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    Comparative Investigation of Anti-Inflammatory Effect of Platelet-Rich Fibrin after Mandibular Wisdom Tooth Surgery: A Randomized Controlled Study
    (Mdpi, 2023) Karaca, Gamze Tanan; Duygu, Gonca; Er, Nilay; Ozgun, Eray
    This study evaluated the anti-inflammatory effect of platelet-rich fibrin (PRF) applied to the extraction socket after impacted mandibular third molar surgery with subjective and objective parameters. Forty-eight patients with impacted wisdom teeth in bilateral and similar positions were included in the study. The control group was formed with the standard surgery and the PRF group was formed with local PRF application in addition to standard procedure (n = 96). The anti-inflammatory activity of PRF on postoperative 2nd and 7th days was evaluated subjectively by clinical parameters and objectively by biochemical parameters. Postoperative 2nd- and 7th-day follow-up data of pain, edema, and trismus in the PRF group were found to be statistically significantly lower. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were found to be statistically significantly lower in the PRF group than the control in the postoperative 2nd-day follow-up period (p < 0.001). There was no statistically significant difference in interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF-& alpha;) parameters when the PRF group and the control group were compared in both follow-up periods (p > 0.05). The study has demonstrated the effectiveness of locally applied PRF after ITM surgery via clinical parameters and objective data. The quantitative analysis of CRP and ERS can be an effective parameter in determining the amount of inflammation after ITM surgery.
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    Does Saline Irrigation at Different Temperatures Affect Pain, Edema, and Trismus After Impacted Third Molar Surgery: A Clinical Trial
    (W B Saunders Co-Elsevier Inc, 2023) Canakci, F. Gulfesan; Er, Nilay; Duygu, Gonca; Karaca, Gamze Tanan
    Purpose: Lower impacted third molar surgery is a very common oral-maxillofacial surgical procedure, which has complications such as facial swelling, pain, and trismus. This clinical trial aimed to compare the intensity of postoperative morbidity (pain, facial swelling, and trismus) following the third molar surgery performed using saline irrigation at different temperatures (4 degrees C, 10 degrees C, or 25 degrees C).Materials and Methods: This double-blind, single-center, split-mouth, randomized prospective clinical trial was conducted among 48 systemically and periodontally healthy patients who had bilaterally asymp-tomatic mandibular third molars. Patients were randomly allocated into 2 groups (n = 24) according to the temperature of the saline used. In each patient, one impacted third molar was determined as the test group (4 degrees C or 10 degrees C saline irrigation) and the other impacted third molar as the control group (25 degrees C saline irri-gation). Trismus and swelling were evaluated on the 1st, 3rd, and 7th days postoperatively. Pain perception by visual analog scale (VAS) and the total number of analgesics taken during the 7 postoperative days were recorded. Data were analyzed using the Shapiro-Wilk test, the chi-square test, one-way analysis of variance, Duncan test, the Kruskal-Wallis test, the Dunn test, and the Friedman test (P < .05).Results: Forty-eight patients (28 females, 20 males) with a mean age of 24.6 +/- 3.8 years were included in the study. The duration of operations was similar. VAS values of test groups [test group 1 (4 degrees C): 4.0, test group 1 (10 degrees C): 8.0] and the number of analgesics taken [test group 1 (4 degrees C): 0, test group 1 (10 degrees) C): 3] were significantly lower (P < .001) than control groups (VAS, control group 1: 13.0, control group 2: 15.5, number of analgesic taken, control group 1: 5.5, control group 2: 4.0). Significant differences were found between the test groups in VAS values and the number of analgesics taken (P < .001). Also, the lowest trismus and facial swelling values were detected in the 4 degrees C test group at all time points (P < .001). Conclusion: In the impacted third molar surgery, the use of cooled saline irrigation during bone removal may be a simple, inexpensive, and effective method for reducing early postoperative complaints. (c) 2022 American Association of Oral and Maxillofacial Surgeons
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    Surgical management of stage-2 medication-related osteonecrosis of the jaw with transplantation of human amniotic membrane: Preliminary results
    (Elsevier, 2022) Canakci, F. GulfeSan; Er, Nilay; Duygu, Gonca; Varol, G. F. Usun
    Medication-related osteonecrosis of the jaw (MRONJ) is a drug adverse reaction. Seven osteonecrosis areas in 5 cases were treated with stage-2 MRONJ using human amniotic membrane (HAM) transplantation after sequestrectomy. Patients were evaluated in terms of infection (pain, erythema, and pus), mucosal coverage, and pain at 1, 2, 4, 8, and 12 weeks. Patients who showed improvement (total mucosal coverage, no sign of infection and pain) at the end of 12 weeks were followed up every 8 weeks. Also, radiographic examinations (panoramic radiography at every 8 weeks, cone-beam computed tomography at every 6 months) were performed to evaluate bone destruction. Complete mucosal closure was achieved in 6 necrosis sites. In only 1 patient, mucosal coverage was not achieved. No pain and infection relapse were observed during the followups. HAM might be an effective material in terms of soft tissue healing and elimination of pain and infection for stage-2 MRONJ. Clinical Trials Registration Number: NCT04967963 (C) 2021 Published by Elsevier Masson SAS.
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    Use of Leukocyte-rich and Platelet-rich Fibrin (L-PRF) Adjunct to Surgical Debridement in the Treatment of Stage 2 and 3 Medication-Related Osteonecrosis of the Jaw
    (Lippincott Williams & Wilkins, 2023) Yalcin-Ulker, Gul Merve; Duygu, Gonca; Tanan, Gamze; Cakir, Merve; Meral, Deniz Gokce
    Medication-related osteonecrosis of the jaw (MRONJ) is characterized by exposed necrotic bone persisting for more than 8 weeks in the maxillofacial region in patients using antiresorptive or antiangiogenetic drugs for several treatment options like bone metastasis or osteoporosis. There are several treatment options studied in scientific literature, and one of them with promising results is using platelet concentrates adjunct to surgical therapy. The aim of this study is to examine the therapeutic effect of leukocyte and platelet-rich fibrin (L-PRF) on patients with MRONJ. This 2-centered study investigated patients referred to oral and maxillofacial surgery departments of 2 university clinics between the years 2014 and 2020 with the diagnosis of MRONJ. Demographic data, the indication of the drug usage, drug type, duration, administration route, and systemic comorbidities of the patients were recorded. L-PRF was applied to 20 osteonecrotic lesions of 19 patients following surgical debridement. The male/female ratio was 5/14. Except 1 of the patients, all of the indications of medication were neoplasia-related. The mean follow-up period of patients was 27.9 & PLUSMN;9.2 months. Most common antirezorptive drug was zoledronate (84.2%). Complete resolution was observed in 16 necrosis sites (80%). It could be concluded that the use of L-PRF may represent an important adjunct in the surgical management of MRONJ.