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Öğe Büyük Agresif Bir Santral Dev Hücreli Granuloma Birlikte Tedavisi (Olgu Sunumu)(2017) Koparal, Mahmut; Alan, Hilal; Gülsün, Belgin; Ağaçayak, K. Serkan; Erdoğdu, I. HalilSantral Dev Hücreli tümörler; çene tümörleri içinde kadınlarda ve mandibulada sık görülürler ve yaşamın ikinci dekatında daha sıktırlar. Tedavisinde lokal küretaj, parsiyel rezeksiyon ve total rezeksiyon uygulanabilir. Bu vaka raporunda 32 yaşında kadın hasta anterior mandibulada ağrı şikayetiyle kliniğimize başvurdu. Fiziksel muayenede servikal lenfadenopati saptanmadı. İntraorol muayenede ülserasyon saptanmadı fakat vestibül bölgede hassasiyet mevcuttu. Bununla beraber dişlerde ve dudakta his kaybı yoktu. Bu vaka raporunda 32 yaşında kadın hastada mandibula basisinde yaygın kemik kaybına neden olan santral dev hücreli tümörün parsiyel rezeksiyon ile tedavisi sunuldu.Öğe Effects of Potentilla fulgens as a Prophylactic Agent in Tibial Defects in Rats(Sci Printers & Publ Inc, 2016) Koparal, Mahmut; Irtegun, Sevgi; Alan, Hilal; Deveci, Engin; Gulsun, Belgin; Seker, UgurOBJECTIVE: To investigate the effects of Potentilla fulgens as a prophylactic agent on tibial defects in the rat. STUDY DESIGN: Twenty-eight male Wistar albino rats weighing 200-215 g each were divided into 3 experimental groups. The tibial bone defect group served as the control group. The experimental groups were Potentilla fulgens with tibial defect (14 days) and Potentilla fulgens with tibial defect (28 days). Extract of Potentilla fulgens was mixed with water (400 mg/kg/day) and given to groups 14 and 28 as drinking water. The histopathological and immunohistochemical characteristics of each tibial bone cavity within each group were observed. The trabecular new bone formation was evaluated by expression rate of osteonectin and osteopontin. RESULTS: In the Potentilla fulgens + tibial defect group (14 days), trabecular bone had started combining extensive new bone formation, osteocyte cells were evident, and lamellar bone was formed. Osteoblasts showed a positive reaction with osteonectin. Osteopontin expression was positively observed between fibrous structures and in the osteoblast and osteocyte cells. This can be considered indicative of new bone formation. In the Potentilla fulgens + tibial defect group (28 days), an increase in expansion in trabecular bone and myeloid tissue was observed. Osteoblastic activity and osteocyte cells began to be observed in new bone fragments. CONCLUSION: In our study we show that Potentilla fulgens extract provided a protective effect on new bone formation and aided in the development of osteocytes and secretion of matrix in osteoblasts. Additionally, we show the inductive effect of the extract on new bone formation. In particular, the expression of osteopontin and osteonectin was also supported with the Western blot technique on the development of osteoblasts and osteocytes, showing a similar trend with our results.Öğe The effects of recombinant human bone morphogenic protein-2 and low-level laser irradiation on synthetic graft healing in a rat bony defect model(E-Century Publishing Corp, 2016) Koparal, Mahmut; Kose, Ibrahim; Atalay, Yusuf; Cakmak, Omer; Alan, Hilal; Agacayak, Kamil Serkan; Erdogdu, Ibrahim HalilWe assessed the benefit of bone morphogenic protein-2 (BMP-2) and low-level laser irradiation (LLLI) on the osseointegration of synthetic bone grafts. Synthetic bone grafts are safe alternatives to autografts. BMP-2 and LLLI have been shown separately to improve bone healing. However, their effects have not been evaluated together with synthetic materials. Here, we used a rat model to compare the efficacy of BMP-2 and LLLI on synthetic graft healing. Male Sprague-Dawley rats (n = 35) were divided equally into groups: control (defect only), graft only, graft and BMP-2, graft and LLLI, and a combination of graft, LLLI, and BMP-2. A 3 x 3 mm monocortical tibial defect was filled using a synthetic graft with or without 2 mg/mL BMP-2 pre-treatment. LLLI was performed using an optical fibre and an indium-gallium-arsenide-phosphate laser for 60 s daily for 7 days, delivering 6.0 J/day. Histopathology was performed 4 weeks post-graft using a standardised scoring system (1-5, based on the degree of healing observed). Groups were compared using the MannWhitney U test, with p values < 0.05 considered significant. Osteogenesis was poor in both the control and graft-only groups (1.4 +/- 0.5 and 2.3 +/- 0.5, respectively). BMP-2-(4.3 +/- 0.5), LLLI-(3.7 +/- 0.5), and BMP-2/LLLI-treated (4.7 +/- 0.5) grafts all displayed significantly more healing than the control or graft alone groups (P < 0.001). Both BMP-2 and LLLI significantly improved the osseointegration of synthetic bone grafts. However, no synergy was noted between the therapies.Öğe Guided bone regeneration with local zoledronic acid and titanium barrier: An experimental study(Spandidos Publ Ltd, 2016) Dundar, Serkan; Ozgur, Cem; Yaman, Ferhan; Cakmak, Omer; Saybak, Arif; Ozercan, Ibrahim Hanifi; Alan, HilalThe aim of this study was to evaluate the effects on new bone formation of autogenous blood alone or in combination with zoledronic acid (ZA), a -tricalcium phosphate (-TCP) graft or ZA plus a -TCP graft placed under titanium barriers. For this purpose, eight adult male New Zealand white rabbits were used in the study, each with four titanium barriers fixed around four sets of nine holes drilled in the calvarial bones. The study included four groups, each containing 2 rabbits. In the autogenous blood (AB group), only autogeneous blood was placed under the titanium barriers. The three experimental groups were the AB+ZA group, with autogenous blood plus ZA, the AB+-TCP group, with autogeneous blood plus a -TCP graft, and the AB+-TCP+ZA group, with autogeneous blood plus a -TCP graft and ZA mixture under the titanium barriers. The animals were sacrificed after 3 months. The amounts of new bone formation identified histomorphometrically were found to be higher after 3 months than at the time of surgery in all groups. The differences between the groups were examined with histomorphometric analysis, and statistically significant differences were identified at the end of the 3 months. The bone formation rate in the AB+-TCP+ZA group was determined to be significantly higher than that in the other groups (P<0.05). In the AB+ZA and AB+-TCP groups, the bone formation rate was determined to be significantly higher than that in the AB group (P<0.05). No statistically significant difference in bone formation rate was observed between the AB+-TCP and AB+ZA groups. Local ZA used with autogeneous blood and/or graft material appears to be a more effective method than the use of autogeneous blood or graft alone in bone augmentation executed with a titanium barrier.Öğe Human papilloma virus(2016) Gunduz, Derya Toprak; Unsal, Haluk Yener; Gülsün, Belgin; Alan, Hilal; Erdogdu, Halil Ibrahim; Koparal, Mahmutİnsan Papilloma Virüsü (HPV) papillomaviridae ailesinden çift sarmal yapıya sahip bir DNA virüsüdür. HPV epidermisin ve mukoz membranın çok katlı yassı epitelinde benign ve malign değişikliklere neden olur. HPV baş, boyun, ürogenital organlar, deri ve mukoz membranlarda görülen birçok benign ve malign lezyonların etyolojik faktörleri arasında gösterilmektedir. HPV'nin baş boyun bölgesinde gözlenenskuamöz hücreli karsinomanın patogenezinde rol aldığı ilk olarak 1983 yılında oral kanser ve HPV enfeksiyonu arasındaki benzerlik gösterildikten sonra anlaşıldı. Oral skuamöz hücreli karsinomada etiyolojik faktör olduğu için HPV enfeksiyonu orofarengeal bölge ile ilişkili kanserlerin bir alt grubu olarak ele alınabilir. Bu özellikleri nedeniyle Maksillofasiyal Cerrahinin ve Diş Hekimliğinin yakın ilgi alanına girmiştir. Birçok HPV ile iliskili enfeksiyonda özellikle tarama, oral bulgular, erken teshis ve tedavi büyük öneme sahiptirÖğe Maksiller sinüs yükseltilmesi operasyonlarında, doğal mineralize hidroksilapatit greftleri ile trombositten zengin plazma karıştırılmış doğal mineralize hidroksilapatit greftlerinin klinik, radyolojik, histomorfolojik karşılaştırılması(Dicle Üniversitesi, 2009) Alan, HilalGünümüzde total ya da parsiyel dişsizliğin tedavisinde osseointegre implantların kullanımı yaygınlaşmıştır. Maksiller posterior bölgede uygulanması planlanan implantların operasyonu bölgedeki anatomik oluşumlar yönünden komplikedir. Maksiller sinüsün sarkması, maksillanın atrofisi sonucu oluşan yetersiz kemik hacmi nedeni ile bu bölgelere herhangi bir müdahale yapmadan implant yerleştirilmesi imkansızdır.İmplant uygulaması için gerekli olan vertikal kemik miktarının arttırılması için sinüs tabanının yükseltilmesi ve greftlenmesine ihtiyaç vardır. Sinüs tabanı elevasyonu dental implant uygulamasını mümkün kılan, interark mesafesinde azalmaya sebep olmayan, vertikal kemik mesafesini arttırmayı amaçlayan maksiller sinüsün internal yükseltilmesidir. Yeterli kemik hacmini oluşturmak için otojen kemik grefti öncelikli olmak üzere çeşitli greftleme yöntemleri tanımlanmıştır.Son yapılan çalışmalar trombositten zengin plazma gibi otojen kaynaklı biyoaktif mediatörler ile kombine edilmiş greftlerin kemik oluşumunu hızlandırdığını bildirmiştir.Yetersiz kemik hacmi olan dişsiz maksillanın endoosseoz implantlar kullanarak protetik tedavisi sinüs elevasyonu ve greftleme işlemleri ile mümkündür, kemik oluşumunun hızlanması için biyoaktif mediatörlerin kullanımının uygun olacağı düşünülmektedir.Bu tez çalışmamızın amacı, implant uygulaması mümkün olmayan atrofik maksiller posterior bölgelere yeterli kemik hacmini oluşturmak için sinüs tabanı elevasyonu ve greft materyalleri uygulanarak elde edilen kemiğin kalite, kantite, boyut ile kemiğin iyileşme süresinin klinik, radyolojik, histolojik ve histomorfometrik olarak değerlendirilmesidir.Tez çalışmamızda Dicle Üniversitesi Diş Hekimliği Fakültesine başvuran iyileşmeyi etkileyen sistemik hastalığı olmayan, maksiller sinüste sarkıklık ve kemik atrofisi bulunan 16 hastaya lokal anestezi altında 22 sinüs yükseltme operasyonu uygulanmıştır. Operasyon öncesi bütün hastalardan panoramik grafi ve koni ışınlı 3 boyutlu dental tomografi (i-CAT®, USA ) alındı. Sinüs yükseltme işleminin 12‘si doğal mineralize hidroksilapatit kullanılarak (HA, Apatos, OsteoBiol®) yapıldı ve kemik penceresine rezorbe olabilen bir kollajen membran (Evolution Membran, OsteoBiol®) yerleştirilerek mukoperiostal flep primer kapatıldı. Diğer 10 sinüs yükseltme operasyonunda doğal mineralize hidroksilapatit ile hastaların kendi kanından elde edilen trombositten zengin plazma (TZP) karışımı kullanıldı ve kemik penceresine rezorbe olabilen membran yerleştirilip mukoperiostal flep primer kapatıldı. Birinci hasta grubunun 10’u 8 ay iyileşme sürecinin, ikinci hasta grubu ise 4 ay iyileşme sürecinin ardından panoramik grafi ve bilgisayarlı tomografiler alındıktan sonra trefin frezlerle kemik biyopsisi alınıp dental implantlar yerleştirildi. Birinci hasta grubundaki 2 hastadan 4. ayın sonunda biyopsi örneği alındı. Alınan biyopsi örnekleri histolojik ve histomorfometrik olarak değerlendirildi.Sonuç olarak; yapılan sinüs yükseltme operasyonlarının ardından hastalarda ortalama 10,6 mm yeni kemik oluşumu sağlanmıştır. TZP+Doğal mineralize hidroksilapatit uygulanan hastalardan 4. ayda alınan kemik biyopsilerinin histolojik incelemesinde doğal mineralize hidroksilapatit uygulanan gruptan 8. ayda alınan kemik biyopsilerinin histolojik incelemesine göre matür kemiğin, trabeküler lamellerin ve osteoid dokunun daha fazla, olduğu saptanmıştır. Ancak gruplar arasında istatistiksel olarak anlamlı bir fark bulunmamıştır. Osseointegrated oral implants are widely used to restore total or partial edentulism. İmplant placement in the posterior maxilla is often complicated due to the insufficient bone volume caused by atrophy of the maxillae and pneumatization of the maxillary sinus.The sinus floor elevation is an internal augmentation of the maxillary sinus, which is intended to increase the vertical bony dimension in the lateral maxilla in order to make the use of dental implants possible. Many techniques have been described to achieve grafting of the maxillary sinus mucosa.Resent efforts to improve wound healing have focused on autogenous sources of bioactive mediators, such as platelet-rich plasma which offer the potential to enhance the biological activity of bone replacement grafts. Prosthetic rehabilitation of the edentulous maxilla using endosteal implant is able to sinus elevation and grafting. It is supported that using of bioactive mediators appropriates for improve bone regeneration time. In our study, for the cases where implant is not possible at atrophic maxillary posterior parts, sinus base elevation and graft materials were applied in order to build the necessary bone volume. The aim of this thesis study is to evaluate the produced bone’s quality, quantity, volume and period of healing process clinically, radiologically, histologically and histomorphogicaly. 22 sinus elevation operations under local anesthesia performed on 16 patients who had applied to Dicle Dentistry Faculty, with no systemic illnesses which may affect healing. Before operations, panoromic graphy and conical beam 3D dental tomographies (i-CAT®, USA ) of all patients were taken. 12 of sinus elevation operations were performed by using natural mineralized hydroxyapatite (HA, Apatos, OsteoBiol®) and then mucoperiosteal flap premier was closed by installing a collagen membrane (Evolution Membran, OsteoBiol®) that can be resorbed on bone window. In other 10 sinus elevation operations, along with mineralized hydroxyapatite, platelet-rich plasma (PRP) mixtures produced from the patients’ own blood samples were used. Then mucopeirosteal flap premier was closed by installing a collagen membrane that can be resorbed on bone window. Panoromic graphy and computerised tomographies of the first group of patients were taken following a-8 month-healing period and for the second group following a-4-month healing period. After that, following bone biopsy taken through trephine frezzes, dental implants were installed. At the end of 4 month healing period, biopsy samples were taken from 2 patients in the first group. The samples were evaluated histomorphologically. Resultly; In histomorphologic evaluation, core biopsies taken from patient using PRP+Natural Mineralized Hidroxylapatit after 4. month were seen greater bone formation, osteoid tissue and lameller matrix. But no significant differences were statistically observed between them.Öğe Verrucous carcinoma and squamous cell papilloma of the oral cavity: Report of two cases and review of literature(Dental Investigations Society, 2015) Alan, Hilal; Aǧaçayak, Serkan; Kavak, Gülten; Özcan, AyşeVerrucous carcinoma (VC) of oral cavity is a rare variant of well-differentiated squamous cell carcinoma and squamous papilloma is a benign proliferation of the stratified squamous epithelium, which results in a papillary or verrucous exophytic mass. There is a certain clinical similarity between squamous cell papilloma and VC. We presented a report of two cases which are VC and squamous cell papilloma that are showed the same clinical appearance but different pathological appearance, with a review of the literature.Öğe WhatsApp messaging improves communication in an oral and maxillofacial surgery team(Elsevier Ireland Ltd, 2019) Koparal, Mahmut; Unsal, Haluk Yener; Alan, Hilal; Uckardes, Fatih; Gulsun, BelginObjective: Smartphones have become very popular among oral and maxillofacial surgeons. WhatsApp is an application that enables users to send voice, text, and multimedia messages using the group communication feature. The purpose of this study was to evaluate the efficiency of WhatsApp messaging as a mode of consultation within an oral and maxillofacial surgery team. Materials and methods: A retrospective study on WhatsApp group conversations amongst oral and maxillofacial surgeons was performed between July 2015 and July 2016. A WhatsApp group consisting of senior and junior surgeons was created, and many consultations were recorded. Seven hundred fifty-six consultations were included in the study. In this study, the arrival and response times of messages, types of cases, timing of consultation's end, consultant locations, contents of multimedia messages, and the categories/types of messages were evaluated. During consultations, some cases were discussed with text messages via WhatsApp, and some cases with voice and image messages via WhatsApp, with or without WhatsApp text messages. In addition, several cases were discussed with video messages via WhatsApp. Thus, a total of 1747 messages reflecting four different message types were included in this study: 754 (43%) were text messages, 752 (43%) were photographic images, 213 (12%) were videos, and 28 (nearly 2%) were voice messages. Results: The most frequent consultations concerned impacted teeth (n = 363, 48.01%). Most consultations were resolved using WhatsApp (n = 306, 64.4%), and consultants were often not in the hospital during these consultations (n = 411, 54.3%). Most messages sent by consultants were conclusive (n = 306, 74.4%). Conclusion: We conclude that WhatsApp is a simple, free, and practical application, which allows efficient consultation when consultants are not in the hospital.
