International Journal of Oral and Maxillofacial Surgery, Feb 1, 2021
The purpose of this study was to provide a United States perspective on alloplastic total joint r... more The purpose of this study was to provide a United States perspective on alloplastic total joint replacement. We sought to estimate the inpatient burden and report the most common adverse events using two administrative datasets. The National Inpatient Sample was queried from October 2015 to December 2016 for total joint replacement admissions using International Classification of Diseases 10 th revision codes, and the Manufacturer and User Facility Device Experience registry was queried from January 2009 to September 2019 using manufacturer brands. The combined final sample included 114 inpatient admissions and 392 adverse events. Mean age was 43.1 years, and most patients were white (82.7%) and female (86.0%). The mean hospital charge was $108,709.43 and the mean length of stay was 2.6 days. The most common adverse events were infection (26.3%), heterotopic bone (20.9%), and poor intraoperative fit (14.0%). Fifty-four percent of cases had bilateral total joint replacements, 24.6% had simultaneous subcutaneous abdominal fat grafting, and 11.4% had simultaneous maxillary repositioning. Fat grafting and maxillary repositioning were not associated with any significant difference in the length of stay or cost. Compared to unilateral cases, bilateral total joint replacements carried significantly greater charges (P < 0.01), but no increased length of stay (P = 0.70), suggesting that bilateral and unilateral cases may experience a similar postoperative course.
Frontiers of oral and maxillofacial medicine, Sep 1, 2022
Oral and maxillofacial surgery operations are susceptible to cause injury to terminal branches of... more Oral and maxillofacial surgery operations are susceptible to cause injury to terminal branches of the trigeminal nerve. The mandibular division is more prone to injury than ophthalmic and maxillary nerves. Inferior alveolar branch of the trigeminal nerve is the most commonly injured branch, followed by the lingual nerve. These nerves may be subjected to neurosensorial disturbance during third molar surgery, followed by sagittal split ramus osteotomy, endodontic therapy and dental implant placement. Local anesthetic injections, pre-prosthetic surgery, various other types of orthognathic surgery, ablative tumor surgery involving mandibular resections, osteoradionecrosis, osteomyelitis or maxillofacial trauma are among other potential etiologic factors. If an inferior alveolar or lingual nerve injury occurs, a timely diagnosis and a proper management are key factors to avoid further or permanent damage. A wide range of therapeutic modalities are available in managing nerve injuries, ranging from simple observation to complex grafting, depending on various factors. Data regarding nerve injuries may not always be reliable since most are based upon personal experience and in a retrospective nature. It is also challenging to draw proper conclusions from studies on nerve injuries due to the differences in outcome criteria and assessment methods. Still, an accurate knowledge of anatomy should be combined with both clinical and radiological data to avoid any nerve-related complications. Thus, this article will present a narrative review of the current literature on the inferior alveolar and lingual nerve injuries, focusing on the functional assessment methods, factors influencing recovery, the contemporary management protocols as well as future trends in nerve repairs.
International Journal of Oral and Maxillofacial Surgery, 2019
lation and suppression of Vimentin, Slug, Snail, and N-cadherin expression. Conclusion: Finally, ... more lation and suppression of Vimentin, Slug, Snail, and N-cadherin expression. Conclusion: Finally, of therapeutic relevance, combined with radiotherapy, CD47 knockdown enhanced the anti-OSCC effect of radiotherapy. Thus, we demonstrate the therapeutic feasibility of a CD47-mediated anti-CSC strategy, and suggest a role for CD47 suppression in potentiating the therapeutic efficacy of radiation therapy in OSCC patients.
Study Design The authors designed a 20-year cross-sectional study using the National Electronic I... more Study Design The authors designed a 20-year cross-sectional study using the National Electronic Injury Surveillance System (NEISS) database. Objective The purpose of the study is to determine the risk factors for hospital admission among individuals who suffer head and neck injuries secondary to trampoline use. Methods The primary predictor variables were a set of heterogenous variables that were categorized into the forementioned study variable groups (patient characteristics and injury characteristics). The primary outcome variable was hospital admission. Multivariate logistic regression was used to determine independent risk factors for hospital admission. Results The final sample consisted of 13,474 reports of trampoline injuries to the head and neck. Relative to females, males (OR 1.66, P < .05) were at an increased risk for hospital admissions. Fractures (OR 35.23, P < .05) increased the risk for hospital admissions relative to dental injuries. Concerning anatomical regi...
incisors (L1). Patients with lesser initial overbite demonstrated proclination of L1 and movement... more incisors (L1). Patients with lesser initial overbite demonstrated proclination of L1 and movement to edge-edge position of incisors. Patients who started in edge-edge position exhibited the most proclination of L1. Discussion: We discovered that pre-treatment incisal edge position correlated with the extent of incisor inclination following OA therapy. Although lateral cephalometric analysis indicated dental changes, patients reported in the follow-up visit that they did not perceive bite changes after OA therapy. We would like to further investigate the progression of dental changes so clinicians can warn patients of predicted side effects and suggest alternative treatment after weighing risks and benefits of OA therapy.
Study Design A retrospective cohort study was conducted using the Kids’ Inpatient Database from 2... more Study Design A retrospective cohort study was conducted using the Kids’ Inpatient Database from 2000 to 2014. Subjects were included if they were 18 years and younger and suffered any type of facial fracture. Objective The purpose this study was to determine the risk factors for incurring panfacial fractures among the pediatric population. Methods The primary predictor variables were a set of heterogenous variables that included patient characteristics, injury characteristics, hospitalization outcomes. The primary outcome variable was panfacial fracture. Logistic regression was used to determine the independent risk factors for panfacial fractures. Results Relative to infants and toddlers, teenagers were nearly three times more likely to sustain panfacial fractures ( P < .01). Relative to no chronic conditions, patients with one or more chronic conditions were more likely to incur panfacial fractures. Motorcycle accidents were over three times more likely ( P < .01) to result ...
Journal of Stomatology, Oral and Maxillofacial Surgery, 2020
PURPOSE The aim of this retrospective study was to investigate the characteristics of cemento-oss... more PURPOSE The aim of this retrospective study was to investigate the characteristics of cemento-osseous dysplasia (COD) lesions for devising a clinical algorithm to help management decisions, specifically discussing the need for a possible surgical intervention versus solely follow-up. MATERIALS AND METHODS One hundred thirty five subjects were thus identified having previously diagnosed and treated for COD from the archives of the pathology in between 2005-2015. These were then re-evaluated. Demographic features, radiographic and histopathologic findings were assessed. RESULTS The most frequent variant was the focal type (n=83), and the mandible (n=131) was predominantly affected jaw bone. Female predilection was evident for all subtypes. Almost half of the lesions (n=72) presented with mixed radiolucent and radiopaque appearances in radiography at the time of the biopsy. Cementicles/psammoma body-like calcifications and trabecular pattern were the most common hard tissue appearances. CONCLUSION COD lesions are non-neoplastic fibro-osseous lesions which can exhibit similar histopathologic and radiologic features with other bone lesions. Ideally, these lesions should be clinically identified and followed-up. Considering the possible complications, a thorough knowledge of these lesions and their differentials is essential in order to avoid unnecessary surgical interventions.
Hyperparathyroidism is nowadays diagnosed early and asymptomatically with the improvements in rou... more Hyperparathyroidism is nowadays diagnosed early and asymptomatically with the improvements in routine biochemical tests and radiological procedures. The late bony complications of the disease have therefore started to decline rapidly. Brown tumours are one of the bony complications of hyperparathyroidism. The mandible is the predominantly affected site in the maxillofacial area. Maxillary involvement is rare. Here, an extremely rare case of a 19-year-old male patient with brown tumours in his maxilla and mandible associated with tertiary hyperparathyroidism is presented. A thorough diagnostic work-up was carried out and treatment options for both hyperparathyroidism and brown tumours were discussed. The importance of different radiological evaluation methods and the consultation between the oral and maxillofacial surgeons, general practitioner dentists, endocrinologists and radiologists are emphasised.
International Journal of Oral and Maxillofacial Surgery, Feb 1, 2021
The purpose of this study was to provide a United States perspective on alloplastic total joint r... more The purpose of this study was to provide a United States perspective on alloplastic total joint replacement. We sought to estimate the inpatient burden and report the most common adverse events using two administrative datasets. The National Inpatient Sample was queried from October 2015 to December 2016 for total joint replacement admissions using International Classification of Diseases 10 th revision codes, and the Manufacturer and User Facility Device Experience registry was queried from January 2009 to September 2019 using manufacturer brands. The combined final sample included 114 inpatient admissions and 392 adverse events. Mean age was 43.1 years, and most patients were white (82.7%) and female (86.0%). The mean hospital charge was $108,709.43 and the mean length of stay was 2.6 days. The most common adverse events were infection (26.3%), heterotopic bone (20.9%), and poor intraoperative fit (14.0%). Fifty-four percent of cases had bilateral total joint replacements, 24.6% had simultaneous subcutaneous abdominal fat grafting, and 11.4% had simultaneous maxillary repositioning. Fat grafting and maxillary repositioning were not associated with any significant difference in the length of stay or cost. Compared to unilateral cases, bilateral total joint replacements carried significantly greater charges (P < 0.01), but no increased length of stay (P = 0.70), suggesting that bilateral and unilateral cases may experience a similar postoperative course.
Frontiers of oral and maxillofacial medicine, Sep 1, 2022
Oral and maxillofacial surgery operations are susceptible to cause injury to terminal branches of... more Oral and maxillofacial surgery operations are susceptible to cause injury to terminal branches of the trigeminal nerve. The mandibular division is more prone to injury than ophthalmic and maxillary nerves. Inferior alveolar branch of the trigeminal nerve is the most commonly injured branch, followed by the lingual nerve. These nerves may be subjected to neurosensorial disturbance during third molar surgery, followed by sagittal split ramus osteotomy, endodontic therapy and dental implant placement. Local anesthetic injections, pre-prosthetic surgery, various other types of orthognathic surgery, ablative tumor surgery involving mandibular resections, osteoradionecrosis, osteomyelitis or maxillofacial trauma are among other potential etiologic factors. If an inferior alveolar or lingual nerve injury occurs, a timely diagnosis and a proper management are key factors to avoid further or permanent damage. A wide range of therapeutic modalities are available in managing nerve injuries, ranging from simple observation to complex grafting, depending on various factors. Data regarding nerve injuries may not always be reliable since most are based upon personal experience and in a retrospective nature. It is also challenging to draw proper conclusions from studies on nerve injuries due to the differences in outcome criteria and assessment methods. Still, an accurate knowledge of anatomy should be combined with both clinical and radiological data to avoid any nerve-related complications. Thus, this article will present a narrative review of the current literature on the inferior alveolar and lingual nerve injuries, focusing on the functional assessment methods, factors influencing recovery, the contemporary management protocols as well as future trends in nerve repairs.
International Journal of Oral and Maxillofacial Surgery, 2019
lation and suppression of Vimentin, Slug, Snail, and N-cadherin expression. Conclusion: Finally, ... more lation and suppression of Vimentin, Slug, Snail, and N-cadherin expression. Conclusion: Finally, of therapeutic relevance, combined with radiotherapy, CD47 knockdown enhanced the anti-OSCC effect of radiotherapy. Thus, we demonstrate the therapeutic feasibility of a CD47-mediated anti-CSC strategy, and suggest a role for CD47 suppression in potentiating the therapeutic efficacy of radiation therapy in OSCC patients.
Study Design The authors designed a 20-year cross-sectional study using the National Electronic I... more Study Design The authors designed a 20-year cross-sectional study using the National Electronic Injury Surveillance System (NEISS) database. Objective The purpose of the study is to determine the risk factors for hospital admission among individuals who suffer head and neck injuries secondary to trampoline use. Methods The primary predictor variables were a set of heterogenous variables that were categorized into the forementioned study variable groups (patient characteristics and injury characteristics). The primary outcome variable was hospital admission. Multivariate logistic regression was used to determine independent risk factors for hospital admission. Results The final sample consisted of 13,474 reports of trampoline injuries to the head and neck. Relative to females, males (OR 1.66, P < .05) were at an increased risk for hospital admissions. Fractures (OR 35.23, P < .05) increased the risk for hospital admissions relative to dental injuries. Concerning anatomical regi...
incisors (L1). Patients with lesser initial overbite demonstrated proclination of L1 and movement... more incisors (L1). Patients with lesser initial overbite demonstrated proclination of L1 and movement to edge-edge position of incisors. Patients who started in edge-edge position exhibited the most proclination of L1. Discussion: We discovered that pre-treatment incisal edge position correlated with the extent of incisor inclination following OA therapy. Although lateral cephalometric analysis indicated dental changes, patients reported in the follow-up visit that they did not perceive bite changes after OA therapy. We would like to further investigate the progression of dental changes so clinicians can warn patients of predicted side effects and suggest alternative treatment after weighing risks and benefits of OA therapy.
Study Design A retrospective cohort study was conducted using the Kids’ Inpatient Database from 2... more Study Design A retrospective cohort study was conducted using the Kids’ Inpatient Database from 2000 to 2014. Subjects were included if they were 18 years and younger and suffered any type of facial fracture. Objective The purpose this study was to determine the risk factors for incurring panfacial fractures among the pediatric population. Methods The primary predictor variables were a set of heterogenous variables that included patient characteristics, injury characteristics, hospitalization outcomes. The primary outcome variable was panfacial fracture. Logistic regression was used to determine the independent risk factors for panfacial fractures. Results Relative to infants and toddlers, teenagers were nearly three times more likely to sustain panfacial fractures ( P < .01). Relative to no chronic conditions, patients with one or more chronic conditions were more likely to incur panfacial fractures. Motorcycle accidents were over three times more likely ( P < .01) to result ...
Journal of Stomatology, Oral and Maxillofacial Surgery, 2020
PURPOSE The aim of this retrospective study was to investigate the characteristics of cemento-oss... more PURPOSE The aim of this retrospective study was to investigate the characteristics of cemento-osseous dysplasia (COD) lesions for devising a clinical algorithm to help management decisions, specifically discussing the need for a possible surgical intervention versus solely follow-up. MATERIALS AND METHODS One hundred thirty five subjects were thus identified having previously diagnosed and treated for COD from the archives of the pathology in between 2005-2015. These were then re-evaluated. Demographic features, radiographic and histopathologic findings were assessed. RESULTS The most frequent variant was the focal type (n=83), and the mandible (n=131) was predominantly affected jaw bone. Female predilection was evident for all subtypes. Almost half of the lesions (n=72) presented with mixed radiolucent and radiopaque appearances in radiography at the time of the biopsy. Cementicles/psammoma body-like calcifications and trabecular pattern were the most common hard tissue appearances. CONCLUSION COD lesions are non-neoplastic fibro-osseous lesions which can exhibit similar histopathologic and radiologic features with other bone lesions. Ideally, these lesions should be clinically identified and followed-up. Considering the possible complications, a thorough knowledge of these lesions and their differentials is essential in order to avoid unnecessary surgical interventions.
Hyperparathyroidism is nowadays diagnosed early and asymptomatically with the improvements in rou... more Hyperparathyroidism is nowadays diagnosed early and asymptomatically with the improvements in routine biochemical tests and radiological procedures. The late bony complications of the disease have therefore started to decline rapidly. Brown tumours are one of the bony complications of hyperparathyroidism. The mandible is the predominantly affected site in the maxillofacial area. Maxillary involvement is rare. Here, an extremely rare case of a 19-year-old male patient with brown tumours in his maxilla and mandible associated with tertiary hyperparathyroidism is presented. A thorough diagnostic work-up was carried out and treatment options for both hyperparathyroidism and brown tumours were discussed. The importance of different radiological evaluation methods and the consultation between the oral and maxillofacial surgeons, general practitioner dentists, endocrinologists and radiologists are emphasised.
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Papers by Firat Selvi