Kamil Serkan Agacayak

Background: Menopause is characterized by the permanent cessation of menstruation and the loss of estrogen-related protective effects on systemic bone metabolism. One of the major consequences of this hormonal alteration is accelerated bone loss and deterioration of bone microarchitecture. Reduced estrogen levels lead to a decrease in bone mineral density and markedly increase the likelihood of osteoporosis development. Objective: The present study aims to systematically assess postmenopausal changes affecting both the volume of graft material that can be harvested from intraoral autogenous block graft donor regions and the relative radiographic bone density characteristics of these grafts, assessed using CBCT-derived Hounsfield Unit (HU) values. Materials and methods: The study population comprised patients who had undergone cone-beam computed tomography (CBCT) at the Faculty of Dentistry for various clinical purposes. Participants were categorized into two groups based on menopausal status. The first group included 30 female individuals between the ages of 20 and 40, while the second group consisted of 30 female patients over the age of 55 who had been diagnosed with menopause by a gynecologist, based on prior hormonal assessments (FSH, LH, and estrogen), and who had experienced at least five years since the onset of menstrual irregularity. Information regarding menopausal status, hormonal assessment findings (FSH, LH, and estrogen levels), medical history, and systemic conditions was retrospectively obtained from the patients’ electronic medical records and archived clinical charts. In total, 60 patients were enrolled in the study. Hounsfield Unit (HU) measurements and graft volume estimations—derived using the Cavalieri principle—were extracted from the CBCT data. In the statistical evaluation, differences between the two independent groups were analyzed using the Student’s t-test for variables with normal distribution, whereas the Mann–Whitney U test was applied to data that did not meet normality assumptions. Results: The findings indicate that menopausal status, along with its accompanying physiological alterations, adversely affects intraoral autogenous block graft donor regions, specifically the ramus and tuberosity. However, in postmenopausal women, the symphysis donor site did not demonstrate any statistically significant variation. Conclusion: Hormone-related skeletal alterations that emerge in the postmenopausal period, particularly osteoporosis, should be recognized as a potential risk determinant in the context of surgical planning. This consideration is especially relevant for oral and maxillofacial surgeons performing procedures that utilize intraoral autogenous block graft donor sites.

Background: The pterygomaxillary region is a complex anatomical area formed by the junction of the maxillary, palatine, and sphenoid bones and contains critical neurovascular structures. Accurate assessment of this region during Le Fort I osteotomy is essential, particularly to prevent hemorrhage and nerve injury that may occur during the pterygomaxillary separation phase. This study aims to investigate the morphometric characteristics of the pterygomaxillary region using cone-beam computed tomography (CBCT) and to evaluate the effects of age, sex, and laterality on these anatomical parameters. Materials and Methods: In this retrospective study, CBCT scans of 200 individuals (100 males and 100 females) aged 20–80 years were analyzed. Axial measurements included distances between the piriform rim, the descending palatine artery, the pterygomaxillary osteotomy line, and the pterygomaxillary fissure. Additionally, the thickness and width of the pterygomaxillary region and pterygoid process, lengths of the medial and lateral pterygoid laminae, and the distance between the greater palatine canal and the medial pterygoid lamina apex were recorded. Measurements were statistically evaluated by sex, age group, and laterality. Results: The following parameters demonstrated statistically significant differences based on the conducted measurements: The distance between the piriform rim and the descending palatine artery was significantly greater on the left side (p < 0.001). The length of the lateral pterygoid lamina increased with advancing age (p = 0.048). The thickness of the pterygomaxillary region was significantly greater in females (p = 0.014). Additionally, the distance between the greater palatine canal and the terminal point of the medial pterygoid lamina was significantly higher in males (p < 0.001). Conclusions: The pterygomaxillary region exhibits anatomical variations that may lead to serious complications during Le Fort I osteotomy. Detailed preoperative evaluation of this area using CBCT can guide surgical planning and help prevent potential vascular and neural complications.

Amaç: Bu retrospektif çalışmanın amacı, 2008-2019 yılları arasında Dicle Üniversitesi, Diş Hekimliği Fakültesi, Ağız Diş Çene Hastalıkları ve Cerrahisi Anabilim Dalı’na başvuran travmaya bağlı maksillofasiyal kırık izlenen hastaların demografik dağılımını ve tedavi yöntemlerini geriye dönük analiz edip elde edilen bulguları değerlendirmek ve tartışmaktır. Gereç-Yöntem: Kliniğimize başvuran 374 maksillofasiyal travma vakasına ait dosya dokümanları toplanarak incelendi. Elde edilen veriler cinsiyet, yaş, etiyoloji, mevsim, anatomik lokalizasyon ve tedavi seçeneklerine göre analiz edildi. Bulgular: Yapılan istatiksel analiz sonucunda 257’si erkek (% 68,7), 117’si kadın(% 31,3) olan 374 hastada 400 maksillofasiyal kırık tespit edildi. Ortalama yaş 25 (7 - 68) olarak tespit edildi. Etiyolojik nedenler sıralandığında düşme 129 hasta (% 34,5) ile ilk sırada yer aldı. Daha sonra sırasıyla 124 hasta (% 33) darp, 69 hasta (% 18,4) trafik kazası, 21 hasta (% 5,6) spor kazası, 12 hasta (% 3,2) iş kazası, 12 hasta (% 3,2) at tepmesi, 4 hasta(%1) ateşli silah yaralanması ve 3 hasta(% 0,80) diş çekim sonrası oluşan çene kırığı olarak analiz edildi. Tedavisi gerçekleştirilmiş 400 kırığın 334’dü (% 83) mandibulada, 46 (% 11) tanesi maksillada, 3 (% 1) tanesi zigomatik kemikte, 3 tanesi(% 1) orbitada ve son olarak 14 tanesi (% 4) çoklu kırık şeklinde görüldü. Sonuç: Maksillofasiyal kırıkların insidansı, etiyolojisi, hastaların demografik özellikleri bölgelere göre çeşitlilik göstermektedir. Bölgeler arasındaki farklılığın daha detaylı anlaşılabilmesi için coğrafik, sosyal ve ekonomik değişkenlere sahip sahaların katılacağı çok merkezli çalışmaların hem hastaların tedavisine hem de literatüre büyük katkı sağlayacağını düşünmekteyiz.

Background: The aim of this study is to investigate the relationship of carotid artery calcifications detected in panoramic radiographs of patients aged 60 or older with isolated systemic diseases. Patients and Methods: From October 2018 to December 2019, 867 panoramic radiographs of patients, who applied to Dicle University Faculty of Dentistry for various dental reasons, were collected for examination. Of these 867 panoramic radiographs, 444 panoramic radiographs were included in this study. Medical data were collected from the archival records of the dental school. Results: The study population consisted of 240 female (54.1%) and 204 male (45.9%) patients. Their mean age was 66 ± 7.3 (range: 60– 92) years. Only 39 (8.8%) of the 444 patients had atherosclerotic plaques. Of the 39 patients with carotid artery calcification, 13 (33.3%) were male and 26 (66.7%) were female. As a result of statistical analysis, carotid artery calcification compared to other systemic diseases was found to be significantly more common in patients with hypertension (p = 0.009). Conclusion: Carotid artery calcifications detected coincidentally in standard panoramic radiographs of dental patients may be important markers for preventing serious risks such as coronary artery disease, stroke, and death. The relationship between carotid artery calcifications found on dental panoramic radiographs and hypertension was significant. Therefore, it seems that detection of carotid artery calcifications on panoramic images of hypertension patients must be considered by dentists.

Dentigeröz kistler çenelerin sık gözlenen odontojenik kistleri arasında olup sıklıkla gömülü mandibular 3. molar dişler ile ilişkilidirler. Bu patolojiler daimi dişlerin kronlarını içine alan iyi huylu kitlelerdir. Genellikle asemptomatik olup dental radyografilerde tesadüfen tespit edilirler. Enfekte oldukları durumda ağrı semptomu oluşturabilirler. Erkeklerde, kadın hastalara oranla iki kat daha fazla görülür ve ortalama görülme yaşı 2. ve 3. dekatlardır. Kistlerin tedavisinde tercih edilecek yöntem; kistin boyutlarına, lokalizasyonuna ve anatomik yapılara uzaklığına bağlı olarak değişebilmektedir. Bu makalede 33 yaşında kadın hastada maksiller kanin dişten kaynaklanan büyük dentigeröz kist olgusu ve enükleasyon ile cerrahi tedavi süreci sunulmuştur. Dentigeröz kistler semptomsuz bir şekilde geniş kemik defektlerine yol açabilir. Bu yüzden tüm gömülü dişlerde radyografik inceleme yapılması oldukça önemlidir.

Aim: The present study aims to employ dental volumetric tomography to examine bone mineral density among men that used antidepressants in the SSRI group for a long time. Method: The present study was conducted through the utilisation of data related to patients that presented to the Faculty of Dentistry of Dicle University and had a dental volumetric tomography (DVT) scan for any reason. The patients were divided into 2 groups based on the use of antidepressants: Group 1 included 68 patients as the control group, and Group 2 consisted of 68 patients that used antidepressants. Radiomorphometric measurements were performed on DVT data: DVT-Mandibular Index (DVT-MI), DVT-Cortical Index (DVT-CI), Hounsfıeld Unit (HU) CORTICAL, and HU SPONGIOSIS values were calculated. Results: The group of patients that used antidepressants exhibited a significant increase in DVT CI and a significant decrease in HU CORTICAL, HU SPONGIOSIS and DVT MI values. These findings were suggestive of osteoporosis. Conclusion: Long-term use of antidepressants should be taken into consideration as a risk factor for osteoporosis in men.

Oral breathing causes many changes in the facial anatomical structures in adult patients. In this study we aimed to determine the effects of long-term oral breathing (>5 years) on the maxillary sinus volumes among adult male patients. We accessed medical records of 586 patients who had undergone cone beam computed tomography (CBCT) for any reason between September 2013 and April 2014. Patients who had undergone cone-beam dental volumetric tomography scans for any reason and who had answered a questionnaire about breathing were screened retrospectively. Cone beam dental volumetric tomography (I-Cat, Imaging Sciences International, Hatfield, PA, USA) was used to take the images of the maxillo-facial area at a setting of 120 kVp and 3.7 mA. This study involved male patients older than 21 years of age. The study included a total of 239 male patients, of which 68 were oral breathers and 171 were nasal breathers. The mean age of the oral breathers was 48.4 years and that of the nasal breathers was 46.7 years and the difference was not statistically significant (p>0.05). The mean maxillary sinus volumes of the oral and nasal breathers were 9043.49±1987.90 and 10851.77±2769.37, respectively, and the difference in maxillary sinus volume between the 2 groups was statistically significant (p5 years) was significantly lower than in nasal breathers, but it remains unclear whether this is due to malfunctioning of the nasal cavity or due to the underlying pathological condition.

Introduction: In this study, we investigated the effects of long-term antihypertensive treatment with calcium channel blockers or beta blockers on the bone mineral density of maxilla, as determined by cone-beam computed tomography (CBCT). Material and methods: This retrospective study was conducted on CBCT images of men older than 55 years who had received different dental indications. Data were grouped into three categories according to the antihypertensive medication history of the patients: group A included patients who had been taking beta-blocker treatment for more than 5 years, group B included patients who had been taking calcium channel blocker treatment for more than 5 years, and the control group included patients who had never used any hypertensive medications before. Results: Statistically significant differences were observed between the beta blocker and calcium channel blocker groups. Conclusion: In hypertension treatment, beta blockers may be preferred to calcium channel blockers in patients at high risk for osteoporosis and bone resorption.

Background:The aim of the present study was to compare the effects of preemptive intravenous tenoxicam and methylprednisolone administrations on extraction of impacted third molars. Material andMethods:This was a placebo-controlled, randomized, doubl...