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Öğe Biostimulatory Effects of Diode Laser and Ozone on Wound Healing in Rats(Galenos Yayincilik, 2018) Alan, Hilal; Guler, Cigdem; Yolcu, Umit; Koparal, Mahmut; Cakir, Ebru; Demir, PinarObjective: Diode laser and ozone can be used to healing of skin wounds. The aim of this study is to evaluate the biostimulatory effects of diode laser and ozone on the healing of sutured skin wounds in rats. Materials and Methods: In this study, 21 adult males Wistar albino rats were used. Three 1-cm-longs, full-thickness incisions were applied to the back of each animal and closed with sutures. Diode laser treatment, irrigation with 0.9% saline solution and ozone therapy was applied to the wounds through 7 days. Animals were euthanized on the 3rd, 7th, and 14th days after treatment, and all wounds were surgically removed for histopathological evaluation. Results: According to histological results, a statistically significant difference was found among the three treatment methods in acute inflammatory reactions on 3rd day (p<0.05). Ozone treatment reduced the intensity of acute inflammatory reactions by the 3rd day (p<0.05). In addition, a statistically significant difference was found between the follow-up periods in all treatment groups for fibrosis (p<0.01). Conclusion: It was found that ozone treatment was more effective when compared to the other treatments for reducing the intensity of acute inflammatory reactions on the healing of sutured skin wounds.Öğe Büyük Agresif Bir Santral Dev Hücreli Granuloma Birlikte Tedavisi (Olgu Sunumu)(2017) Koparal, Mahmut; Alan, Hilal; Ağaçayak, Serkan; Erdoğdu, Halil; Gülsün, BelginÖz: Santral 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 Comparison of the Anesthetic Efficiency of Lidocaine and Tramadol Hydrochloride in Orthodontic Extractions: A Split-Mouth, Prospective, Randomized, Double-Blind Study(W B Saunders Co-Elsevier Inc, 2020) Ege, Bilal; Ege, Miray; Koparal, Mahmut; Alan, HilalPurpose: The aim of the present randomized controlled split-mouth clinical study was to evaluate and compare the clinical anesthetic efficacy of lidocaine and tramadol hydrochloride in orthodontic extractions. Materials and Methods: A total of 32 systemically healthy patients requiring bilaterally maxillary first premolar extractions for orthodontic reasons were included. Each patient received 1.8 mL of lidocaine (36 mg lidocaine HCI and 0.0225 mg epinephrine) on 1 side and 1.8 mL tramadol (50 mg tramadol HCl and 0.0225 mg epinephrine diluted to 1.8 mL by distilled water) on the other side. The anesthetic solutions were infiltrated into the buccal vestibule (local infiltration) based on a computer-generated list. In each patient, the time of anesthetic onset and finish, anesthetic activity, duration of postoperative analgesia, additional analgesic medication, wound healing, possible side effects, and satisfaction levels were recorded intraoperatively and postoperatively for both sides. Results: Although no relevant differences were found between the solutions for anesthetic onset, lidocaine was significantly more effective statistically for the total anesthesia duration. Comparing the anesthetic activity at 5 minutes before extraction, we found that tramadol was significantly more effective statistically compared with lidocaine. Similarly, tramadol was significantly more effective statistically than lidocaine for satisfaction level and wound healing. Moreover, compared with tramadol, in terms of postoperative pain, the visual analog scale scores with lidocaine were significantly higher at statistically 7, 8, 9, and 10 hours during the first 12 hours. In general, the lidocaine values were dramatically higher than were the tramadol values. Conclusions: The results of the present study suggest that using tramadol combined with epinephrine can be an alternative local anesthetic for maxillary first premolar tooth extractions in oral-maxillofacial surgery. (C) 2019 American Association of Oral and Maxillofacial SurgeonsÖğe Conservative treatment of recurrent temporomandibular joint dislocation with autologous blood injection(Turgut Özal Tıp Merkezi Dergisi, 2016) Koparal, MahmutAbstract Aim: Temporomandibular joint (TMJ) dislocation is very distressing condition and is common in society. TMJ may be treated by conservative methods but the cases with persistent may require surgical.Autologous blood injection(ABI) to TMJ is a nonsurgical method provides more effective outcomes compared to other methods and has been long studied in the literature. ABI is based on the injection of the blood drawn from the antecubital fossa into the superior joint space. The inflammatory changes develop in the joint and maturation of blood after the administration of ABI limit the mandibular movements.Eminectomy seems to provide a permanent solution for the surgical treatment of TMJ, it is a risky method since the mandibular area is neighbored by critical anatomical structures.Therefore conservative methods should be tried before initiating advanced surgical techniques. Materials and Methods: This study included patients had a long history of 3 or more episodes of dislocation during daily activities (e.g. eating, drinking, laughing, and yawning), rejected undergoing surgery, and had no history treatment due to this complaint. Of these, 23 patients with TMJ dislocation underwent ABI to TMJ. Results: At 1-year follow-up, no complication was observed in any patient and the complaints resolved in all but 2 patients. Conclusion: We consider that autologous blood injection to TMJ is a useful to be used in the treatment of recurrent TMJ with no need for surgical treatment. Keywords: Autologous blood injection; Temporomandibular Joint; Chronic Dislocation.Öğe Dentist visits of Syrian refugees and the cost of their dental healthcare(2019) Koparal, Mahmut; Ege, Bilal; Keskinruzgar, Aydin; Yapici Yavuz, Gunay; Erdogmus, Zozan; Unsal, Mustafa NafizAim: To investigate dental problems of Syrian refugees in southeast Turkey and assess the burden of their dental healthcare costs to government. Material and Methods: A retrospective study included dental records of Syrian refugees who applied to Adıyaman Dental Hospital (ADH), were compared with Adıyaman public by years.Results: In 2012, the most common treatments were tooth extraction and complicated tooth extraction, the total dental care cost of such refugee patients was $3,082.14 and the median cost per refugee was $4.43. The most common treatment provided to both the Adıyaman public and Syrian refugees in 2017 was dental filling. In the same year, total dental care cost of refugees was $603,303.69, the median cost per refugee was $22.20. The total dental care cost of the Adıyaman public was $3,869,524.96, the median dental care cost in Adıyaman public was $17.95 for one person in 2017.Conclusions: Dental problems of Syrian refugees and the financial burden of their dental healthcare to the government significantly increased.Keywords: Refugee; dental care cost; Syrian; immigrant; treatment; budgetÖğe Effects of low-level laser therapy following surgical extraction of the lower third molar with objective measurement of swelling using a three-dimensional system(Spandidos Publ Ltd, 2018) Koparal, Mahmut; Kucuk, Ayse Ozcan; Alan, Hilal; Asutay, Fatih; Avci, MehmetThe aim of the present study was to evaluate and compare the effects of single- and two-dose low-level laser therapy (LLLT) on the postoperative swelling, trismus and pain of patients undergoing extraction of impacted mandibular third molars. In addition, edema was volumetrically measured with a 3dMD face system. A total of 45 patients were randomly divided into three treatment groups (15 patients in each group) as follows: Group 1, receiving routine management with ice application and serving as the control group; Group 2, receiving a single dose of LLLT immediately following surgery; and Group 3, receiving two doses of LLLT, immediately following surgery and on day 2 after surgery. In the present study, a gallium-aluminum-arsenide (0.3 W, 40 sec, 4 J/cm(2)) diode laser device was applied extraorally at the insertion point of the masseter muscle. The trismus, pain level and facial swelling of the patients were evaluated. The visual analog scale (VAS) was used to examine the pain degree, while a 3dMD face photogrammetric system was used to evaluate the volumetric alterations of the swelling. The results indicated no statistically significant differences in the mean swelling or trismus among the three groups. The mean VAS measurements did not differ significantly among the groups at postoperative day 2; however, significantly reduced VAS values were observed in Group 2 compared with Group 1 at postoperative day 7 (P<0.05). The present study demonstrated that, although single-dose or two-dose LLLT had beneficial effects on the swelling, trismus and pain level, a significant reduction was only observed in the pain level at postoperative day 7.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 Evaluation of the effects of the low-level laser therapy on swelling, pain, and trismus after removal of impacted lower third molar(Biomed Central Ltd, 2016) Alan, Hilal; Yolcu, Umit; Koparal, Mahmut; Ozgur, Cem; Ozturk, Seyit Ahmet; Malkoc, SiddikBackground: In current study we aimed to examine the effect of a low-level laser therapy on the pain, mouth opening and swelling of patients whose impacted 3rd molar tooth was extracted in addition measurement volumetrically to the edema with 3dMD face system. Methods: It was surveyed 15 patients who had bilateral symmetric lower 3rd molars. Surgical sides of patients were randomly separated into two groups: the study group and the control group. It was applied extra oral low-level laser therapy (LLLT, 0.3 W, 40 s, 4 J/cm(2)) to the study group (n = 15) after the surgical operation and on the 2nd day. Only routine postoperative recommendation (ice application) was made in the control (n = 15) group. The maximum mouth opening, pain level and facial swelling evaluated. 3dMD Face r (3dMD, Atlanta, GA) Photogrammetric System was used to evaluate volumetric changes of the swelling. Results: There was no statistically significant difference in the edema and interincisal opening between the groups and the pain level in the laser group was significantly lower than in the control group on the 7th postoperative day. Conclusions: Although there were decreasing trismus, swelling, and pain level, with this LLLT, there was significant difference only in the 7th day pain level in the laser group compared with the control group.Öğe Güneydoğu Anadolu Bölgesi’nde yedi farklı dental anomalinin görülme sıklığı(Selcuk Dental Journal, 2018) Koparal, Mahmut; Ünsal, Haluk Yener; Alan, Hilal Türker; Yalçın, Mustafa; Ege, Bilal; Gülsün, BelginÖz: Amaç: Bu çalışmanın amacı, Güneydoğu Anadolu Bölgesinde yaşayan bireylerde yedi farklı dental anomalinin görülme sıklığının ve cinsiyetler arasındaki dental anomali görülme yatkınlıkların değerlendirilmesidir. Gereç ve Yöntemler: Çalışma Adıyaman Üniversitesi Dişhekimliği Fakültesi’ne ve Adıyaman Ağız ve Diş Sağlığı Merkezi’ne çeşitli nedenlerle müracat etmiş hastalardan rastgele seçilen 4256 hastaya ait panoramik radyografi görüntüleri üzerinde retrospektif olarak tasarlandı. Hastalara ait panoramik radyografi görüntüleri dental anomalilerin tespit edilmesi amacıyla 2 araştırmacı tarafından değerlendirildi. Çalışmada hastaların panoramik radyografi görüntüleri üzerinde tespit edilen, alt keser diş eksikliği, sürnümerer diş, ektopi, gömülü kalma, mikrodonti, taurodontism ve dilaserasyon olmak üzere 7 tip dental anomali cinsiyetler arası dağılımına göre istatistiksel olarak analiz edilmiştir Bulgular: En sık görülen anomali %4,2 oranıyla gömülü kalma olarak tespit edildi. Taurodontizm % 0,02 lik oranla en az görülen anomali olarak tespit edildi. Gömülü diş görülme sıklığı erkek bireylerde, kadınlara kıyasla istatistiksel olarak anlamlı derecede daha fazla bulunmuştur. Ektopik diş görülme oranı, erkeklerde kadınlara nazaran istatistiksel olarak anlamı derecede fazla bulunmuştur. Kadınlarda alt keser diş eksikliği görülme oranı, erkeklere göre istatistiksel olarak anlamlı derecede fazla bulunmuştur. Sonuç: Güneydoğu Anadolu Bölgesinde yaşayan bireylerde gömülü kalma, en sık rastlanılan anomali olarak karşımıza çıkmaktadır. Alt keser diş eksikliği kadınlarda daha fazla görülürken, gömülü diş ve ektopiye erkeklerde daha sık rastlanılmıştır. Bunun yanında, sürnümerer diş, dilaserasyon, taurodontizm ve mikrodonti gibi anomalilerin görülme sıklığı bakımından cinsiyetler arasında farklılık tespit edilmemiştir. Taurodontizm en az rastlanılan anomali olarak tespit edilmiştir.Öğe Human papilloma virus(Turgut Özal Tıp Merkezi Dergisi, 2016) Koparal, Mahmut; Alan, Hilal; Gündüz, Derya Toprak; Gülsün, Belgin; Ünsal, Haluk Yener; Erdoğdu, Halil İbrahimAbstract Human papillomavirus (HPV) is a double-helix DNA virus in the papillomaviridae family. HPV has an affinity for epithelial tissue and causes benign and malignant changes to the stratified epithelium of the epidermis and mucous membranes. HPV is an etiological factor in many benign and malignant lesions of the head, neck, urogenital organs, skin, and mucous membranes. The role of HPV in the pathogenicity of squamous cell carcinoma in the head and neck area was first recognised in 1983 after findings showed histopathologic similarities between oral cancer and HPV infection. Because HPV has been implicated as the etiological factor for oral squamous cell carcinoma, HPV infection can be regarded as a subgroup of cancers affecting the oropharyngeal region. Due to these characteristics, HPV infection has been of particular interest in the field of maxillofacial surgery and dentistry. Screening, oral findings, early diagnosis, and proper treatment are of paramount importance in many HPVrelated infections. Keywords: Human Papillomavirus; HPV; Oral Cancer.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 Inferior alveolar nerve paresthesia due to radicular cyst: A case and review of literature(2019) Ege, Bilal; Koparal, Mahmut; Yapici Yavuz, Gunay; Keskinruzgar, Aydin; Geyik, Abdussamed; Aydin Turk, BilgeRadicular cysts are inflammatory jaw cysts that form in the apices of infected and necrotic pulp teeth. They are usually asymptomatic and tend to grow slowly. However, depending on the progressive size of the lesion and its relation to neighboring tissues, it may cause mobility, root resorption and displacement. In addition, a limited number of studies have been reported in which paresthesia occurs as a result of local pressure caused by periapical pathology and various mandibular intraosseous lesions on nerve tissue. In this study, treatment process of the paresthesia of inferior alveolar nerve caused by radicular cyst which is remained asymptomatic for a long time in the left posterior mandible is presented in a 33 year-old male patient and it is evaluated in the light of current literature.Öğe Investigation preoperative seroprevalence of hbsag, anti-hbs, anti-hcv, anti-hiv and vaccination level of patients undergoing dental surgical procedure under local anesthesia(2019) Ege, Bilal; Koparal, Mahmut; Ozcan Kucuk, AyseAim: Health care workers especially dentists are at risk due to the fact that they are in direct contact with the blood and body fluids. In the present study, it was aimed to determine the preoperative seropositivity of HBsAG, anti-HBs, anti-HCV, and anti-HIV in the patients undergoing dental surgical procedure under local anesthesia.Material and Methods: 1598 patients who were admitted to Department of Oral and Maxillofacial Surgery between 2017-2018 and underwent surgical intervention for various reasons were included. Demographic data and serum samples taken preoperatively from patients were retrospectively evaluated in terms of HBsAg, Anti-HBs, Anti-HCV and Anti-HIV seropositivity by using archive records. Furthermore, the vocational and educational status of the HBsAg (+) patients in addition their awareness about hepatitis were investigated.Results: Of the 1598 patients, 591 (37%) were males; 1007 (63%) were females. The total number of patients with HBV carriers was 73 (4.6%), the number of anti-HBs-positive patients was 828 (51.8%), and the number of anti-HCV-positive patients was 3 (0.19%). Anti-HIV positivity has been observed in none of the patients. When evaluated according to the age ranges, HBsAg was mostly detected positive in the age ranges of 21-30 and 30-40; when evaluated according to sex, HBsAg was detected higher in women.Conclusions: Knowing the prevalence of infectious diseases is highly important for both the prevention and early diagnosis of these diseases. Besides, knowing the seropositivity of these diseases before surgical interventions will facilitate for both oral and maxillofacial surgeons and other health care personnel to take necessary safety precautions against disease transmission. For this purpose, although it was observed in our study that the preoperative HBsAg, anti-HBs, anti-HCV and anti-HIV seroprevalence were not higher than those in the population were, all health care workers should be trained in occupational diseases, vaccinated and followed up at regular intervals.Keywords: HBsAg; Anti-HCV; Anti-HIV; local anesthesia; dental surgery; seroprevalance; vaccine.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.
