Abdulkadir Burak Cankaya

Patient-specific titanium meshes have emerged as an important advancement in maxillofacial bone regeneration by combining the biological principles of guided bone regeneration with contemporary digital technologies. This chapter provides a comprehensive overview of the rationale, design, clinical applications, and future perspectives of customized titanium meshes in oral and maxillofacial reconstruction. The biological mechanisms underlying bone regeneration, including angiogenesis, osteogenesis, mechanical stability, and bone remodeling, are discussed to highlight the factors contributing to successful regenerative outcomes. Recent advances in cone-beam computed tomography, computer-aided design/computer-aided manufacturing (CAD/CAM), virtual surgical planning, and additive manufacturing have enabled the fabrication of patient-specific meshes that improve anatomical adaptation, reduce surgical time, and enhance the predictability of bone augmentation. Clinical applications in vertical and horizontal ridge augmentation, combined alveolar defects, peri-implant reconstruction, and larger maxillofacial defects are reviewed, together with reported outcomes and common complications such as mesh exposure and infection. Factors influencing treatment success, including soft tissue management, graft selection, fixation stability, and patient-related variables, are also addressed. Finally, emerging developments in artificial intelligence, computational design, advanced manufacturing, surface modification technologies, and regenerative medicine are explored as promising strategies for further improving the biological and mechanical performance of customized titanium meshes. Overall, patient-specific titanium meshes represent a predictable and increasingly evidence-based approach for three-dimensional bone regeneration, offering significant potential to improve reconstructive outcomes and expand the scope of personalized treatment in contemporary oral and maxillofacial surgery.

Traditional success metrics in oral and maxillofacial surgery (OMFS) primarily emphasize clinician‐reported outcomes such as anatomical correction, osseointegration, skeletal stability, and disease control. However, growing evidence indicates a frequent mismatch between these objective measures and patient‐reported outcome measures (PROMs) and quality of life (QoL), particularly in interventions affecting facial appearance and socially relevant functions. This narrative review examines the alignment and divergence between clinical outcomes and PROMs across major OMFS subspecialties, including dental implantology, orthognathic surgery, temporomandibular joint surgery, and oral cancer reconstruction. Across these domains, technical success often fails to translate into perceived patient benefit, with persistent functional, esthetic, or psychosocial concerns despite clinical stability. These findings underscore the need to redefine success in OMFS beyond structural restoration. Incorporating standardized PROMs as coprimary outcomes and adopting patient‐centered, multidisciplinary care models are essential for achieving outcomes that reflect both clinical efficacy and meaningful improvements in patients’ lived experiences.

Aim: Mandibular angle fractures account for 23-42% of all mandibular fractures, with treatment options often debated due to the region's anatomical complexity. While single miniplate fixation has shown low complication rates, issues like screw loosening remain a challenge. Polymethylmethacrylate (PMMA) has been widely used in orthopedic surgery to improve screw stability. This study aimed to evaluate the effect of PMMA on the stability of loosened screws in mandibular angle fractures. Material and Method: Twenty hemimandibles from sheep cadavers were divided into control and experimental groups. In the control group, standard 2.0 mm screws were inserted without PMMA augmentation. In the experimental group, a 1.6 mm pilot hole was used to simulate screw loosening, and PMMA was injected into the screw tracts before screw insertion. Both groups underwent vertical force testing using a hydraulic device, with displacement values measured at 50 N of force. Statistical analysis was performed using the Student t-test, with significance set at p

Aim: This study proposes to investigate the influence of various surgical guide designs on the generation temperature in the cortical and cancellous regions of the osteotomy site. The working hypothesis was that open guides are more efficacious in controlling excessive heat generation in cortical and cancellous areas. Materials and Methods: Implant osteotomy was performed on specimens simulating D3 bone density using surgical guides produced with three different designs: an open guide, a guide with an external cooling channel, and a closed guide. Temperature increases occurring in the cortical layer from a depth of 2 mm and in the cancellous layer from a depth of 10 mm were measured with type K thermocouples. Results: Temperature averages recorded from a depth of 2 mm during osteotomy show statistically significant differences between groups ( p = .003). The temperature rise in the group using a closed surgical guide was significantly higher than in the groups using an open surgical guide and a surgical guide with an external cooling channel on the cortical layer, while the temperature increase did not show any significant difference in both cortical and cancellous layers between the open guide and guide with external cooling channel. Temperature averages recorded from a depth of 10 mm do not show statistically significant differences between groups ( p = .054). Conclusion: Using open surgical guides or surgical guides with external cooling channels among the guided surgical systems is a more reliable way to keep the thermal increase under control.

Sürme zamanı geldiği halde diş dizisi üzerinde yer almamış dişler gömük dişler olarak adlandırılır. Mandibular ikinci büyük azı dişleri nadir olarak gömük kalırlar. Genellikle bu gömüklük fiziksel bir engel ya da sistemik bir hastalık sonucu ortaya çıkar. Mandibular ikinci büyük azı dişlerinin derin gömüklüğü ise oldukça nadirdir. Bu olgu sunumunda farklı yaşlarda farklı semptomlarla kliniğimize başvuran kadın hastalardan bahsedilmiştir. İki olgunun radyolojik olarak incelemesi sonucu derin gömük mandibular ikinci büyük azı dişleri görülmüştür. Minimal invaziv tekniklerle iki hastanın diş çekimleri gerçekleştirilmiş uzun dönem kontrollerde herhangi bir fraktür gözlenmemiştir. Oldukça ender görülen derin gömük mandibular ikinci büyük azı dişleri genellikle genç yaşta fark edildiğinde ortodontik tedavi ile doğru konuma getirilirler. Diş çekimi fraktür riski nedeniyle en son tedavi seçeneği olarak düşünülmektedir. Ancak bu olgu raporunda enfeksiyon ve kist varlığı sebebiyle dişlere çekim endikasyonu konulmuştur. Derin gömük mandibular ikinci büyük azı dişleri patolojiye eşlik ettiğinde dişlerin minimal invaziv şekilde çekilmesi gereklidir. Diğer durumlarda bu dişler cerrahi, ortodontik ve protetik açıdan değerlendirilip ona göre tedavi edilmelidir.

Removal of an impacted maxillary third molar can be challenging for both dental clinicians and oral surgeons. Frequently encountered complications include infection, pain, swelling, root fractures, trismus, and haemorrhage. In addition, unexpected displacement of the maxillary third molar may be encountered during the extraction process. This case report presents a maxillary third molar displaced to the infratemporal fossa, as well as removal of the tooth following 1 month, along with the causative factors. The roles of orthopantomography and dental volumetric tomography scans in determining the localization of the tooth are discussed, together with different surgical options and risks for surgical removal of the tooth from the infratemporal fossa.

Aim: Bisphosphonates (BPs) are inorganic pyrophosphate analogs used for the treatment of various diseases. This study aimed to evaluate the knowledge and attitudes of general dental practitioners (GDP), specialist trainees (ST), and specialists (S) in Turkey toward medication-related osteonecrosis of the jaw (MRONJ) and to optimize future training programs in this field.Materials and Methods: A self-report questionnaire consisting of 7 questions about demographic data, knowledge about BPs, MRONJ and treatment modalities was prepared and send to the members of Turkish Dental Association via email. Results: A total of 209 participants were included in this survey. The mean age of the ST group was significantly lower than the mean ages of the GDP and S groups (P= 0.003, P= 0.038). GDP are less likely to think of BPs administration and radiotherapy treatment than S or ST upon observation of an exposed bone in the head-and-neck region (P=0.048, P=0.008). In comparison to the S and ST groups, the GDP group displayed less knowledge regarding the radiological and intraoral examination of patients undergoing BP therapy (P= 0.034).Conclusion: The increasing awareness of dentists about usage and side effects of BPs is important for preventing MRONJ. The GDP group displayed significantly less knowledge regarding the radiological and intraoral examinations of patients undergoing BP therapy. Greater efforts are required to increase education and knowledge of MRONJ and BPs among dental practitioners.

Aim: Although there are many materials that can be used for retrograde filling in surgical endodontics, none of them can be regarded as an ideal material yet. The purpose of this study was to compare the surface topography of three different root-end filling materials.Methods: 36 extracted single rooted human incisor teeth were cleaned and decoronated to standardized 10 mm root lengths. The root segments were prepared and 2 mm apical resection were performed. The samples were randomly separeted to three groups (Group A: Ca(OH)2, Group B: MTA Angelus, Group C: ProRoot MTA), each comprised of 12 roots. Materials were placed as 2 mm apical barriers and obturated with guttapercha and AH-Plus sealer. Each group dimidiated two subgroups (A1,A2,B1,B2,C1,C2). Groups A1,B1,C1 were stored in normal saline (NS), groups A2,B2,C2 were stored in neutral phosphate buffer saline (NPBS) solution and samples were incubated at 370C for 2 weeks. Stereomicroscope (32X) was used to photograph the root-end filling.Results: All specimens demonstrated white crystals formation and sediment over the root-end filling materials and on the superficial border of the root-end cavities’ wall as a white plague. A2,B2,C2 samples have more crystal sediment on root-end fillings than samples A1,B1,C1. Dissolution and corrosion were observed in groups A1, A2.Conclusions: The results of this study revealed that calcium hydroxide is more resorbable than MTA Angelus and ProRoot MTA. The crystals formation and precipitation were observed in neutral phosphate buffer saline solution was more than normal saline solution for all groups as a hydroxiapatite crystals.

Objective. Previous studies have shown the effect of amalgam removal on the healing of oral lichenoid lesions (OLLs); however, no specific replacement materials have been suggested. The present series evaluated long-term results following the complete replacement of amalgam restorations with feldspathic ceramic inlay-onlay restorations for a group of patients with OLLs whose lesions were suspected to be related to amalgam restorations.Materials and Methods. Twenty-four patients who had OLLs suspected to be related to their amalgam restorations were initially recruited. The patients underwent patch tests for a series of dental materials, in addition to clinical and histopathological examination. Sixteen (67%) of the 24 patients had their amalgam replaced with feldspathic ceramic inlay-onlay restorations and were examined within a follow-up period of 3 months to 5 years.Results. After 3 months of clinical follow-up, complete healing (63%) was noted in all patients with OLLs whose lesions were in only close contact with their amalgam restorations. Healing was significantly related to the combination of lesions with close contact with the amalgam restoration and a diagnosis of OLL (x²test, P=0.02).Conclusion. Feldspathic ceramic can be safely used as a replacement material for patients with OLLs to diminish adverse reactions to amalgam restorations.

The objective of this study was to analyze gender-stratified data of patients who underwent day surgery in a hospital based on the type of treatment, type of local anaesthesia, and local anaesthesia complications. By learning all these parameters, it is our main goal to find answers to questions such as what we can do in hospital conditions, what we can win, and what operations we can treat. A retrospective review was performed to assess hospital records of 10,750 dental patients who received oral surgery under local anaesthesia at the Istanbul University Department of Oral and Maxillofacial Surgery from August 2013 through June 2016. Patients mostly received surgery for wisdom teeth, dental implants, or odontogenic cysts or tumours. Men aged 31–40 years (23.66%) and women aged 21–30 years (30.73%) were the largest groups undergoing operations. Surgery for an impacted tooth was the most common ambulatory procedure, accounting for 54.2% of operations. The second most common ambulatory procedure was dental implant surgery (10.2%), followed by root (7.4%), odontogenic cyst (7.2%), and impacted canine surgeries (6.4%). The most common age group receiving surgery was 21–30 years old (3304 patients, 60.75%). Twice as many women as men underwent surgery. Day case surgery is an expanding area of health care and a valuable method of treating patients in many aspects of oral surgical practice. Different medical and dental specialties can benefit from this ambulatory approach to treatment, which also reduces treatment costs.