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Objectives: Maxillary transverse deficiency is one of the most common skeletal problems. Patients who have completed skeletal maturity, maxillary transverse deficiency can be treated with surgically assisted rapid maxillary expansion. Orthodontic forces affect the cells in the periodontium to form biologically active substances responsible for remodeling. These substances can be detected in the content of the gingival crevicular fluid (GCF). This study aimed to investigate changes in RANK, RANKL and OPG in the gingival crevicular fluid after surgically assisted rapid maxillary expansion., Materials and Methods: A total of 16 patients with a maxillary transverse deficiency were included in the study. Gingival crevicular fluid samples were collected from the mesiobuccal regions of the upper left central, lateral incisors, first and second premolar teeth before the operation (T0), after activation period (T1) and at the 4th month (T2) after the retention period. Changes in RANK, RANKL and OPG levels of gingival crevicular fluid samples were investigated., Results: RANK and RANKL amounts were found to be significantly increased in the first and second premolar teeth after expansion, and OPG amounts were significantly decreased in central incisor and first premolar teeth. RANKL was also significantly higher in the first premolar teeth than in the second premolar after retention., Conclusion: According to the results of the study, RANK, RANKL and OPG levels are changed in the gingival crevicular fluid after surgically assisted rapid maxillary expansion., Clinical Relevance: Using tooth-borne appliances for SARME operations alters the biological content of the GCF. For avoiding these interactions, bone-borne appliances may be used for SARME procedures., Competing Interests: Conflict of interestOnur Berkün declares that he has no conflict of interest. Yavuz Fındık declares that he has no conflict of interest. Orhan Akpınar declares that he has no conflict of interest. Zuhal Yetkin Ay declares that she has no conflict of interest. Timuçin Baykul declares that he has no conflict of interest., (© The Association of Oral and Maxillofacial Surgeons of India 2021.)

Background: Prostate cancer (PCa) is one of the most important causes of death in men and thus new therapeutic approaches are needed. In this study, antiproliferative and anti-migration properties of a coumarin derivative esculetin were evaluated., Methods: Human PCa cell lines PC3, DU145, and LNCaP were treated with various concentrations of esculetin for 24 to 72 hours, and cell viability was determined by the MTT test. Cell cycle and apoptosis were analyzed by using cell-based cytometer. Gene expression levels were assessed by reverse transcription and quantitative real-time PCR, cell migration was determined by the wound healing assay. The protein expression was measured by Western blotting., Results: Esculetin inhibited cell proliferation in a dose- and time-dependent manner. Cell migration was inhibited by esculetin treatment. Administration of esculetin significantly reduced the cells survival, induced apoptosis and caused the G1 phase cell cycle arrest shown by image-based cytometer. The induced expression of cytochrome c , p53, p21 and p27, and down-regulated CDK2 and CDK4 may be the underlying molecular mechanisms of esculetin effect. Esculetin suppressed phosphorylation of Akt and enhanced protein expression of tumor-suppressor phosphatase and tensin homologue., Conclusions: Our findings showed that the coumarin derivative esculetin could be used in the management of PCa. However, further in vivo research is needed., Competing Interests: CONFLICTS OF INTEREST No potential conflicts of interest were disclosed.

Epidermoid and dermoid cysts account for <0.01% of all oral cavity lesions with dermoid cyst which is twice as common to epidermoid. Epidermoid cysts are benign lesions that occur rarely in children. They usually present early in life as an asymptomatic mass. The treatment option is surgical and intraoral or extraoral approaches can be performed according to the localization and size of the mass. This report presents an 11 year old child with a sublingual epidermoid cyst treated extraorally.

Background: Various materials and techniques have been developed to facilitate bone healing process and reduce its healing period. In recent studies, it is pointed out that, platelet-rich fibrin (PRF) which is derived autogenously from the own blood of the individuals, increase regeneration and accelerate the healing of the wound, due to the consisting various growing factors. The aim of the experimental study is to evaluate the efficiency of PRF and PRF/autogenous graft combination on bone healing in different time intervals., Materials and Methods: A total of 24 skeletally mature New Zealand rabbits were used. Animals were divided randomly into two groups. Two bone defects with a diameter 3, 3 mm were created on the right and left tibia in all group animals. Only particulate autogeneous bone graft, only PRF, combination of PRF and autogeneous bone graft and empty bone cavity, were performed to all animals. The animals in the first experimental group were sacrificed after 30 days. The animals in the second experimental group were sacrificed after 60 days from the operation. Histomorphometrical and statistical analysis was performed. The data were analyzed using Tukey test (P < 0.05 for osteoblast number, P < 0.01 for osteoclast and new bone area values)., Results: Histomorphometrical analyzes showed that either PRF used alone or used in conjuction with autogenous bone graft, PRF accelerated the healing of the bone defects. There were statistically significant differences in osteoblast, osteoblast and new bone area values in PRF alone and autogenous graft with PRF than the other groups., Conclusion: Our preliminary result demonstrated that PRF increase new bone formation and has a positive effect on early bone healing.

Purpose: To evaluate the etiopathogenesis, clinical features and surgical approaches for removal of ectopic third molars in the mandible., Methods: We report a case of an impacted mandibular third molar dislocated on mandibular sigmoid notch. 20 cases of ectopic mandibular third molars reported in the English-language literature, identified from Pubmed and Medline databases are also reviewed., Results: Among the 20 article reported in the presented study, ectopic third molars were generally located in the condylar region. The common symptoms of the clinical examination were pain, trismus, swelling, temporomandibular joint syndroms or no symptoms., Conclusions: Ectopic third molar may be asymptomatic initially with clinical manifestations, later on as adjacent structures are affected. The surgical approach must be carefully planned for the aim of choosing the more conservative technique that produces the minimum trauma to patients. Key words:Ectopic third molar, sigmoid notch, cyst.

Reconstruction of the mandible with a free fibular graft is one of the most common treatment choices following tumor resection. But as the graft is often vertically deficient, pathological fracture may occur because of occlusal forces after prosthetic rehabilitation. Distraction osteogenesis can be a good choice for the repair of the fibular flap. In this report, a case of fractured fibula flap after 7 years, rehabilitated with a posteriorly directed vertical distractor, will be presented.

Secondary alveolar bone grafting is a method that enables an excellent oral rehabilitation of the patients having cleft palate. Many types of bone grafts have been used for reconstruction of the cleft, including autogenous bone and bone substitutes. Platelet-rich fibrin (PRF) has been shown to be effective in grafting the defect. The aim of this presentation is to report the closure of an alveolar cleft with the use of symphyseal bone grafts harvested with platelet rich fibrin under local anesthesia. PRF may be a good treatment choice depending on the early radiographical view of the defect and uneventfull healing.

Objective: This study aims to experimentally investigate the efficiency of Ankaferd Blood Stopper (ABS) on early and long-term bone healing and its effects on bone surfaces., Materials and Methods: Thirty adult male Wistar albino rats were used in the study. These rats were randomly divided into three groups, and bilaterally bone defects were created in the femur of each rat. A 3.0-mm-deep monocortical circular defect was created with a 3.0 mm diameter trephine drill on the proximal part of the femur, and 0.05 mL ABS was applied to the experimental group while the control group was left untreated. Group 1, group 2, and group 3 rats were sacrificed on days 7, 28, and 42, respectively. Trabecular bone area (Tb.Ar), medullary bone diameter (Me.Dm), osteoblast area (Ob.Ar), osteoid area (O.Ar) and mineralized bone area (Md.Ar) were examined in the histomorphometric analysis. Also new bone formation was scored according to the histologic evaluation Results: The results showed that while new the to day 7 experimental group showed much more bone formation than the to day 7 control group, there was no significant difference between the to day 28 and day 42 experimental groups and to day 28 and day 42 control groups. Accordingly, ABS applied in bone cavities only had a larger accelerator effect on bone healing for the seventh-day to day 7 experimental group. In clinical observations, no allergic or inflammatory reactions were observed on the skin and other preoperative and postoperative periods. Moreover in, the histomorphometric study, necrotic areas and infection areas were not observed., Conclusion: ABS has an acceleratory effect on the short-term bone healing process and is a reliable agent for routine use. However, its effects on the long-term bone healing process are insignificant. We think that a wide series of research projects are required to confirm the effects of ABS speeding up the healing process in addition to its characteristic as a blood stopping agent., Conflict of Interest: None declared.

Objective: Posttraumatic ankylosis of the TMJ can be caused by many different pathogenic mechanisms. Prosthetic alloplastic grafts and autogenous grafts are the options for surgical treatment., Methods: Seven patients were examined clinically and radiologically. Autogenous interpositioners were used for treatment of TMJ ankylosis., Results: No major complications were seen after surgery. Interincisal distances have significantly widened following mouth opening exercises for one year., Conclusions: Human skulls have many structure and shape differences, so it is difficult to replace a jaw joint successfully with an artificial one. Using autogenous tissues seems an appropriate choice for treatment.

Objective: The aim of this study was to evaluate and compare the effects of rapid maxillary expansion (RME) and surgically assisted RME (SARME) in the sagittal, vertical, and transverse planes., Study Design: Orthodontic records of 28 patients were selected retrospectively and divided into two treatment groups. Group 1 comprised 14 patients (4 boys, 10 girls, mean age 14.2 ± 0.74 years) who had been treated with RME. Group 2 comprised 14 patients (4 boys, 10 girls, mean age 19.6 ± 2.73 years) who had been treated with SARME. Measurements were performed on lateral and posteroanterior cephalograms and dental casts obtained before (T0) and after (T1) expansion., Results: Statistically significant differences were found in soft tissue convexity angle, anterior face height, and upper nasal width in group 1, and in U1-NA length and posterior face height measurements in group 2 (P<.05). In both groups significant increases were found in interpremolar, intermolar, maxillary, and lower nasal widths and in anterior lower face height (P<.01). Statistically significant intergroup differences were found in the ANB angle (P<.05) and maxillary intercanine (P<.01) measurements., Conclusion: With both RME and SARME, successful expansion of maxillary dentoalveolar structures and nasal cavity and palatal widening were achieved. Sagittal plane effects of SARME were similar to those of RME on dental skeletal and airway measurements.

Aim: To determine the efficacy of the topical application of Ankaferd Blood Stopper (ABS) on hemorrhagic diathesis following dental procedures under different conditions., Background: Some patients have a tendency to bleed excessively after dental surgery for a variety of reasons, making oral surgical procedures more risky for these patients. Since hemorrhage can cause major morbidity and mortality, the identification of a novel, effective hemostatic agent could improve the management of excessive bleeding that occurs during dental procedures., Case Descriptions: Four patients (3 females, 1 male) aged 28-45 with bleeding tendencies due to different presurgical conditions such as von Willebrand Disease, chronic liver failure, and mitral valve replacement presented for tooth extraction. Hematological consultations were obtained prior to surgical intervention and their international normalized (INR) ratio values were adjusted to less than 1.5; none received clotting factor replacement. All the extractions were performed under local anesthesia with and without epinephrine. In the presence of postsurgical bleeding, the efficacy of the ampule form of topical ABS was observed. Sex, age, anamnesis, von Willebrand Factor, activated partial thromboplastin time, factor VIII, and platelet counts of patients were recorded prior to the extractions., Conclusions: ABS was found to be effective within 10 to 20 minutes in controlling bleeding in most of the patients after dental surgery. These observations suggest the use of ABS may be a beneficial hemostatic agent for use in patients with hemorrhagic diathesis following tooth extraction. Additional research is needed to clarify the role of this unique medicinal product in the surgical treatment of dental patients with bleeding tendency., Clinical Significance: ABS has demonstrated potential for being an effective hemostatic agent for the treatment of excessive bleeding following dental surgery in four patients with hemorrhagic diathesis.

Objectives: The majority of the pathologic structures which are seen in the oral and maxillofacial region are either cystic or tend to show cystic changes. They may have not specific clinical and radiographic findings. Therefore, it is difficult to differentiate these lesions preoperatively. For this purpose, in this research, the value of fine-needle aspiration cytology (FNAC) in preoperative diagnosis was investigated by comparing with the postoperative histopathologic diagnosis., Methods: One hundred aspirates from cystic lesions in the oral and maxillofacial region were included in this study. All of the samples except one were examined histopathologically and the results were compared., Results: The results of the FNAC specimens obtained from 100 lesions were compared with histopathologic diagnosis of these lesions. According to these results, 12 insufficient (12%), 7 positive (7%), 81 negative (81%) specimens were obtained. Among these 88 lesions, 69 of them were diagnosed specifically by cytological examination (78.4%). 62 of the 69 specific diagnoses achieved by cytological examination were confirmed histopathologically (89.85%). The histological types of the seven lesions were missed by cytological examination. There were not any complications related with the fine-needle aspiration procedure in the research., Conclusions: According to these results, the value of fine-needle aspiration biopsy in cystic lesions of the maxillofacial region is found as successful as in the solid lesions.

Objectives: The primary goal of prosthetic obturation is closure of the maxillectomy defect and separation of the oral cavity from the sinonasal cavities by use of different bulb designs. The aim of this study was to evaluate the articulation performance of obturator patients with three different buccal extension designs., Methods: Five patients with palatal defects of comparable sizes at ages ranging from 42 to 74 were evaluated. Starting at postoperative 4 months, speech intelligibility (SI) was assessed without a prosthetic obturator and with an obturator of buccal extensions 15 mm (high), 10 mm (medium) and 5 mm (low), respectively. Assessments were performed at four week intervals for adaptation. The articulation performance of patients with different buccal extension designs were evaluated on speech intelligibility. The data tested using Friedman test., Results: The mean SI score without an obturator was 45.04%+/-5.86%. SI was found to be significantly increased with obturators of any buccal extensions with the mean values 90.50%, %94.24% and 91.20% for high, medium, and low buccal extensions respectively. When the SI score was compared between three buccal extension types medium was found to be significantly higher compared to others (P<.05)., Conclusions: Obturators improve speech intelligibility irrespective of their buccal extension levels. Nevertheless, medium size buccal extension enables the optimum sealing for better articulation.

Introduction: Rehabilitation of patients after surgical removal of carcinomas in facial skeleton is one of the most difficult therapies of the stomatognathic system. Significant deformation of tissues, dysfunctions of the stomatognathic system with concurrent biological imbalance of the oral cavity environment frequently affect the treatment to become arduous. Scars and contraction of the oral crevice may cause serious psychological deficiencies that are another aspect of the treatment schedule., Case Presentation: Three Turkish patients ages 46 (male), 61 (male) and 24 (female) who experienced similar operations were rehabilitated with maxillary obturators. The situations was ideal for patient no 1. Patient no 2 could not receive an immediate obturator and patient no 3 rejected using permanent obturator. The paper describes the advantages of a surgical obturator which is constructed before operation and inserted immediately following partial maxillectomy and expresses long term complications when neglecting the use of definite obturator prosthesis, in the light of three cases., Conclusion: The primary objective of oral-maxillofacial and plastic surgeons and prosthodontists when treating tumors is to eliminate disease and to improve the quality of life including the facial contours which influences the psychological condition of patient. Neglecting immediate obturator construction may cause serious facial appearance problems due to soft tissue contracture. When permanent obturator is rejected, serious contracture of soft tissues and facial disharmony is inevitable.