Tosun Tosun

Trauma-related oral lesions are common in clinical practice of dentistry and they can impair patients’ normal oral function and cause pain in patients’ eating, chewing, and talking. An injury to the oral mucosa can result from physical, chemical, or thermal trauma. Such injuries can result from accidental tooth bite, hard food, sharp edges of the teeth, hot food, or excessive tooth brushing. Some injuries can also be caused by iatrogenic damage during dental treatment or other procedures related to oral cavity. In this chapter, oral mucosal trauma and injuries will be examined in four subclasses: physical and mechanical traumas of oral mucosa; chemical injuries of the oral mucosa; radiation injuries; and electrical, thermal burns.

Implant dentistry treatment target to avoid any kind of edentulous state including tooth loss due to trauma. In the literature there are numerous case reports and few clinical studies documenting treatment options of post-trauma patients by dental implants. Principally there are some limitations of dental implant application related to the age and available bone volume of patients. Implant candidate should complete bone growth as the metallic implants do not follow bony development phases. Most often traumatic dental injuries occur in childhood and implant treatment should postponed. In this aspect the major problem associated with dental implant placement is the lack of adequate bone volumes at the future time of surgery as such cases receives traumatic dental injury in the early years and disuse atrophy occurs during waiting period. Future trends and strategies in dental traumatology in general and with special attention to dental implant applications are based on the education of population in terms of emergency treatments and urgent transport of patients to the clinics.

Background: The osteotome technique has been successfully used for implant placement when a limited vertical height is available at posterior maxilla. However, it is not clear if new bone is formed at the apical portion of the implant placed by this technique without any bone graft. The aim of this study was to radiographically evaluate bone formation around dental implant surfaces exposed to the space created at the sinus floor without the presence of any graft material.Methods: Forty patients (21 male, 19 female; mean age 46.7 years) who received a total of 75 dental implants together with indirect sinus lifting procedure were included. Initial and 6‐month postoperative panoramic films were scanned and analyzed using a commercially available software program. Implants were divided into two groups: initial alveolar bone height Results: The mean implant length placed at locations with Conclusions: It is possible to radiographically observe a gain of approximately 3 to 4 mm of bone from the sinus floor to the implant apex. The amount of initial alveolar bone height, presence of sinus membrane perforation, and the amount of exposed implant surface appear to play a role in the presence or absence of radiopacity within the elevated sinus floor, following 6 months of healing. J Periodontol 2005;76:385‐390.

The aims of the present study were to use polysomnographic analysis to confirm sleep bruxism (SB) and to evaluate clinical findings of dental implant treatment in SB patients. The present study comprised the retrospective analysis of 368 patients with a total of 838 endosseous implants. Nineteen patients who experienced mechanical complications, such as implant or abutment fractures, loosened gold screws, or occlusal surface wear or damage, were selected for polysomnographic analysis to monitor sleep symptoms. Six patients in the study group were identified as having SB, and this was confirmed by polysomnographic analysis. The SB electromyographic episodes were at least 20% of the patients' maximum voluntary contractions while awake and were scored. Most of the bruxism episodes (80%) were seen in light sleep stages. Only 5% of bruxism episodes were detected during rapid-eye-movement sleep. Sleep stage recordings were similar in all individuals. Bruxism episodes did not cause arousals. Patients were unaware of their nocturnal parafunctional habits. Despite protection with night guards, all patients were reported to have continued bruxism. Since possible occlusal parafunctional habits may be evident in any stage of dental treatment, treatment outcome risks must be considered. Polysomnographic study was evaluated as an effective, low-cost method to confirm occlusal parafunctional habits during sleep. Precautions against SB in patients having dental implant treatment have not been properly clarified. However, night guard protection appears to have some validity in patients having sleep bruxism.

Background: The aim of the present study was to compare the peri‐implant soft tissue health status of implants supporting overdentures with bar attachments or ball attachments in the mandible, as well as patient satisfaction with these attachment types.Methods: The study included a Dolder bar group with 18 cases (43 implants) and a ball attachment group with 18 cases (51 implants). The mean function period in the Dolder bar group was 49 months (range: 12 to 72 months) and in the ball attachment group, the mean was 23 months (range: 12 to 40 months). Implants were clinically evaluated by using a modified plaque index (mPI), modified sulcus bleeding index (mSBI), and probing depths. Patient satisfaction with the treatment was recorded using a questionnaire.Results: mPI, probing depth, and mSBI did not statistically differ between groups (Mann‐Whitney U test, P >0.05). Patient satisfaction was similar with both retentive systems.Conclusion: Within the limits of this study, we concluded that there was no significant difference between the 2 attachment types used for implant‐supported overdentures with respect to the soft tissue health status or patient satisfaction. J Periodontol 2002;73:1067‐1070.

Palatal implants have been used in the last 2 decades to eliminate headgear wear and to establish stationary anchorage. The aim of this investigation was to establish a method and easy protocol for palatal implant placement. The study comprised 8 male and 15 female patients each having a 4.5 x 8-mm stepped screw titanium implant placed in the palatal region for orthodontic purposes. A surgical template containing metal drill housing was prepared. Angulation of the drill housing was controlled according to the radiologic tracing of the maxilla transferred to a plaster cast section in the paramedian plane. Implants were placed using a noninvasive technique (incision, flap, and suture elimination) and left transmucosally to facilitate the surgical procedure and reduce operations. The paramedian region was selected so as to avoid connective tissues of the palatine suture and because it was considered to be a suitable host site for implant placement. After 3 months of healing, all implants were osseointegrated and no implant was lost throughout the orthodontic treatment. Palatal implants can be used effectively for anchorage maintenance and space-gaining procedures. Usage of a 3-dimensional surgical template eliminated faulty implant placement, reduced chair time, and minimized trauma to the tissues while enhancing osseointegration.

Background: The reconstruction of edentulous patients with adequate bone volume and density by using dental implants has become a viable treatment option with high predictability. However, initial stabilization is difficult to achieve in the posterior maxillary regions where cortical bone is thin or absent due to severly resorbed alveolar ridges. Maxillary sinus lift procedures applied with various grafting materials enable clinicians to place implant‐supported prostheses even in cases with increased pneumatization of the maxillary sinus.Methods: The purpose of this study was to evaluate histologically and clinically different grafting materials used in maxillary sinus floor augmentation. Deproteinized bovine bone granules (DBBG), demineralized freeze‐dried bone powder (DFBP), and porous hydroxyapatite (PHA) were used as grafting materials. A total of 19 implants in 8 patients were placed into grafted sites. In 3 patients, a 2‐stage approach was used wherein implants were inserted after a 6‐month healing period following a sinus lift procedure. Specimens were taken with a trephine drill, and the site of the specimen was enlarged to accept an implant. For the remaining cases, a 1‐stage approach, which included sinus lifting and implant placement, was used and bone biopsies were taken during the uncovering stage. After 6 months of healing, fixed prosthetic restorations were fabricated.Results: The healing period progressed without any complications, and all implants were loaded. The mean functioning time was 12 months, varying from 9 to 24 months.Conclusion: The results indicate that DFBP resorbs earlier than PHA and DBBG in sinus lift procedures. J Periodontol 2001;72:1436‐1442.