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Öğe Correction of Posttraumatic Maxillary Deficiency by Anterolateral Alveolar Osteotomy(1998) Gürol, M.; Uçkan, S.; Güler, N.; Kürkçü, M.; İnan, O.Anterolateral alveolar osteotomy was performed in a patient who experienced facial trauma in a traffic accident. Bony sequela had remained in the maxilla after the emergency surgery, affecting the facial appearance. A different technique of osteotomy for this unusual type of deformity is presented.Öğe Distraction Osteogenesis of Basal Mandibular Bone for Reconstruction of the Alveolar Ridge(Churchill Livingstone, 2002) Uçkan, S.; Dolanmaz, Doğan; Kalaycı, Abdullah; Cilasun, U.Alveolar distraction is being used increasingly for alveolar bone reconstruction in patients with severe mandibular defects. When there has been total loss of alveolar bone, distraction of the mandibular basal bone is necessary. Distraction osteogenesis is considerably more challenging in mandibular basal bone than in alveolar bone. The low level of the cut increases the technical difficulty and may result in a poor outcome. We describe three cases in which more than 10 mm of distraction of mandibular basal bone was required. Semirigid distraction devices were used to reconstruct the alveolar structures in each case.Öğe Maxillofacial Hydatid Cyst(W B SAUNDERS CO, 2002) Ataoğlu, Hanife; Uçkan, S.; Öz, G.; Altınörs, N.[Abstract not Available]Öğe Temporomandibular Internal Derangement: Correlation of Mri Findings With Clinical Symptoms of Pain and Joint Sounds in Patients With Bruxing Behaviour(British Inst Radiology, 2003) Güler, N.; Yatmaz, P. I.; Ataoğlu, H.; Emlik, D.; Uçkan, S.Objectives: The aim of this study was to correlate magnetic resonance imaging (MRI) findings of effusion, disc displacement, condylar bony changes and disc form with clinical findings of pain and sounds in patients with bruxing and non-bruxing behaviour. Methods: Disc displacement was confirmed by MRI in 102 joints from 64 patients (total of 128 joints) with bruxing behaviour who were referred for clinically diagnosed internal derangements of the temporomandibular joint (TMJ). Sixty joints with internal derangement from 30 patients without bruxing behaviour served as a control group. The clinical inclusion criteria were pain in the preauricular area and muscles of mastication, limitation or deviation in mandibular range of motion, and TMJ sounds. Signs of bruxism were diagnosed clinically and were obtained from the patient's history given on their first visit. Pain was evaluated using a visual analogue scale. Results: Of the 102 joints in the study group with disc displacement, 53 (52%) showed disc displacement with reduction and 49 (48%) showed disc displacement without reduction. In the control group, 16 joints were classified as normal. Of the remaining 44 joints, 27 (61%) had disc displacement with reduction and 17 (39%) had unilateral disc displacement without reduction. Condylar bony changes were seen in 55% of the reducing joints in the study group and in 38% of the reducing joints in the control group, compared with 86% of the non-reducing joints in the study group and 24% of the non-reducing joints in the control group. There was a strong correlation between age and degenerative change in the study group. In the reducing joints, there was a significant difference in the prevalence of condylar bony changes between the study and control groups (P < 0.01). In non-reducing joints, 30% of painful joints in the study group and 59% of those in the control group showed a strong signal in the joint space on T-2 weighted imaging. Statistically significant differences between the study and control groups were also found for disc form and the prevalence of effusion and disc displacement. Joint sounds were important in unilaterally affected joints in the study group. A statistically significant correlation was found between joint sounds and reducing joints (P < 0.05). Conclusion: It was demonstrated that a higher prevalence of condylar bony changes occurred in reducing joints in patients with bruxing behaviour.Öğe Temporomandibular joint internal derangement: relationship between joint pain and MR grading of effusion and total protein concentration in the joint fluid(BRITISH INST RADIOLOGY, 2005) Güler, Nurhan; Uçkan, S.; İmirzalioğlu, P.; Açıkgözoğlu, SaimObjectives: The objective of this study was to determine whether there is any association between the protein concentration in the synovial fluid and (i) the amount of articular hydrops, as graded in magnetic resonance (MR) images, and (ii) joint pain in temporomandibular joints (TMJs) with and without displacement of the disc. Patients and methods: This study involved 16 joints in 16 patients referred to our clinic with the complaint of pain and limited mouth opening. The control group consisted of 15 joints in 15 patients with unilaterally normal disc and condyle relationship and no pain while the opposite side had a non-painful joint with disc displacement without reduction (DDwoR). The subjects and controls were different individuals and only a single joint was used for each. Pain and dysfunction were evaluated by visual analogue scale. Bilateral proton density and T-2 weighted images of the TMJs of the 31 subjects were analysed for fluid and condyle bony changes as well as disc position. The amount of fluid, identified as an area of high signal intensity in the region of the upper and lower joint spaces, was characterized as none, minimal, moderate or marked. Arthrocentesis was performed both for synovial fluid analysis of total protein concentration and the treatment of the joints with DDwoR. Total protein concentration was measured by using protein dye binding on spectrophotometry. Results: All patients experienced a significant (P < 0.01) increase in maximal mouth opening immediately post-arthrocentesis. In the study group, the disc was displaced most frequently in an anteriormedial direction (75%) and deformation of disc form was seen in 13 joints. Condylar bony changes were seen in 27% of joints in the control group and in 81 % of joints in the study group. A statistically significant association was found between joints with disc displacement, disc form and condylar bony changes (P < 0.05). In the control group, only one joint, which had an osteophyte, showed joint effusion QE) with moderate fluid. In the study group, only four joints had no fluid (25%). JE was found in 10 (63%) joints with disc displacement on anteromedial direction, in 10 (63%) joints with disc deformation and in 10 (63%) joints with osteophytes and erosion. Mean total protein concentration was 16.87 +/- 7.9 (range 7.4 - 34.1 mg dl(-1)) in control joints, 55.08 +/- 35.16 (range 21.5- 153.9 mg dl(-1)) in study joints. There were significant differences in the mean total protein concentration between the control and study groups (P < 0.01). Significant positive correlation was found between the total protein concentration and JE (r = 0.65, P < 0.01). No significant correlation was found between the level of pain and dysfunction and JE and total protein concentration in either control or study groups (P > 0.05). Conclusion: Pain in the TMJ was not related to MR findings of effusion in internal derangement and synovial fluid aspirate findings of total protein concentration. However, total protein concentration was related to the amount of JE in DDwoR joints and painful joints were more likely to demonstrate the JE.Öğe A Three Dimensional Numerical Interaction Model for the Fixation of Mandibular Fractures(2001) Uçkan, E.; Ak, S.; Uçkan, S.; Keypour, H.Two and three dimensional finite element models (FEM) were developed to simulate the behavior of a fractured jaw bone and the fixation materials. Mini-plates with various geometric and material properties and screw combinations were considered. Their effects on the variation of maximum stress contours were investigated. The geometric and material properties of the plate, screw and bone were seen to play important roles in effecting the relative displacement at the fractured surface and the spatial variation of the maximum stress across the jaw bone. Softer materials yielded less stress concentrations around the screws while increasing the relative deformation at the fractured surface and stiffer ones caused higher stress concentrations while decreasing the displacements. Results were also seen to be dependent on the loading and the need for the use of patient specific 3D solutions was emphasized.
