Diş Hekimliği Fakültesi / Faculty of Dentistry

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Dişeti ve dental folikül dokularında mezenkimal kök hücre araştırması ve plastisitelerinin karşılaştırılması
(Başkent Üniversitesi Diş Hekimliği Fakültesi, 2008) Eroğlu, Tamer; Uçkan, Sinan
Mezenkimal kök hücreler, rejeneratif potansiyelleri, immünsupresif özelikleri ve destek doku olusturma potansiyelleri nedeniyle hücresel tedavi için ilgi çekmektedir. Kemik iliği, göbek kordonu, çevre kanı, amniotik sıvı, periost, yağ dokusu, sinovial membran ve kas gibi birçok kaynaktan elde edilebildiği gibi maksillofasiyal bölgede de MKH izolasyonu ile ilgili çalısmalar bulunmaktadır. Ağız ortamında en kolay ulasılan bölgelerden biri olan ve sürekli yenilenmekte olan disetinin MKH’ler için potansiyel bir kaynak olabileceğiyle ilgili bir çalısmaya literatürde rastlanmamıstır. Ayrıca dental folikül dokusundan MSC izolasyonu ile ilgili sınırlı sayıda çalısma mevcuttur. Çalısmada, çekim endikasyonu konulmus gömülü 20 yas disi olan 6 hastada insizyon esnasında çıkarılan disetinden ve dental folikül dokusundan alınan doku örneklerinden hücre kültürü yapılmıs ve tüm örneklerden adezyon özelliği gösteren MKH’lerin izolasyonu yapılmıs ve kültürde çoğaltılmıstır. Akım sitometri yöntemi ile hücrelerin immünfenotipleri tanımlanmıs ve adiposit, osteosit, kondrosit ve nöronal hücrelere farklılasabilme potansiyelleri arastırılmıstır. Her iki dokudan da gelistirilen MKH’lerin CD105, CD 73, CD 90 gibi stromal antijenleri yüksek oranda (%60-98) tasıdığı gösterilmistir. Hücreler kültürde 8. pasaja kadar ilerletilmis ve analizler 2, 5 ve 8. pasajlarda yapılmıstır. Pasajlar arasında yüzey antijen ekspresyonları yönünden farklılık saptanmamıstır. Kültürde çesitli uyaranlar kullanılarak yapılan farklılasma deneylerinde diseti ve folikülden elde edilen hücrelerin adipojenik ve osteojenik farklılasma kapasitelerinin bulunduğu gösterilmis, kondrojenik farklılasma elde edilmemistir. Ayrıca, uygun uyaranlar ile nöronal hücre morfolojisine değisme olduğu gözlenmistir. Bu çalısmalarda diseti ve dental folikül dokularından elde edilen MKH lere ait farklılık gözlenmemistir. Fibroblastlar ile birçok ortak özellik tasıyan MKH’lerin fibroblasttan ayrımı için, kültürde hücre yoğunluğunun, adezyon özelliklerinin, yüzey antijen ekspresyonlarının ve farklılasma özelliklerinin detaylı karsılastırması yapılmıstır. Baslangıç hücre yoğunluğu, erken veya geç adezyon göstermeleri ve yüzey antijenleri yönünden fibroblast ve MKH’lerin ayırt edilmesine katkıda bulunacak bir farklılık saptanmamıstır. Hücrelerin kök/projenitör özelliğini göstermesi açısından en önemli özellik olan çok yönlü farklılasma kapasiteleri test edildiğinde (8. pasaja kadar), ileri pasajlarda da farklılasma kapasitesinin korunmasının hücrelerin kök/projenitör özellikleri ile uyumlu olduğu, böylelikle genellikle 3.pasajdan sonra farklılasma özelliği bulunmayan fibroblastlardan ayırt edilebileceği düsünüldü. Elde edilen sonuçlar, diseti dokusunun noninvaziv metodla elde edilebilmesi ve defekt bölgesine yakın olması ile bilinen ağız içi kaynaklara ek bir MKH kaynağı olabileceğini düsündürmüstür. Mesenchymal stem cells draw attention for cell based therapy with their regenerative, and tissue supporting potential and immunosuppresive caharacteristics. MSCs can be isolated from several tissues such as bone marrow, umbilical cord, peripheral blood, amniotic fluid, periosteum, fat, synovial membrane and muscle. Like in different tissues, suitable MSC resources at the maxillofacial region have been investigated and related reports are published in the literature. No studies have been published in the literature about the gingival tissue which is the most easiest approachable site in the oral cavity with a high regeneration potential. Furthermore, isolation of MSCs from dental follicle tissues have been described in a few number of studies. In this study, impacted third molars of 6 patients were extracted in a routine surgical procedure and gingival/ dental follicle tissue samples was obtained during the incision and extraction period. Along all samples, MSCs with an adhesion property have been isolated and expanded in culture. Immunophenotyping was perfomed by flow cytometry and adipocyte, osteocyte, chondrocyte, and neuronal differentiation potential of these stem cells were tested and the characteristics of gingival and follicle stem cells were compared. It has been demonstrated that MSCs obtained from both tissues have a high frequency of specific stromal antigens (%60-98) such as CD105, CD 73, CD 90. Cells have been expanded through passage 8 and characterized at 2. 5. 8. passages. No differance have been determined about surface antigen expression speciality between the passages. Differantiation assays with various stimulants in the culture points out that dental follicle and gingiva derived cells have adipogenic and osteogenic differantiation capacity however there was no evidence of chondrogenic differantiation. Furthermore, with suitable stimulants alteration to neuronal cell morphology was observed. In this study there was no difference between the differantiation potentials of MSCs derived from gingival and dental follicle tissue. Because of their similarities, the detailed comparison of plating density, adhesion properties, surface antigen expressions and differantiation potentials have been performed to distinguish MSCs from fibroblasts. Initial plating density, early or late adhesion properties and surface antigen expressions did not contribute to distinguish MSCs from fibroblasts. Multilineage differantiation potential through the late passages is one of the most important criteria to distinguish MSCs from fibroblasts. The differantiation potential of gingiva and dental follicle derived cells through passage 8 denoted the MSC/progenitor specialities of these cells. Besides the differantiation potential of fibroblasts usually ends at the passage 3. In this study MSCs continuing differantiation through passage 8 was the most important criteria to separate these cells from fibroblasts which has a differantiation potential through passage 3. Obtained results suggest that the gingival tissue is considered as an alternative source of stem cells to the other intraoral stem cell sources with it is in close proximity to the recipient site and can be obtained easily by a non- invasiv method.
Alt çene tam ve kısmi dişsizlik vakalarında diş, implant ve diş-implant destekli hareketli protez uygulamalarında protetik yapılar ve çevre dokulardaki stres, gerinim ve yer değiştirmenin 3 boyutlu sonlu elemanlar stres analiz yöntemi ile değerlendirilmesi
(Başkent Üniversitesi Diş Hekimliği Fakültesi, 2012) Dağlık, Deniz; Çağlar, Alper
Bu çalışmanın amacı; mandibular diş, implant ve diş-implant destekli hareketli protezlerde, kortikal ve trabeküler kemiğin, protezin, dentinin, implantın, periodontal ligament ve tutucu elemanların biyomekanik davranışını, üç boyutlu sonlu elemanlar stres analizi ile değerlendirmektir. Üç boyutlu dişsiz mandibula modelinde dört farklı tasarım oluşturulmuştur. 1. tasarımda, kanin dişler bölgesinde iki adet implant, 2. tasarımda iki kanin diş, 3. tasarımda iki kanin diş ve ikinci molarlar bölgesinde iki adet implant ve 4. tasarımda kanin ve ikinci molar dişler bölgesinde ikişer adet implant locator tutucularla birlikte alt çene hareketli protez desteği olarak kullanılmıştır. Yükleme, sol kanin, premolar ve molar dişlerin cusp tepelerinden vertikal olarak toplam 100 N olarak uygulanmıştır. Sonlu elemanlar stres analizinde 3. ve 4. tasarımlar, 1. ve 2. tasarımlarla kıyaslandığında daha az yer değiştirme ve mukozada daha düşük temas basıncı ve basma stresleri göstermiştir. 4. tasarımda implant çevresi kortikal kemikte, locatorda, locator matrisinde ve housing parçada yükleme yapılmayan taraf posterior implantında en yüksek stresler oluşmuştur. 3. tasarımda posterior bölgeye implant yerleştirilmesiyle kanin dişlerde dentin ve periodontal ligamentte oluşan stresler azalmıştır. Posterior bölgeye implant yerleştirilmesiyle, ikinci molar bölgesinde trabeküler kemikte oluşan gerinim değerleri artmıştır. Posterior implant çevresindeki kortikal kemikte oluşan en yüksek değerler, kemikte rezorbsiyona neden olabileceği belirtilen en yüksek değerlerin altında görülmüştür. Dişsiz alveoler krette oluşan gerinim değerleri Frost’un kemik yapımı ve rezorpsiyonunu tanımladığı stimulasyon pencere aralığı değerlerinin alt sınırına yakın olduğu, posteriora implant yerleştirilmesiyle bu bölge kemiğinde oluşan gerinimlerin arttığı ve stimulasyon pencere aralığı değerleri içinde oluştuğu görülmüştür. En yüksek stresler dört implant kullanılan tasarımda posterior implantta, locator parçada, locator matrisinde ve housing parçada oluşmuştur. Elde edilen stres değerleri materyallerin dayanma sınırının altında oluşmuştur. Bu streslerin ve gerinimlerin, kemik rezorbsiyonu ve locator tutucu parçaya olan etkilerinin uzun dönemli klinik çalışmalarla değerlendirilmesi gerekmektedir. The aim of this study is to evaluate the biomechanical behavior of trabecular and cortical bone, denture, dentin, implant, periodontal ligament, and retentive elements on tooth, implant and implant-tooth supported removable overdenture prosthesis by three dimensional finite element analysis. Four different designs were constructed in 3 dimensional edentulous mandibular model. In the first design, two implants on canine tooth region; in the second design, two canine teeth; in the third design, two canine teeth and two implants on second molar region and in the fourth design, two implants each with locator retentive on canine and second molar region were used as mandibular removable overdenture prosthesis support. Loading was applied vertically on left canine, premolar and molar teeth with a total of 100 N. Designs 3 and 4 showed lower displacement and low contact pressure and compressive stresses at mucosa when compared with model 1 and 2 on finite element analysis. Cortical bone around posterior implants, locator abutment, locator matris and housing at unloaded posterior implant sites showed higher stresses in design 4. Stress values of periodontal ligament and dentin was decreased with the placement of implant at posterior region in model 3. With the placement of implant at posterior region, the strain values were increased on trabecular bone in second molar region. The highest stresses that occur on cortical bone around the posterior implant were lower than the highest values indicated to cause bone resorption. The results showed that strain values occurred on edentulous posterior alveoler ridge were close to the lowest values of numerical analyses of stimulus window scale defined for bone apposition and resorption by Frost; with placement of implant to posterior region strain values were increased in this bone region and all strain values were grouped in Frost’s stimulus window scale. The highest stress values were obtained on posterior implant, locator, matris and housing in design where four implants were used. The stress values were below materials endurance limit. However, effects of obtained stress and strain values on bone resorption and locator retention should be evaluated with long term clinical studies.
A Clinical Comparison of Cordless and Conventional Displacement Systems Regarding Clinical Performance and Impression Quality
(2014) Acar, Ozlem; Erkut, Selim; Ozcelik, Tuncer Burak; Ozdermr, Erdem; Akcil, Mehtap; https://orcid.org/0000-0001-5685-4409; 24360008; JJF-5618-2023
Statement of problem. it is not clear whether newly introduced cordless displacement systems are better able to manage gingiva than conventional systems. Purpose. The purpose of this in vivo study was to evaluate the gingival management ability of 4 different displacement methods with a standardized subgingival preparation finish line. Material and methods. The effects of 4 displacement techniques on gingival management and impression quality were evaluated by means of 6 evaluation criteria. A subgingival preparation finish line of between 1 and 2 mm was ensured, and the buccal aspects of 252 (n=63) teeth were clinically assessed for ease of application, time spent, bleeding, remnants, and dilatation. The complete reproduction of the preparation finish line and the bubble and void formations on polyether impressions were also evaluated. The data were statistically analyzed with the chi(2) test (alpha=.05). The Bonferroni correction was used to control Type I error for the pairwise comparison groups (alpha=.008). Results. Statistically significant differences were found for all criteria among the groups (P<.05). The nonimpregnated displacement cord group was the least effective group in terms of bleeding and impression quality (P<.008). The aluminum chloride impregnated cord group and the displacement paste with cap group were found to be comparable in terms of remnants, dilatation, and impression quality (P>.008). The retraction cap with paste group showed better results for ease of application, time spent, and bleeding than the aluminum chloride impregnated cord group (P<.008). Although the group with aluminum chloride impregnated cord, displacement paste, and cap showed better results for dilatation, it was time consuming and difficult (P<.008). Conclusions. Except for the nonimpregnated cord group, all of the groups were comparable and clinically useful, with perfect or acceptable impression qualities.
Use of Cone-Beam Computed Tomography in Diagnosis of An Otherwise Undetected Periapical Lesion in An Anomalous Tooth
(2014) Gulsahi, Ayse; Ates, Ufuk; Tirali, Resmiye Ebru; Cehreli, Sevi Burcak; https://orcid.org/0000-0001-6487-3984; HGA-3970-2022; AAD-2907-2020; AAD-6138-2021
Fusion is a developmental anomaly of dental hard tissues. Since dental fusion is characterized by irregular coronal morphology and a complex endodontic anatomy, endodontic therapy of such teeth may present a serious clinical challenge. Cone-beam computed tomography (CBCT) is a useful tool for the management of complex endodontic problems and dental anomalies. In the case presented here, a CBCT scan revealed morphological details as well as the severity of periapical infection that had not been visualized with conventional imaging techniques. The results obtained with detailed imaging led to a change in the treatment plan.
Interdisciplinary Management of an Adult Patient with A Class III Malocclusion
(2014) Pektas, Zafer Ozgur; Kircelli, Beyza Hancioglu; 24370388
The coexistence of a skeletal class III deformity and partial edentulism poses a clinical challenge and requires a comprehensive evaluation followed by a multidisciplinary approach. This clinical report presents the integrated management of a class Ill malocclusion in a 50-year-old woman with partial edentulism. The patient received adjunctive orthodontic treatment with a rigid temporary anchorage device, a Le Fort I maxillary osteotomy, and prosthodontic rehabilitation with removable maxillary copings, an overdenture, and a mandibular partial removable dental prosthesis with precision attachments.
Depigmented skin and phantom color measurements for realistic prostheses
(2014) Tanner, Paul; Leachman, Sancy; Boucher, Kenneth; Ozcelik, Tuncer Burak
PurposeThe purpose of this study was to test the hypothesis that regardless of human skin phototype, areas of depigmented skin, as seen in vitiligo, are optically indistinguishable among skin phototypes. The average of the depigmented skin measurements can be used to develop the base color of realistic prostheses. Methods and MaterialsData was analyzed from 20 of 32 recruited vitiligo study participants. Diffuse reflectance spectroscopy measurements were made from depigmented skin and adjacent pigmented skin, then compared with 66 pigmented polydimethylsiloxane phantoms to determine pigment concentrations in turbid media for making realistic facial prostheses. ResultsThe Area Under spectral intensity Curve (AUC) was calculated for average spectroscopy measurements of pigmented sites in relation to skin phototype (P=0.0505) and depigmented skin in relation to skin phototype (P=0.59). No significant relationship exists between skin phototypes and depigmented skin spectroscopy measurements. The average of the depigmented skin measurements (AUC 19,129) was the closest match to phantom 6.4 (AUC 19,162). ConclusionAreas of depigmented skin are visibly indistinguishable per skin phototype, yet spectrometry shows that depigmented skin measurements varied and were unrelated to skin phototype. Possible sources of optical variation of depigmented skin include age, body site, blood flow, quantity/quality of collagen, and other chromophores. The average of all depigmented skin measurements can be used to derive the pigment composition and concentration for realistic facial prostheses.
The Effect of Temperature and Contact Time of Sodium Hypochlorite on Human Roots Infected with Enterococcus Faecalis and Candida Albicans
(2014) Gulsahi, Kamran; Tirali, R. Ebru; Cehreli, S. Burcak; Karahan, Zeynep Ceren; Uzunoglu, Emel; Sabuncuoglu, Bizden; https://orcid.org/0000-0003-3510-7265; https://orcid.org/0000-0001-6487-3984; 23011474; AAX-5565-2021; AAD-2907-2020; AAD-6138-2021
The aim of this study was to evaluate the effectiveness of 2.5 % NaOCl at different temperature and time intervals on Enterococcus faecalis and Candida albicans-infected human roots. A total of 112 root cylinders prepared from extracted single-rooted humans were infected by E. faecalis (Group A, n = 56) or C. albicans (Group B, n = 56); 3 root cylinders served as negative controls. Both groups were further divided into 6 subgroups according to three contact times (30 s, 1 min, 5 min) with NaOCl at two different temperatures (25 or 37 A degrees C). Microorganism growth was controlled at the 24th and 48th hours. Statistical analysis was performed using the Chi-square test. While NaOCl at 25 A degrees C for 5 min was the most effective irrigation regimen to eliminate E. faecalis (p < 0.001), NaOCl at 37 A degrees C for 5 min exhibited significantly superior antifungal properties (p < 0.05). At the same contact times, difference in the temperature of NaOCl did not affect the growth of either E. faecalis or C. albicans. As a result, the irrigation time of NaOCl was more effective than the temperature to eliminate E. faecalis, while pre-heating of NaOCl to 37 A degrees C increased its effectiveness on C. albicans at 5 min contact time.
Short-Term Evaluation of Nasal Changes After Maxillary Surgery
(2014) Yilmaz, Alev; Polat-Ozsoy, Omur; Arman-Ozcirpici, Ayca; Uckan, Sina
Objective: To determine the nasal soft-tissue profile changes in skeletal Class III patients who underwent maxillary or bimaxillary orthognathic surgery. Materials and Method: This clinical retrospective study consists of 40 patients (19 male and 21 female) who had undergone orthognathic surgery. All patients received single jaw maxillary (9 patients) or bimaxillary surgery (31 patients). Standardized lateral cephalograms obtained before operation and at least 6 months after the operation were used. Twelve measurements (4 skeletal and 8 soft-tissue measurements) were made. The distributions of the variables were checked by Shapiro-Wilk test. Paired-samples t test was used for parametric data and Wilcoxon sign rank test for nonparametric data, to analyze the differences between pre- and postoperative measurements. Results: After orthognathic surgery, SNA and ANB increased; SNB decreased significantly. A significant reduction in nasofrontal angle, TH-Prn, and nasal tip projection and a significant increase in nasofacial angle were found. In addition, superior movement of the nasal tip was found, and as a result, the nasal hump decreased. The N-Sn/Pr ratio, nasal tip angle, and nasolabial angle did not show any significant changes. Conclusion: It can be concluded that more vertical nasal changes rather than sagittal nasal changes are observed after maxillary surgery.
Comparison of Microleakage of A Multi-Mode Adhesive System with Contemporary Adhesives in Class II Resin Restorations
(2014) Tuncer, Duygu; Celik, Cigdem; Cehreli, Sevi Burcak; Arhun, Neslihan; https://orcid.org/0000-0002-5936-0196; AAA-1576-2021; AAD-6138-2021; R-2536-2019
Aim: The aim was to compare the microleakage of resin composite bonded with different adhesive systems in class-II cavities at enamel or dentine margins. Material and methods: 60 extracted human molar teeth received slot cavity preparations on mesial and distal surfaces (mesial cervical margin was prepared in enamel and distal in dentine). They were randomly divided into five groups (n=12) according to the adhesive system: Group-A: Silorane Bond (S), Group-B: Adper Single Bond 2 (SB), Group-C: Clearfil SE Bond (CSE), Group-D: Single Bond Universal (USel) (selective etch-and-rinse), Group-E: Single Bond Universal (USE) (all-in-one). The preparations were restored using the same resin composite (Filtek Ultimate) except Group A which was restored by Silorane composite. The teeth were thermocycled, immersed in dye, sectioned, and dye penetration was evaluated quantitatively using image analysis. The data were analyzed using the two-way analysis of variance and Bonferroni test. Results: In all groups, there was no statistically significant difference between enamel margins at occlusal and gingival sites (p>0.05). The statistical difference between Group-A (S) and Group-B (SB) was significant at all margins. Group-B (SB) presented the greatest microleakage amounts at all margins and the highest scores were obtained in the dentine. Likewise, SB demonstrated statistically significant differences between dentine and enamel margins (occlusal and gingival)(p<0.05). Conclusion: All adhesive systems showed similar microleakage values between enamel margins in occlusal and gingival regions. However, when the gingival margin is located in the dentine, etch&rinse adhesive systems may not be a choice in terms of microleakage prevention.
Digital Evaluation of The Accuracy of Impression Techniques and Materials in Angulated Implants
(2014) Kurtulmus-Yilmaz, Sevcan; Ozan, Oguz; Ozcelik, Tuncer Burak; Yagiz, Ayberk; https://orcid.org/0000-0001-5685-4409; 25446736; JJF-5618-2023
Objectives: The aim of this study was to investigate the accuracy of 2 different impression techniques and 3 different impression materials in models simulating parallel and angulated implants. Methods: Three master models simulating partial edentulous mandible with 2 implants at the sites of second premolars (parallel) and second molars with different angulations (parallel, 10 degrees or 20 degrees angulated) were fabricated. Two different impression techniques [ splinted direct (D), indirect (I)] and 3 different monophase impression materials [ polyether (PE), vinyl polysiloxane (VPS), vinyl polyether silicone (VPES)] were used for each master model and a total of 180 impressions were made (n = 10). Master model and casts were scanned by a modified laser scanner and data were transferred to VRMesh software. Master model and duplicate cast scans were digitally aligned observing the superposition of anatomic markers. Angular and coronal deviations between master and duplicated copings were calculated and data were statistically analyzed. Results: Mean angular and coronal deviations were in a range of 0.205-0.359 degrees and 22.5633.33 mu m, respectively. Statistical analysis revealed that the angulation of implant affected both coronal and angular deviations of the impression copings (P < 0.05). According to statistical analyses, for parallel implants, the accuracy of impression materials and techniques were ranging as VPS-D = PE-D > VPS-I = PE-I > VPES-D > VPES-I from most accurate to the least. For 10 degrees and 20 degrees angulated implants the most accurate material and technique was VPS-D whereas the least accurate combination was VPES-I (P < 0.05). Conclusion: Angulation, impression technique and material were found to be effective on the accuracy of implant impressions. Clinical significance: Clinicians may prefer VPS impression material and splinted direct technique for impressions of both parallel and up to 20 degrees angulated implants. (C) 2014 Elsevier Ltd. All rights reserved.
Maxillary Expansion Via Palatal Mini-Implants: A Preliminary Study
(2014) Arman-Ozcirpici, Ayca; Yilmaz, Alev; Polat-Ozsoy, Omur
Objective: This study evaluates the skeletal and dental effects of a mini-implant supported maxillary expansion (MISME) appliance that applied forces directly to the maxilla. Materials and Method: Records of 9 patients (5 female and 4 male patients; mean age = 12 years 8 months) with indications of maxillary expansion were included in this study. After insertion of four miniscrews (1.6 mm in diameter, 7 mm in length), an acrylic expansion device was bonded on the screws. Two miniscrews were placed in the anterior palate bilaterally, 3-4 mm lateral to the suture and 3-4 mm posterior to the incisive foramen. Two miniscrews were placed bilaterally between the second premolar and first molar roots in the palatal alveolus. The MISME appliance was activated with a semi-rapid protocol until the desired expansion was achieved. The average treatment duration was 97.1 +/- 62.2 days. Measurements from cephalometric, posteroanterior radiographs and dental casts taken before and after expansion were evaluated statistically. The nonparametric Wilcoxon test was used for not normally distributed parameters (i.e., Nperp-A), and the parametric paired t test was performed for normally distributed parameters. A finding of p < 0.05 was considered to be statistically significant. Results: Forward movement of the maxilla (p<0.05) as well as an increase in nasal and maxillary skeletal and dental widths (p<0.001) were observed in the sample group. Maxillary intermolar, intercanine, and palatal widths also increased (p<0.001) without buccal tipping of molars. A slight posterior rotation of the mandible was seen. Dentoalveolar measurements did not show any significant changes. Conclusion: The MISME appliance showed successful expansion of the maxilla without such side effects as buccal tipping of molars and bite opening. This appliance, which provides parallel expansion, can be a simple and economic alternative to transpalatal distraction.
Dental Anxiety and Fear: Relationship with Oral Health Behavior in a Turkish Population
(2014) Yozugullu, Bulem; Gulsahi, Ayse; Celik, Cigdem; Bulut, Sule
The aim of this study was to assess fear and anxiety in dental patients. Five hundred patients were evaluated using the Modified Dental Anxiety Scale and the Dental Fear Scale, along with a questionnaire. Oral health status was assessed using the Decayed, Missing, and Filled Teeth (DMFT)/Decayed, Missing, and Filled Surfaces (DMFS) index. Statistic al analysis was performed (P <.05). Sex significantly affected dental anxiety (P <.05), and sex, marital status, having children, and time elapsed since last visit to clinician affected dental fear (P <.05). DMFT/DMFS scores were not related to dental anxiety or fear (P >.05). Female sex alone was a significant predictor of dental anxiety; female sex, adulthood, marriage, having children, and time passed since last visit to a clinician are significant predictors of fear.
Is The Incidence of Temporomandibular Disorder Increased in Polycystic Ovary Syndrome?
(2014) Soydan, Sidika Sinem; Deniz, Kagan; Uckan, Sina; Unal, Asli Dogruk; Tutuncu, Neslihan Bascil; https://orcid.org/0000-0002-3798-7326; https://orcid.org/0000-0002-1816-3903; 25124832; ABG-5027-2020
The prevalence of temporomandibular disorders is higher among women than men (ratio 3:1 -9:1). Polycystic ovary syndrome(PCOS) is the most common endocrine disorder in women, which is characterised by chronic low-grade inflammation and excess of androgenic hormones that lead to metabolic aberrations and ovarian dysfunction. Increased activities of various matrix metalloproteinases (particularly MMP-2 and 9) in the serum of these patients has been reported, and it has been hypothesised that high activities of MMP may contribute to loss of matrix and chronic inflammation of the fibrocartilage in temporomandibular disorders. Our aim was to evaluate the incidence of temopormandibular dysfunction in women with PCOS compared with an age-matched, disease-free, control group. We studied 50 patients with previously diagnosed PCOS and 50 volunteers who had normal menstrual cycles. We made a comprehensive clinical examination of the temporomandibular joint (TMJ) and muscles of mastication in both groups and recorded the Visual Analogue Scores (VAS) for pain. There were significant differences (p<0.001) in the incidence of temporomandibular disorders (n=43 (86%) in the PCOS group compared with n=12 24% in the control group), muscle tenderness(n=32 (64%) in the PCOS group compared with n=14 (28%) in the control group) and pain in the TMJ (mean (SD) VAS 2.9 (2.61) compared with 0.3 (1.56). We confirm the higher incidence and severity of disorders of the TMJ in patients with PCOS and suspect that chronic low-grade inflammation may play a part in the aetiology of the disease. Copyright (C) 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Effects of different orthodontic adhesives and resin removal techniques on enamel color alteration
(2014) Boncuk, Yasemen; Cehreli, Zafer C.; Polat-Ozsoy, Omur
Objective: To investigate the color alterations in enamel following the use of different orthodontic bonding resins and adhesive residue removal burs. Materials and Methods: Metal brackets were bonded to extracted human premolars (n = 175) by using an etch-and-rinse adhesive system, a self-etch adhesive system (SEP), or a resin-modified glass ionomer cement (RMGIC). After 24 hours of photoaging, the brackets were removed and the adhesive residue on the tooth surfaces was cleaned with either a tungsten carbide bur or a Stainbuster bur. Tooth colors were measured with a spectrophotometer at baseline, after adhesive removal, and after additional photoaging. Color evaluation was made, and color differences induced by photoaging were calculated. Statistical evaluation was made using the Kruskal-Wallis test and the Mann-Whitney U-test, with Bonferroni correction. Results: All specimens showed discoloration at varying levels. The highest color change was observed in the etch-and-rinse adhesive/tungsten carbide bur group. When the etch-and-rinse and self-etch adhesives were used, adhesive-remnant removal with Stainbuster burs resulted in significantly lower discoloration. The type of bur did not affect the extent of enamel discoloration in the RMGIC group. Conclusions: Orthodontic treatment alters the original color of enamel, and both the adhesive system and the resin-removal methods are responsible for this change. When brackets are bonded with the etch-and-rinse system or the SEP, cleaning the adhesive residuals with Stainbuster burs is recommended for minimal change. RMGIC can be safely cleaned with tungsten carbide burs.
Camouflage Treatment of a Severe Open Bite Case
(2014) Yilmaz, Alev; Arman-Ozcirpici, Ayca
An Alternative Impression Technique for Complete Dentures
(2014) Yilmaz, Burak; Ozcelik, Tuncer Burak; https://orcid.org/0000-0001-5685-4409; 24286641; JJF-5618-2023
This article describes a technique for creating adequate space for an even thickness of polyvinyl siloxane (PVS) impression material at the periphery during complete denture impression making. A PVS border molding material is injected around the borders of a custom tray, a 17-mu m-thick stretch wrap film is folded into 4 layers, and a tray-shaped piece slightly larger than the size of the custom tray is placed on the tray covering the borders. After the border molding procedure is completed, the film is removed and the definitive impression completed with a medium-viscosity PVS impression material.
The Influence of Bilateral Sagittal Split Ramus Osteotomy on Submental-Cervical Aesthetics
(2014) Soydan, S. S.; Uckan, S.; Ustdal, A.; Bayram, B.; Bayrak, B.; 24946129; K-2259-2018
The effect of orthodontic-surgical treatment on submental-cervical region was evaluated in a very limited number of studies. The aim of this study was to evaluate submental-cervical soft tissue contour changes following mandibular advancement and set-back procedures via bilateral sagittal split ramus osteotomy. Sixty-seven patients were included in this study. Group 1 consisted of 27 skeletal Class II patients who underwent mandibular advancement surgery, whereas Group 2 consisted of 40 skeletal Class III patients who underwent mandibular set-back surgery. Various linear and angular measurements were performed on pre-operative and sixth month post-operative cephalometric radiographs. A new method was used to evaluate the amount of sagging at submental region. The submental length did not change in Group 1; however, it decreased significantly in Group 2 (P<005). The angle between submental plane and facial plane decreased to 959 degrees from 988 degrees in Group 1(P<005), whereas it increased to 931 degrees from 882 degrees in Group2 (P<005). The change of submental soft tissue sag was almost stable in Group 1, while 034mm increase of sag was observed in Group 2. This increase was not statistically significant (P>005). Mandibular set-back and advancement procedures do not remarkably change the submental sag following approximately 6mm jaw movement. Although mandibular advancement did not significantly effect submental length, soft tissue followed mandibular set-back with a ratio of 1:1 at C-point to projection of soft tissue pogonion and 1:07 at C-point to soft tissue menton distances.
Microtensile Bond Strength of Composite-to-Composite Repair with Different Surface Treatments and Adhesive Systems
(2014) Celik, Cigdem; Cehreli, Burcak Sevi; Bagis, Bora; Arhun, Neslihan; https://orcid.org/0000-0002-5936-0196; AAA-1576-2021; R-2536-2019
Objectives: The purpose was to investigate the effect of different surface treatments and bonding agents on the repair bond strength of different resin-based restorative materials by microtensile bond strength (TBS) testing protocol. Materials and Methods: 24 Grandio SO(VOCO) and 24 Filtek Z250(3M) resin composite blocks were prepared. Half of the samples (N=12) were diamond bur-roughened and the other half (N=12) were sandblasted by 50m aluminum oxide particles. They were further divided into four sub-groups (n=3) and received the following: Sub-Group1: Adper Single Bond2 (Etch&Rinse) (3M); Sub-Group2: Clearfil SE (Self-etch) (Kuraray); Sub-Group3: Beauty Bond (HEMA-free all-in-one) (Shofu); Sub-Group4: All Bond3 (HEMA-free, hydrophobic, etch&rinse) (Bisco). The samples were repaired by Filtek Z250 to form a block. All of the resultant sub-groups combinations consisted of one of the composite type, surface treatment type, and adhesive systems. A total of 18 groups were prepared including 2 homogeneous blocks. They were thermocycled and TBS measurements were performed. Data were statistically analyzed with Kruskall-Wallis and Mann-Whitney U tests. Results: The experimental regroups' TBS reached to 34.67-66.36% and 43.44-95.52% of the cohesive bond strength for Grandio SO and Z250, respectively. The pre-existing composite type is found to be statistically important. When the surface is bur-finished Grandio performed better; when air-abrasion is considered Z250 showed higher bond strength. All-in-one adhesive system produced the weakest bond strength at all parameters. Conclusion: It may be suggested that when the pre-existing composite is unknown, air-abrasion may be performed with etch&rinse or two-step self-etch adhesives.
Management of Bisphosphonate-Related Osteonecrosis of the Jaw With a Platelet-Rich Fibrin Membrane: Technical Report
(2014) Soydan, Sidika Sinem; Uckan, Sina; 24075235
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a challenging complication resulting from the long-term application of bisphosphonates. In most cases, BRONJ occurs after a surgical procedure involving the jawbone. Currently, the management of BRONJ remains controversial, and there is no definitive treatment other than palliative methods. Platelet-rich fibrin (PRF) represents a relatively new biotechnology for the stimulation and acceleration of tissue healing and bone regeneration. This technical note describes the total closure of moderate bone exposure in persistent BRONJ in 2 weeks with a double-layer PRF membrane. PRF may stimulate gingival healing and act as a barrier membrane between the alveolar bone and the oral cavity. PRF may offer a fast, easy, and effective alternative method for the closure of bone exposure in BRONJ. (C) 2014 American Association of Oral and Maxillofacial Surgeons
Hall Versus Conventional Stainless Steel Crown Techniques: in Vitro Investigation of Marginal Fit and Microleakage Using Three Different Luting Agents
(2014) Erdemci, Zeynep Yalcinkaya; Cehreli, S. Burcak; Tirali, R. Ebru; https://orcid.org/0000-0001-6487-3984; 25197992; AAD-6138-2021; HZK-4947-2023
Purpose: This study's purpose was to investigate microleakage and marginal discrepancies in stainless steel crowns (SSCs) placed using conventional and Hall techniques and cemented with three different luting agents. Methods: Seventy-eight human primary maxillary second molars were randomly assigned to two groups (N=39), and SSCs were applied either with the Hall or conventional technique. These two groups were further sub grouped according to the material used for crown cementation (N=13 per group). Two specimens in each group were processed for scanning electron microscopy investigation. The extent of microleakage and marginal fit was quantified in millimeters on digitally photographed sections using image analysis software. The data were compared with a two-way independent and a two-way mixed analysis of variance (P=.05). Results: The scores in the Hall group were significantly worse than those in the conventional technique group (P<.05). In both groups, resin cement displayed the lowest extent of microleakage, followed by glass ionomer and polycarboxylate cements (P<.05). Conclusions: Stainless steel crowns applied using the Hall technique displayed higher microleakage scores than those applied using the conventional technique, regardless of the cementation material. When the interaction of the material and technique was assessed, resin cement presented as the best choice for minimizing microleakage in both techniques.