Diş Hekimliği Fakültesi / Faculty of Dentistry
Permanent URI for this collectionhttps://hdl.handle.net/11727/2120
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Item Prosthetic Complications with Mandibular Bar-Retained Implant Overdentures Having Distal Attachments and Metal Frameworks: A 2-To 12-Year Retrospective Analysis(2023) Ciftci, Gozde; Somay, Suphi Deniz; Ozcan, Isil; Ozcelik, Tuncer Burak; Yilmaz, Burak; 0000-0001-5685-4409; 34998584; JJF-5618-2023Statement of problem. Long-term reports on 2-implant-retained overdentures having metal frameworks and bars containing distal attachments are scarce.Purpose. The purpose of this retrospective study was to evaluate prosthetic complications with 2-implant-retained mandibular overdentures with metal frameworks having either screw-or cement-retained cantilevered bars with distal attachments.Material and methods. Seventy-three edentulous study participants who had been treated with mandibular overdentures with 2 implants were included. The parameters assessed were acrylic resin fractures (base fracture, fracture at midline), debonding of teeth, opposing prosthesis fracture, need for relining or rebasing, abutment and bar screw loosening and fracture, ball or bar attachment or clip wear, fracture or detachment, bar fracture, and implant loss. Statistical analysis was performed by using the Mann-Whitney U test as the data were not normally distributed. The categorical variables between the groups were analyzed by using the Fisher exact test (alpha=.05).Results. Twenty-seven prostheses had a cement-retained bar, and 46 bars were screw-retained. Of 73 overdentures, 68 were metal-reinforced. The mean observation time was 5.9 years with a range between 2 and 12 years. The most common complication was wear of the Rhein 83 polymer attachment followed by bar screw loosening. The cumulative survival rate for overdentures was 91.9% at 6.8 years. The service life of cement-retained prostheses was significantly longer (P<.05). Bar, resin base, and mid-line fractures were only seen with cement-retained prostheses. The number of times an attachment change was required did not differ between cement-and screw-retained bars. Of 191 implants, 3 were lost, and the cumulative survival rate was 93.5% at 7.5 years. No significant difference was found between retention types in terms of implant loss (P>.05).Conclusions. Based on the participant population observed, the survival rates of 2-implant-retained mandibular overdentures and their implants in the medium term were high. Wear of the polymer attachment was commonly seen. Overdentures with cement-retained bars had bar or acrylic resin fractures. Mandibular 2-implant-retained overdentures with a screw-retained bar containing bilateral distal attachments had fewer prosthetic complications and high implant survival in the medium term.Item An Alternative Impression Technique for Complete Dentures(2014) Yilmaz, Burak; Ozcelik, Tuncer Burak; https://orcid.org/0000-0001-5685-4409; 24286641; JJF-5618-2023This 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.Item 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-5618-2023Statement 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.Item 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-5618-2023Objectives: 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.Item The Effect of Different Polishing Sequences on the Adhesion of Streptococcus mutans to Feldspathic Porcelain(2016) Yuzugullu, Bulem; Celik, Cigdem; Ozcelik, Tuncer Burak; Erkut, Selim; Yurdakul, Pinar; Ocal, Yesim; Sener, Burcin; https://orcid.org/0000-0002-5936-0196; AAA-1576-2021The aim of this research was to determine whether extra-oral surface treatments on feldspathic porcelain surfaces influence initial adhesion of Streptococcus mutans. Ninety-six porcelain specimen discs were fabricated and divided into six equal groups according to surface treatment: fine-grit diamond polishing (Group 1); self-glazing (Group 2); overglazing (Group 3); overglazing followed by a finishing procedure and then overglazing (Group 4); Pearl Surface polishing (Group 5); and Diamond Twist SCLTM polishing (Group 6). Surface roughness and hydrophobicity were assessed. An S. mutans suspension was incubated on each specimen group and evaluated. A one-way analysis of variance, post-hoc Tukey honestly significantly different test, Friedman test, and t-test were used for statistical analysis. Group 1 showed the highest surface roughness (p < 0.001) and bacterial adhesion (p < 0.05). Groups 5 and 6 specimen surfaces presented significantly higher contact angles (p < 0.05). Group 1 had the highest S. mutans adhesion, followed by Groups 3, 5, 6, 2, and 4 (p < 0.05). Reglazing after grinding may therefore decrease bacterial adhesion beneficially.Item Effect of Cement Space on The Marginal Fit of CAD-CAM-Fabricated Monolithic Zirconia Crowns(2016) Kale, Ediz; Seker, Emre; Yilmaz, Burak; Ozcelik, Tuncer Burak; 0000-0001-8761-0298; 0000-0002-7101-363X; 27460314; O-2753-2013; AAE-5350-2019Statement of problem. Monolithic zirconia crowns fabricated with computer-aided design and computer-aided manufacturing (CAD-CAM) have recently become a common practice for the restoration of posterior teeth. The marginal fit of monolithic zirconia crowns may be affected by different cement space parameters set in the CAD software. Information is scarce regarding the effect of cement space on the marginal fit of monolithic zirconia crowns fabricated with CAD CAM technology. Purpose. The purpose of this in vitro study was to evaluate the effect of cement space on the marginal fit of CAD-CAM-fabricated monolithic zirconia crowns before cementation. Material and methods. Fifteen right maxillary first molar typodont teeth with standardized anatomic preparations for complete-coverage ceramic crowns were scanned with a 3-dimensional laboratory scanner. Crowns were designed 3-dimensionally using software and then milled from presintered monolithic zirconia blocks in a computer numerical control dental milling machine. The cement space was set at 25 mu m around the margins for all groups, and additional cement space starting 1 mm above the finish lines of the teeth was set at 30 mu m for group 25-30, 40 mu m for group 25-40, and 50 mu m for group 25-50 in the CAD software. A total of 120 images (3 groups, 5 crowns per group, 8 sites per crown) were measured for vertical marginal discrepancy under a stereoscopic zoom microscope and the data were statistically analyzed with 1-way analysis of variance, followed by the Tukey honestly significant difference test (alpha=.05). Results. The results showed that different cement space values had statistically significant effect on the mean vertical marginal discrepancy value of tested crowns (P<.001). The mean marginal discrepancy was 85 mu m for group 25-30, 68 mu m for group 25-40, and 53 mu m for group 25-50. Conclusions. Within the limitations of this in vitro study, it was concluded that the cement space had a significant effect on the marginal fit of CAD-CAM-fabricated monolithic zirconia crowns. The marginal fit improved as the cement space decreased.Item Effect of Fabrication Stages and Cementation on The Marginal Fit of CAD-CAM Monolithic Zirconia Crowns(2017) Kale, Ediz; Yilmaz, Burak; Seker, Emre; Ozcelik, Tuncer Burak; 28434679Statement of problem. Monolithic zirconia crowns fabricated using computer-aided design and computer-aided manufacturing (CAD-CAM) technology have recently become an alternative dental prosthetic treatment. The marginal fit of monolithic zirconia crown may be affected by different stages of the fabrication procedures in the laboratory and cementation. Information regarding the accuracy of fit of monolithic zirconia crowns at different stages of fabrication and cementation is limited. Purpose. The purpose of this in vitro study was to evaluate the effect of different stages of fabrication and cementation on the vertical marginal discrepancy (VMD) of CAD-CAM fabricated monolithic zirconia crowns. Material and methods. Six ivorine right maxillary first molar typodont teeth with standardized anatomic preparations for complete coverage ceramic crowns were scanned with a 3-dimensional laboratory scanner. Crowns were designed using CAD software and milled from presintered monolithic zirconia blocks in a 5-axis dental milling machine. A cement space of 25 pm for the margins and a 50-gm space starting 1 mm above the finish lines of the teeth were virtually set in the CAD software. A total of 144 measurements were performed on 6 specimens with 8 measurement locations in 3 different stages using stereoscopic zoom microscopy; after initial production of the crowns (post-sintering group), after glazing (post-glazing group), and after cementation (post-cementation group). The VMD values were statistically analyzed with 1-way repeated measures ANOVA and the Holm-Sidak method (alpha=.05). Results. Different stages of fabrication and cementation significantly affected the VMD of tested crowns (P=.003). The mean VMD was 38 gm for post-sintering group, 38 pm for post-glazing group, and 60 mu m for post-cementation group, with statistical differences between the post-sintering group, the post-cementation group (P<.002), and the post-glazing group and post-cementation group (P<.003); there were no statistical differences between the post-sintering group and the post-glazing group (P=.966). Conclusions. Within the limitations of this in vitro study, glazing did not significantly change the VMD of CAD-CAM monolithic zirconia crowns. Cementation significantly increased the VMD values.Item Marginal fit of 3-unit CAD-CAM zirconia frameworks fabricated using cone beam computed tomography scans: an experimental study(2021) Belgin, Huseyin Berkay; Kale, Ediz; Ozcelik, Tuncer Burak; Yilmaz, Burak; 34665345Whether cone beam computed tomography (CBCT) scans can be used for the fabrication of computer-aided design and computer-aided manufacturing (CAD-CAM) fixed dental prostheses (FDPs) is not known. The purpose of the present study was to compare the marginal fit of 3-unit zirconia FDPs fabricated by using CBCT or 3-dimensional (3D) laboratory scanning. Extracted second premolar and molar teeth in a maxillary typodont model were prepared. The first molar was removed and the typodont model was scanned with a laboratory or a CBCT scanner to generate two virtual 3D cast groups (3DL and CBCT). Forty four 3-unit zirconia FDPs were designed on virtual casts and milled. The vertical marginal discrepancy (VMD) was measured by x100-magnification microscopy at seven locations on each abutment. A total of 616 measurements were made at 14 fixed locations in two groups of 22 specimens. The VMD data for 3DL and CBCT groups were statistically analyzed using the Mann-Whitney U test (alpha = 0.05). The mean VMDs on premolar ranged between 44 and 55 mu m (median: 43-55 mu m) in 3DL, and 74 and 100 mu m (median: 72-93 mu m) in CBCT; and on the molar, between 47 and 114 mu m (median: 46-114 mu m) in 3DL, and 91 and 162 mu m (median: 93-156 mu m) in CBCT. There was a significant difference between the gaps in 3DL and CBCT groups (p < 0.001). FDPs fabricated using 3D laboratory scanner had significantly smaller VMDs. Nevertheless, the 3-unit zirconia FDPs fabricated using CBCT scans presented promising marginal integrity.Item Marginal fit of CAD-CAM monolithic zirconia crowns fabricated by using cone beam computed tomography scans(2020) Kale, Ediz; Cilli, Mesutcan; Ozcelik, Tuncer Burak; Yilmaz, Burak; 31653403Statement of problem: Information regarding the precision of monolithic zirconia crowns fabricated by using a standard computer-aided design and computer-aided manufacturing (CAD-CAM) workflow is available. However, information on the effect of a modified workflow using 3D laboratory scanning and/or cone beam computed tomography (CBCT) for monolithic zirconia crown fabrication is lacking. Purpose: The purpose of this in vitro study was to evaluate the effect of different scans on the marginal fit of CAD-CAM monolithic zirconia crowns fabricated by 3D laboratory scanning and CBCT. Material and methods: An extracted maxillary left first molar was prepared and digitized by using a 3D laboratory scanner (D900; 3Shape A/S) (control group). The tooth was also scanned by CBCT (i-CAT; Imaging Sciences) to generate a second virtual 3D model (CBCTscan group). A tooth cast out of polyurethane (PU) (Zenotec Model; Wieland) was reproduced from the CBCT data by using a CAD software program (Dental System 2.6; 3Shape A/S) and milling machine (CORiTEC 550i; imes-icore) and further scanned by using the 3D laboratory scanner to generate a third virtual 3D model to represent a clinical scenario where a patient's cast is needed (PU3DLab group). A monolithic zirconia crown design (cement space: margin 40 mu m, 1 mm above 70 mu m) was used on the virtual models, and crowns were fabricated out of presintered zirconia blocks (ZenostarT4; Wieland) by using a 5-axis milling machine (CORiTEC 550i; imes-icore). The crowns were sintered (Sinterofen HT-S Speed; Mihm-Vogt), and the vertical marginal discrepancy (VMD) was measured by x100-magnification microscopy. Measurements were made at 384 points in 3 groups of 16 specimens. The measurements for each specimen were averaged, and VMD mean values were calculated. The Kruskal-Wallis test was used for the statistical analysis (alpha=.05). The Mann-Whitney U test and Bonferroni adjustment were further used to compare the pairs (alpha=.017). Results: The mean VMD value was 41 mu m (median: 38 mu m) for the control group, 44 mu m (median: 42 mu m) for the CBCTscan, and 60 mu m (median: 58 mu m) for the PU3DLab. No significant difference was found between control and CBCTscan groups (P=.274). However, there was a significant difference between control and PU3DLab and CBCTscan and PU3DLab groups (P<.001). Conclusions: Marginal fit of the crowns fabricated by using the 3D laboratory scanner and through the direct use of CBCT was better than that of the crowns fabricated by using the workflow that combined the use of CBCT, PU cast, and 3D laboratory scanner. All tested protocols enabled the fabrication of monolithic zirconia crowns with a marginal discrepancy smaller than 120 mu m.Item Marginal Adaptation of Provisional CAD/CAM Restorations Fabricated Using Various Simulated Digital Cement Space Settings(2018) Ozcelik, Tuncer Burak; Yilmaz, Burak; Seker, Emre; Shah, Karnik; 30231093Purpose: The ideal digital cement space value for the fabrication of provisional computer-aided design/ computer-aided manufacturing (CAD/CAM) crowns with clinically acceptable marginal adaptation is not well known. The aim of this study was to evaluate the effect of different simulated cement space settings on the marginal tit of poly(methyl methacrylate) (PMMA) provisional CAD/CAM restorations. Materials and Methods: An extracted premolar tooth was prepared using ceramic crown preparation guidelines and represented both natural teeth and/or custom implant abutments. The prepared tooth abutment was scanned with a three-dimensional (3D) laboratory scanner (D900, 3Shape). CAD design software was used to subsequently design a premolar crown core with three different simulated cement space settings (20 to 40 mu m, 20 to 50 mu m, 20 to 60 mu m). PMMA blocks were used to mill the specimens (n = 9, N = 27). Using a stereo zoom microscope, a total of 36 images for each of the 3 groups (9 crowns per group, 4 sites per crown) were captured to measure the mean vertical marginal discrepancy for every group. One-way analysis of variance (ANOVA) was used to analyze the data, and the post hoc Tukey multiple comparison test was performed. Results: The marginal gap values of the PMMA cores fabricated using the three cement space settings were significantly different from each other (P < .001). The marginal gap was smaller with a 20- to 60-mu m setting compared with 20 to 50 mu m and 20 to 40 mu m, and the 20- to 50-mu m setting allowed for smaller marginal gaps compared with 20 to 40 mu m (P < .001). Conclusion: Within the limitations of this study, the marginal gaps of CAD/CAM-fabricated PMMA cores were smaller when the cement space was larger. The smallest marginal gaps were achieved when a 20- to 60-mu m cement space was used (P < .001).