Ahmet Akti

Introduction: The inferior alveolar nerve block (IANB) is the most widely used mandibular anaesthesia technique; however, it remains prone to failure due to both anatomical and operator‐related factors. Understanding these factors is essential to enhancing student training and patient comfort. This study aimed to identify risk factors associated with IANB failure among dental students. Materials and Methods: A prospective observational study was conducted at Selcuk University Faculty of Dentistry (February 2023–July 2024). Fourth‐ and fifth‐year right‐handed dental students administered IANBs to 340 patients using the Halstead technique with 4% articaine and epinephrine. Anaesthesia success was evaluated after 10 min through both clinical testing and patient feedback by a blinded assessor. Logistic regression analyses identified significant predictors of failure, while receiver operating characteristic (ROC) curves assessed discriminative performance. Results: Out of 340 procedures, 301 were successful, yielding an overall success rate of 88.5%. Failures were associated with limited interincisal opening, higher body mass index (BMI) and lower student experience level. Multiple logistic regression confirmed these three as independent predictors ( p < 0.05). Among these, BMI showed the strongest predictive performance (AUC = 0.72), followed by interincisal distance (AUC = 0.68) and student grade (AUC = 0.66). Conclusion: IANB success depends on both operator experience and patient morphology. Incorporating structured psychomotor and simulation‐based anaesthesia training early in dental education may reduce failure rates and improve clinical proficiency.

Background: Radiographic evaluation of bone regeneration following maxillary sinus floor elevation commonly emphasizes volumetric gains. However, the qualitative microarchitecture of the regenerated bone, particularly when assessed via two-dimensional imaging modalities, such as panoramic radiographs, remains insufficiently explored. This study aimed to evaluate early trabecular changes in grafted maxillary sinus regions using fractal dimension, first-order statistics, and gray-level co-occurrence matrix analysis. Methods: This retrospective study included 150 patients who underwent maxillary sinus floor augmentation with bovine-derived xenohybrid grafts. Postoperative panoramic radiographs were analyzed at 6 months to assess early healing. Four standardized regions of interest representing grafted sinus floors and adjacent tuberosity regions were analyzed. Image processing and quantitative analyses were performed to extract fractal dimension (FD), first-order statistics (FOS), and gray-level co-occurrence matrix (GLCM) features (contrast, homogeneity, energy, correlation). Results: A total of 150 grafted sites and 150 control tuberosity sites were analyzed. Fractal dimension (FD) and contrast values were significantly lower in grafted areas than in native tuberosity bone (p < 0.001 for both), suggesting reduced trabecular complexity and less distinct transitions. In contrast, higher homogeneity (p < 0.001) and mean gray-level intensity values (p < 0.001) were observed in the grafted regions, reflecting a more uniform but immature trabecular pattern during the early healing phase. Energy and correlation values also differed significantly between groups (p < 0.001). No postoperative complications were reported, and resorbable collagen membranes appeared to support graft stability. Conclusions: Although the grafted sites demonstrated radiographic volume stability, their trabecular architecture remained immature at 6 months, implying that volumetric measurements alone may be insufficient to assess biological bone maturation. These results support the utility of advanced textural and fractal analysis in routine imaging to optimize clinical decision-making regarding implant placement timing in grafted sinuses.

Aim: The aim of this study was to evaluate the quality of information provided by YouTube™ videos on zygomatic implants. Material and Method: YouTube™ videos were searched using the keyword "Zygomatic implants". The first 200 videos were analyzed. After exclusion, the remaining 94 videos were independently analyzed by two investigators for demographic characteristics and content usefulness. All videos were rated as poor, fair, or excellent based on a usefulness score that assessed the quality and flow of the content. Overall video ratings included duration, views, likes, dislikes, and comments. Video content was analyzed using an 8-point scoring list. All videos were categorized according to their source. Categorical data were analyzed using Pearson's chi-squared test. For non-normally distributed data, the Kruskal-Wallis test was used for between-group comparisons, and post-hoc Dunn's test was used for multiple comparisons. The significance level was set at p

Ameloblastic fibroma (AF) is a rare benign odontogenic tumor that usually occurs in the first two decades of life. It can occur in the mandible or maxilla but is most commonly found in the posterior region of the mandible. A 6-year-old female patient applied to our clinic due to swelling in her mouth. The patient had no medical history of previous trauma or pain in the affected area. Enucleation of the tumor was performed under general anesthesia. Following enucleation, surrounding bone curettage was performed and adjacent teeth were removed. As a result of morphological and immunohistochemical examinations, the patient was diagnosed with ameloblastic fibroma. Although AF is a rare tumor, it is more common in children. Patients with AF need to be followed for a long time due to the ability of AF to turn into ameloblastic fibrosarcoma, which is its malignant form. The patient is followed frequently and has been asymptomatic for 1 year.

Amaç: Teknolojideki gelişmeler ile bireylerin daha önce ulaşamadığı yada bulunması zor olan bilgilere ulaşabilmesi günümüzde artık daha da kolaylaşmıştır . İnternet; bilgiye hızlı ve ucuz bir şekilde erişmenin ve paylaşmanın en geçerli yoludur. Sağlık bilgileri de internette en çok aranan konulardan biridir. Bu çalışmada Türkçe web sitelerindeki bruksizm ile ilgili hasta bilgilendirme metinlerin okunabilirlik ve içerik açısından değerlendirilmesi amaçlanmıştır. Materyal ve Metod: Metinlerin okunabilirlik düzeyini belirlemek için Ateşman okunabilirlik indeksi kullanılırken, içerik değerlendirmesi bruksizmin tanımı, etiyolojisi, klinik tipleri, tanı ve tedavisi ile ilgili genel sorularla değerlendirilmiştir. Verilerin analizi için SPSS 23 istatistik paket programından yararlanılmıştır. Bulgular: Çalışma kapsamında 161 web sitesi incelenmiş olup bunlardan 100 tanesi değerlendirmeye alınmıştır. Arama dağılımında özel diş klinikleri (%78,2) daha fazla ön plana çıkmıştır. Yapılan istatiksel analize göre web sitelerinin okunabilirlik verilerinde % 85’inin orta zorlukta, %10’nun zor % 5’inin kolay olduğu görülmüştür. Ayrıca web sitelerindeki hasta bilgilendirme metinlerinin genelinde; bruksizmin etiyolojisi ve hangi sebeplerle oluştuğu (%62), klinik formları (%68), teşhis (%58) ve tedavisine (%55) yönelik bilgilerin yetersiz olduğu gözlemlenmiştir. Sonuç: Hasta bilgilendirme metinleri hazırlanırken toplumumuzun sağlık okuryazarlık düzeyi göz önüne alınıp daha kolay okunabilen ve anlaşılır metinler hazırlanmalıdır. Kamu kurumları da bu metinleri internette yayınlanmadan önce denetlemeli, gerekli düzeltmeleri ilgililere iletmeli ve düzeltmeler sonrasında yayınlanmasına izin vermelidir. Anahtar Kelimeler: bruksizm, internet, okunabilirlik, sağlık bilgisi

Nasotracheal intubation is a standard blind procedure associated with various complications. The selection of the appropriate nostril is crucial to preventing most of these complications. The present study aimed to evaluate the predictive ability of cone-beam CT (CBCT) images to select the correct nostril for nasotracheal intubation. The study encompassed 60 patients who underwent maxillofacial surgery with nasotracheal intubation under general anaesthesia. While the anaesthetist made the appropriate nostril selection clinically according to a simple occlusion test and spatula test, the radiologist made the selection after analysing various CBCT findings such as the angle and direction of nasal septum deviation (NSD), minimum bone distance along the intubation path, and the presence of inferior turbinate hypertrophy. The appropriateness of these choices made blindly at different times was evaluated using descriptive statistics, chi-squared test, and independent samples t-test. The study found that 83.3% of the suggested nostril intubations were successful. We also observed that intubation duration was longer when inferior turbinate hypertrophy was present (P = .031). However, there was no statistical relationship between the presence of epistaxis and septal deviation (P = .395). Nonetheless, in 64.3% of cases with epistaxis, the intubated nostril and the septum deviation direction were the same. Pre-operative evaluations using CBCT can aid anaesthetists for septum deviation and turbinate hypertrophy, as both can impact intubation success rates and duration.

Background: The aim of this study was to evaluate the biocompatibility and effectiveness in terms of osseointegration of dental implants composed of novel injectable bone grafts with and without ostrich eggshell particles and membrane protein in rabbit femur. Methods: Sixteen adult male New Zealand rabbits were used in this study. A bone defect was created in each animal’s right and left femur, and a dental implant was placed adjacent to the defect. Two graft materials were prepared, one containing the membrane protein and the other not. In two groups, the defects were filled with these materials. In the negative control group (NC, (n:8)), the defects were left empty. A commercial product of biphasic calcium sulfate was used as a positive control material (PC, n = 8). The graft groups were defined as the group with the membrane protein (MP+, (n:8)), and without the membrane protein (MP−, n:8). The animals were euthanized at the 12th week after surgery. The samples were investigated using histology, histomorphometry, and micro-computed tomography. Data were statistically analyzed using one-way ANOVA and Tukey’s tests (p = 0.05). Results: Both the PC and MP+ groups had similar newly formed bone areas, and the mean values of these groups were significantly (p < 0.05) higher than those of the MP− and NC groups. The PC group had the highest amount of unresorbed material, while the MP− group had the lowest amount of unresorbed material. The bone–implant contact (BIC) scores of the PC and MP+ groups were significantly higher (p < 0.05) than that of the NC group. The connective tissue area of the PC group was the lowest, which was significantly lower than the other groups (p < 0.05). Conclusions: The grafts produced are highly biocompatible and also showed osteoproductivity. Their cost-effectiveness and osteoproductive activity require further investigation.

Suture materials are natural or synthetic biomaterials used to close tissues together. After surgical procedures in the mouth, the surgical site and the sutures are physically affected by many different factors. This study was conducted to evaluate the effects of frequently consumed beverages on the tensile strength of monofilament PGLA (polyglycolide-co-l-lactide) and multi-filament PGCL (polyglycolide-co-caprolactone) absorbable sutures. In particular, PGLA and PGCL absorbable sutures, which are frequently used in oral surgery, were used to evaluate the change in the strength of suture materials. The suture materials were soaked in tea, coffee, and cola drinks five times a day for 5 min each and the rest of the time in artificial saliva. All suture materials were aged via thermal cycling. Tensile strengths were tested at 0, 3, 7, and 14 days. Mixed ANOVA (four replicates: within-group comparison and two factors: between-group comparison) was performed to evaluate the effects of groups and time on the tension levels of the Tekmon and Vicryl suture materials. Analysis of Variance was used for the within- and between-group comparisons, with the Bonferroni corrected t-test for multiple comparisons. For the PGCL suture material, there were significant decreases in tension levels in artificial saliva, tea, coffee, and cola at time T3 compared to T0, T1, and T2, and at T1 and T2 compared to T0. For the PGLA suture material, there were significant decreases in tension levels in artificial saliva, tea, coffee, and cola at time T3 compared to T0, T1, and T2. There was also a significant decrease in tension level at time T2 in cola compared to T0. The present study demonstrates that beverages significantly decrease the strength of suture materials for 14 days after surgery. In particular, cola decreased the resistance of the PGCL suture material more significantly in the first week when compared to other beverages.

Giriş: Panoramik radyografiler, dental implant tedavisi öncesi değerlendirme ve tedavi protokollerinin hazırlanmasında radyografik bir yöntem olarak sıklıkla kullanılmaktadır. Bu retrospektif çalışmanın amacı, maksiller ve mandibular posterior bölgeye dental implant yapılmış hastalarda, preoperatif panoramik radyografik görüntüler üzerinde yapılan planlamaya göre belirlenen implant boyları ile yerleştirilmiş implant boyları arasındaki korelasyonu incelemek ve panoramik radyografinin bu kapsamda güvenilirliğini ve yeterliliğini değerlendirmektir. Materyal ve Metod: Çalışmada, Mart 2023 ile Şubat 2024 tarihleri arasında dental implant tedavisi için kliniğimize başvuran 568 hastanın dosyası incelenmiştir. Bu bağlamda, maksiller ve mandibular posterior bölgeye implant yapılmış ve preoperatif panoramik radyografisi olan hastalar çalışmaya dahil edilmiştir. Radyografik görüntülerde uzunluk ölçümünü engelleyen artefaktlar bulunan, açılı implant yapılmış, eksternal ve internal sinüs lifting yapılmış hastalar ve vertikal augmentasyon yapılmış hastalar çalışma dışı bırakılmıştır. İstatiksel analizler için SPSS 23 (SPSS Inc., Chicago, IL, USA) yazılımı kullanılmıştır. Bulgular: Çalışmaya, toplamda 234 hastada 443 dental implant dahil edilmiştir. Örneklemdeki hastaların cinsiyet dağılımı, %54'si (n=126) kadın ve %46’si (n=108) erkek hastadan oluşmaktadır. İmplantların %46,7’si (n=207) maksiller posterior %53,3’si (n=236) mandibular posterior bölgeye uygulanmıştır. Planlanan implant boyları ile yapılmış implantlar arasındaki intraclass correlation coefficient uyum katsayısı 0,9014 olarak bulunmuştur. Erkekler arasında bu oran 0,9036; kadınlar arasında 0,9 olarak ölçülmüştür. Bu sonuçlar, planlanan ve uygulanan implant boyları arasında yüksek düzeyde bir uyum olduğunu göstermektedir. Sonuç: Panoramik radyografi, dental implant tedavisi öncesinde implant uzunluğunun belirlenmesinde basit, kolay ulaşılabilir ve yararlı bir araç olarak kabul edilebilir. Ancak planlamayla daha uyumlu implant tedavisi için konik ışınlı bilgisayarlı tomografi gibi ileri radyografik tetkiklere de ihtiyaç bulunmaktadır.

Implant surgery in individuals with atrophic maxilla presents challenges, particularly concerning nasal cavity complications such as perforations, implant migration, and airway obstruction. While panoramic radiographs offer diagnostic convenience, their two-dimensional nature limits the evaluation of anatomical structures. Cone beam computed tomography (CBCT) provides a three-dimensional assessment, enhancing surgical planning accuracy and potentially reducing complications. With the aim of understanding the measurement differences between panoramic radiographs and CBCT images, this retrospective study examined CBCT images of patients with severely atrophic maxilla taken between September 2021 and December 2023 at the Ahmet Keleşoğlu Faculty of Dentistry. Virtual implants were placed in various tooth regions using OnDemand3D software. The incidence of nasal cavity perforations and vertical bone height differences between panoramic radiographs and CBCT images were evaluated. For this purpose, vertical bone length measurements in panoramic and CBCT images were compared for the virtual implant placement areas. Statistical analyses, including t-tests and ANOVA, were performed to determine significant differences among quantitative measurements, and a chi square test with Bonferroni corrected z-tests were used for possible associations between ratios. CBCT data from 59 patients, totaling 1888 virtual implants, revealed significant differences in implant depths among tooth regions (F = 9.880, p < 0.001). Canine regions showed higher perforation risks, especially with 12 mm and 14 mm implants. Panoramic radiographs often overestimated vertical bone height in canine and first premolar regions compared to CBCT measurements, which could lead to increased perforation risks. Radiographic evaluations using CBCT prior to implant surgery in atrophic maxilla cases are crucial to prevent nasal cavity complications. Panoramic radiographs may inadequately represent three-dimensional anatomy, underscoring the importance of CBCT for accurate implant placement and surgical planning. Further studies should consider varying implant sizes and brands to generalize findings.