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Öğe Assessment of maxillary sinus changes after le fort I osteotomy surgery(Lippincott Williams & Wilkins, 2020) Akbulut, Nihat; Çakmak, Emine Şebnem Kurşun; Bayrak, SevalObjective: The goal of this retrospective study is to examine the changes of maxillary sinus volume, sinus membrane thickness (SMT) and the distance between the floor of maxillary sinus and ostium after Le Fort I osteotomy. Methods: A total of 30 patients who underwent Le Fort I osteotomy were evaluated just before and 1 year after the surgical operation. Linear and volumetric measurements were done via 3D-DOCTOR software on sectional and 3D images. Results: Decrease in maxillary sinus volume, increase in SMT and no change in distance between the floor of the maxillary sinus and ostium were detected after surgery. After surgery, SMT was found higher in advancement + impaction group. Conclusion: This paper clarified that Le Fort I osteotomy affects the volume and thickness of the maxillary sinuses that may lead to deterioration of the ciliary activity and failure in the drainage which are predisposing factors for sinus pathologies. In maxillary osteotomies of later ages, maxillary sinus examination and follow-up should be performed regularly in order to maintain sinus health.Öğe Effects of modified step Le Fort I advancement surgery on nostril area and inferior nasal structures volume in class III patients: A retrospective clinical study(Springer Heidelberg, 2023) Akbulut, Nihat; Akbulut, Sibel; Bayrak, Seval; Şen, Esengül; Altan, Ahmet; Kaymaz, GizemnurObjectiveThe effect of the modified step Le Fort I osteotomy on the inferior nasal structures and the nostril area was evaluated.Materials and methodsThis study included 24 patients who had modified step Le Fort I osteotomy. Inferior nasal concha volume (INCV), meatus nasi inferior volume (MNIV), the sum of both structures volume (TV), and nostril area (NA) were evaluated in pre- (T0) and postoperative (T1) periods.ResultsFor all patients, NA increased both on the right side (p = 0.011) and left side (p = 0.050) after surgery. The INCV and TV values were lower in T1 than those in T0; however, a statistically significant decrease of INCV and TV was found only in the right side of males (p = 0.039 and p = 0.050, respectively). No significant difference was found in MNIV between T0 and T1 measurements (p > 0.05).ConclusionMaxillary advancement with the modified step Le Fort I osteotomy technique increased the NA, which may have a positive effect on breathing function. On the other hand, although TV tended to decrease, MNIV did not change after surgery as the same decreasing tendency also existed in INCV.Öğe Effects of root-end filling on the fractal dimension of the periapical bone after periapical surgery: Retrospective study(Springer Heidelberg, 2019) Aydın, Zeliha Uğur; Toptaş, Orçun; Bulut, Duygu Göller; Akay, Neşet; Kara, Tolgahan; Akbulut, NihatObjective The aim of this study was to investigate the effects of root-end filling after periapical surgery on the fractal dimension (FD) of the periapical bone. Methods Thirty-eight patients who underwent periapical surgery were included in this study. The cases were divided into two subgroups: (1) In the gutta-percha group, root cavity and root-end fillings were not performed after root resection. In this group, there were 14 female patients and 6 male patients. (2) In the mineral trioxide aggregate (MTA) group, the root end was filled with MTA after root resection. In this group, there were 13 female patients and 5 male patients. Each patient underwent two periapical radiographs, one shortly after periapical surgery (10-15 days) and another one 1 year after periapical surgery. Regions of interest (ROIs) located close to the infected root apex were selected for each radiograph. Periapical radiographs were digitized and processed with an FD analysis using the box-counting method. Results FD was significantly increased in both groups over time (p < 0.05). The increases in FD between groups were not significant (p > 0.05). Conclusions Mathematical morphology combined with the box-counting method showed that the FD change was independent of the root-end filling at the 1-year follow-up after periapical surgery.Öğe Evaluation of bony changes observed in mandibular osteotomy lines and mandibular condyles following bilateral sagittal ramus osteotomy by fractal analysis(Springer, 2022) Çolak, Sefa; Altan, Ahmet; Bayrak, Seval; Akbulut, NihatObjectives This study aimed to evaluate the surgically impacted trabecular changes in mandibular osteotomy lines and mandibular condyles after bilateral sagittal split ramus osteotomy using the fractal analysis method. Materials and method The study population consisted of 30 patients (9 male, 21 female) diagnosed with mandibular prognathism and operated with bilateral sagittal split ramus osteotomy under general anesthesia. Fractal analyses observed the alterations on the trabecular structure of osteotomy lines, and mandibular condyles on panoramic radiographs obtained preoperatively, postoperatively, 1st week, 6th month, and 12th month. The box-counting method was used to evaluate the changes in trabecular structure by fractal analysis. P-values of less than 0.05 were considered significant. Results The fractal dimension values in both osteotomy lines and mandibular condyles were significantly decreased on postoperative 1st week regarding preoperative values. However, fractal dimension values commenced increasing in the following postoperative period. The fractal dimension values of the horizontal and vertical osteotomy lines reached their preoperative values on postoperative 6th and 12th month, respectively. The decreased fractal dimension values observed in the early postoperative period in the right and left condyles reached their preoperative values at the 6th postoperative month. Conclusion Fractal analyses performed postoperatively can provide information about trabecular changes and bone healing of structures such as osteotomy lines directly affected by bilateral sagittal split ramus osteotomy and indirectly affected mandibular condyles. The results support that fractal analysis can be used together with clinical data in the evaluation of bone healing process.Öğe Evaluation of pharyngeal airway by cone-beam computed tomography after mono- and bimaxillary orthognathic surgery(Wolters Kluwer Medknow Publications, 2022) Sarı, Merve; Şen, Esengül; Akbulut, Nihat; Bayrak, Seval; Demir, OsmanIntroduction: The aim of this study was to evaluate the changes of the pharyngeal airway obtained using mono-and bimaxillary orthognathic surgery in patients with skeletal malocclusion. Material and Methods: The analysis was conducted on cone-beam computed tomography images taken preoperatively and postoperatively of patients undergoing mono-or bimaxillary orthognathic surgery. The pharyngeal airway was divided into four airway volume segments and measured by planimetry. Results: The bimaxillary surgery group showed an increase in nasopharynx and velopharynx volumes and a decrease in glossopharynx and hypopharynx volumes (P < 0.05). The mandibular setback surgery group showed decreases in glossopharynx, hypopharynx, oropharynx, and pharynx volumes (P < 0.05). The mandibular advancement surgery group showed increases in glossopharynx, hypopharynx, oropharynx, and pharynx volumes (P < 0.05). The maxillary advancement surgery group showed increases in nasopharynx, velopharynx, and pharynx volumes (P < 0.05). Discussion and Conclusion: Mandibular setback surgery had a narrowing effect on the pharyngeal airway volume. Maxillary advancement surgery compensated for the constrictive effect of mandibular setback surgery on both the oropharynx and pharynx volumes. Although maxillary and mandibular advancement surgery affected different sites, these were the operations that contributed most to the increase in pharyngeal volume.Öğe Trabecular structure designation using fractal analysis technique on panoramic radiographs of patients with bisphosphonate intake: A preliminary study(Springer, 2019) Demiralp, Kemal Özgür; Çakmak, Emine Şebnem Kurşun; Bayrak, Seval; Akbulut, Nihat; Atakan, Cemal; Orhan, KaanObjectiveThis study was performed to evaluate the trabecular pattern of patients with cancer taking bisphosphonates on panoramic images using fractal dimension (FD) analysis by comparison with healthy subjects and to assess whether any difference exists between regions.MethodsFD analysis was conducted using ImageJ 1.3 software (National Institutes of Health, Bethesda, MD, USA) with the box-counting method on panoramic radiographs of 33 patients taking bisphosphonates (13 males and 20 females) and 33 healthy sex- and age-matched individuals.ResultsFD values were higher (1.390.14) in the study group than control group (1.38 +/- 0.07) (p0.05). No difference was detected in the FD values among the tested regions. The mean FD values in the control and study groups were as follows: region 1, 1.49 and 1.41 (p=0.54); region 2, 1.36 and 1.37 (p=0.84); region 3, 1.35 and 1.42 (p=0.11); and region 4, 1.39 and 1.39 (p=0.90), respectively. Female patients showed significantly lower values above the mandibular canal on the distal side of the second premolar and anterior to the mental foramen than did male patients (p0.05). Age was unrelated to the FD in the study group (p0.05).ConclusionsThe FD values of the patients with cancer taking bisphosphonates were higher than those of the controls. FD analysis showed the potential for examining bone structure in panoramic radiographs. Studies with a larger sample size are necessary to confirm these results.