piezosurgery in cyst enucleation, further study in this area is recommended.Öğe A Simple Solution for Vector Control in Vertical Alveolar Distraction Osteogenesis(Allen Press Inc, 2014) Kocyigit, Ismail Doruk; Tuz, Hakan H.; Ozgul, Ozkan; Coskunses, Fatih Mehmet; Kisnisci, Reha S.One of the important and frequent complications in alveolar distraction osteogenesis is vectorial change of the transport segment. This report presents a simple solution for vector angulation control by placing intermaxillary fixation screws intraoperatively. Advantages of the technique are also discussed.Öğe Spontaneous Healing of Mandibular Noncontinuous Defect Caused by Medication-Related Osteonecrosis of the Jaw(Lippincott Williams & Wilkins, 2016) Yazan, Murude; Atil, Fethi; Kocyigit, Ismail Doruk; Tekin, Umut; Tuz, Hakan Hifzi; Misirlioglu, MeldaBackground: Bisphosphonates are used throughout supportive cancer therapies for the treatment of osteoporosis and metastatic bone diseases, but they invariably induce medication-related osteonecrosis of the jaw (MRONJ). This medicational modality may induce consequential losses that can lead to spontaneous or surgical therapy related bone fractures or defects. MRONJ stages and treatment alternatives are described in the current procedures. Accordingly, treatments for stages 0 and 1 are conservative whereas the treatment for stage 3 is surgical resection of the necrotic bone. Stage III MRONJ therapy is still controversial within the scope of conceivable bone fractures or defects. When the development of MRONJ is refractory to conventional treatment modalities, surgical management can be suggested. The aim of this study was to evaluate the results of the surgical treatment of MRONJ as part of a medical patient. Methods: A 72-year-old man was referred to our department for extensive pain of the left mandibular region that occurred after tooth extraction. It was identified in his medical history that he had received a nitrogen-containing intravenous bisphosphonate (Zometa; Novartis, East Hanover, NJ) therapy for prostate cancer. He had been administered 4 mg. IV Zolenat 9 times during the first year of therapy, followed by 2 doses of the same amount of Zolenat in the second year. Results: The treatment started with a therapy that combined antibiotics and antibacterial mouth rinse with chlorhexidine for maintaining oral hygiene. After the maturity of the sequestrum was identified through radiographic examination, the patient was treated by the segmental resection of the extensive necrotic bone, resulting in discontinuity of the mandibular corpus. Two years later, spontaneous bone healing occurred along the residual defect on the mandible. Conclusion: Treatment options for the defects resulting from MRONJ are still under debate, and no evidence-based guidelines are available. However, due to the results displayed in this patient; it may be a sound approach to closely follow up and observe MRONJ-related bone to prevent additional complications.Öğe Stress Analysis of Zygomatic Implants on the Augmented Maxillary Sinus: Is It Necessary to Graft?(Lippincott Williams & Wilkins, 2017) Kaman, Suleyman; Atil, Fethi; Tekin, Umut; Ozgul, Ozkan; Onder, Mustafa Ercument; Yilmaz, Seda; Kocyigit, Ismail DorukPurpose: Zygomatic implants are becoming an ideal therapy with advanced implant-supported prosthetic treatment for the posterior atrophic maxilla. The purpose of this study is to examine the quantity and distribution of stress, which was caused by zygomatic implants placed using intrasinus method with or without augmentation to the atrophic posterior maxilla. Materials & Methods: In this study, 3-dimensional atrophic edentulous maxilla models with and without sinus augmentation are designed with computer-aided programs. Stress analysis was carried out on the created computer models for maxillary alveolar cortical bone, for cortical bone in the zygomaticomaxillary suture, and for zygomatic spongy bone at the apex of the zygomatic implant and for metal substructure of Von Misses stress data. Results: Having augmented the maxillary sinus with graft, it was observed that after the loading especially in the posterior region, the tensile and compressive stresses on the alveolar crest was distributed more homogeneously and the stress generated on the cortical bone was reduced through the graft. Conclusion: Although zygomatic implants are graftless solutions for athrophic maxilla, sinus augmentation will be useful for bearing stress around the implants.
