Diş Hekimliği Fakültesi / Faculty of Dentistry
Permanent URI for this collectionhttps://hdl.handle.net/11727/2120
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Item The Evaluation of Enamel Matrix Derivative on the Bone Regenerative Potential of the Dental Implant with the Transcrestal Sinus Floor Elevation Approach: A Randomized, Parallel CBCT Study(Başkent Üniversitesi Diş Hekimliği Fakültesi, 2024-09-23) Ozbay, Deniz; Tunc, Samet; Corekci, Ahu Uraz; Ayyildiz, Berceste Guler; Cula, SerpilPurpose: To evaluate the clinical and radiographic results of simultaneous implant placement using transcrestal sinus floor elevation (TSFE) with and without enamel matrix derivative (EMD) application. Materials and Methods: Twenty-four patients were randomly assigned into two groups: The EMD+TSFE group (n = 13 patients, 20 implants) received TSFE with EMD application, and the TSFE group (n = 11 patients, 20 implants) received TSFE without EMD application. The patients were recalled at 3 (T3) and 12 (T12) months postsurgery. The residual bone height (RBH), implant protrusion length (IPL), peri-implant sinus bone level (SBL), endo-sinus bone gain (ESBG), and implant stability (ISQ) were measured. Multivariate regressions were performed for the groups. Results: At T3, the ESBG was 3.72 +/- 0.85 mm in the EMD+TSFE group and 3.10 +/- 0.05 mm in the TSFE group, and there were statistically significant differences (P P < .05). However, there were no statistically significant differences in ESBG at T12 between the groups (P P > .05). ISQ values did not show a statistical difference between the groups at T1 and T3, but at T3 in the TSFE+EMD group, there was a statistical increase in the intragroup evaluation compared to the TSFE group. Conclusions: The use of EMD in TSFE procedures is effective in new bone formation at the apical part of the implant during the early healing period, but in the long term, no significant difference was shown between cases in which EMD was or was not used in terms of new bone formation and primary and secondary stabilization. Int J Oral Maxillofac Implants 2024;39:615-624. doi: 10.11607/jomi.10506Item Global Immune-Nutrition-Inflammation Index As A Novel Comprehensive Biomarker In Predicting The Radiation-Induced Trismus Rates In Locally Advanced Nasopharyngeal Carcinoma Patients(Başkent Üniversitesi Diş Hekimliği Fakültesi, 2024-07-20) Somay, Efsun; Topkan, Erkan; Bascil, Sibel; Durankus, Niluefer Kilic; Senyurek, Sukran; Ozturk, Duriye; Pehlivan, Berrin; Selek, UgurNasopharyngeal carcinoma (NPC) is a prevalent cancer in certain regions, often treated with concurrent chemoradiotherapy (CCRT), which can lead to complications such as radiation-induced trismus (RIT). In this study, we aimed to evaluate whether the novel pretreatment Global Immune-Nutrition-Inflammation Index (GINI) can predict RIT in locally advanced nasopharyngeal carcinoma (LA-NPC) patients undergoing CCRT. Data of LA-NPC patients presenting without RIT were reviewed retrospectively. Any post-CCRT maximum mouth openings (MMO) <= 35 mm were considered RIT. The GINI index was calculated using the formula: GINI = (CRP x Monocytes x Platelets x Neutrophils) divided by (Albumin x Lymphocytes). We used receiver operating characteristic (ROC) curve analysis to examine the potential correlation between pretreatment GINI measures and post-CCRT RIT status. Logistic regression analysis examined the independence of the association between confounding factors and RIT rates. The study comprised 230 participants, and 52 (22.6%) received an RIT diagnosis. The optimal pre-CCRT GINI cutoff that dichotomizes RIT rates was determined to be 1424 (area under the curve [AUC]: 76%; sensitivity: 75.0%; specificity: 71.7%; J-index: 0.463). RIT incidence was significantly higher in the GINI >= 1424 group than in its GINI < 1424 counterpart (43.3% vs 9.3%; Hazard ratio (HR): 4.76; P < 0.001). Multivariate logistic regression analysis revealed that a pre-CCRT GINI >= 1424 was an independent predictor of increased RIT rates after definitive CCRT in this patient group (P < 0.001). In conclusion, the present results revealed that elevated pre-CCRT GINI measures (>= 1424) can efficiently and independently predict elevated RIT rates in LA-NPC patients after CCRT.Item Long-Term Clinical Comparison Of A Resin-Based Composite And Resin Modified Glass Ionomer In The Treatment Of Cervical Caries Lesions(Başkent Üniversitesi Diş Hekimliği Fakültesi, 2024-06-16) Koc-Vural, Uzay; Kerimova-Kose, Leyla; Kiremitci, ArlinThis 72-month study compared the clinical effectiveness of a resin-based composite (RBC) (Spectrum TPH3, Dentsply Sirona) with a resin-modified glass ionomer cement (RMGIC) (Riva Light Cure, SDI) in restoring cervical caries lesions (CCLs). Thirty-three patients, each with at least two CCLs, were enrolled. After caries removal, the dimensions of the cavities were recorded. In a split-mouth study design, a total of 110 restorations were randomly placed. Fifty-five restorations were placed with RBC using an etch-and-rinse adhesive system (Prime&Bond NT, Dentsply Sirona), while the remaining 55 were restored with RMGIC. The restorations were assessed at baseline, 6, 12, 18, 24, 36, 60, and 72 months according to modified USPHS criteria. Statistical analysis included Pearson Chi-square, Friedman tests, Kaplan Meier, and Logistic Regression analysis (p < 0.05). After 72 months, 47 restorations in 19 patients were evaluated (55% follow-up rate). Seventy-five percent of the RBC (n = 26) and 74% (n = 21) of the RMGIC restorations were fully retained. There were no significant differences between materials regarding retention and marginal adaptation (p > 0.05). Cavity dimensions, caries activity, and retention exhibited no correlation (p > 0.05). The increase in marginal staining in both groups over time was significant (p < 0.001). RMGIC restorations exhibited higher discoloration than RBC restorations (p = 0.014). At 72 months, three secondary caries lesions were detected in both restoration groups: two RMGIC and one RBC. There were no reports of sensitivity. After 72 months, both RBC and RMGIC restorations were clinically successful, with similar retention and marginal adaptation scores. However, it is noteworthy that RMGIC restorations tend to discoloration over time compared to RBC. The trial is registered in the database of "Clinical Trials". The registration number is NCT0372-2758, October 29, 2018.Item Pre-Chemoradiotherapy High Platelet Counts Predict Jaw Osteoradionecrosis In Locally Advanced Nasopharyngeal Carcinoma Patients(Başkent Üniversitesi Diş Hekimliği Fakültesi, 2024-09-15) Somay, Efsun; Topkan, Erkan; Kucuk, Ahmet; Ozturk, Duriye; Ozkan, Emine Elif; Ozdemir, Beyza Sirin; Besen, Ali Ayberk; Mertsoylu, Huseyin; Pehlivan, Berrin; Selek, UgurIntroduction: This retrospective study aimed to investigate if pretreatment platelet (PLT) levels can predict the risk of osteoradionecrosis of the jaw (ORNJ) in patients with locally advanced nasopharyngeal carcinoma (LA-NPC) who received concurrent chemoradiotherapy (CCRT). Material &Methods: ORNJ instances were identified from LA-NPC patients' pre- and post-CCRT oral exam records. All pretreatment PLT values were acquired on the first day of CCRT. Receiver operating characteristic curve analysis was used to determine the optimal PLT cutoff that divides patients into two subgroups with distinctive ORNJ rates. The primary outcome measure was the association between pretreatment PLT values and ORNJ incidence rates. Results: The incidence of ORNJ was 8.8 % among the 240 LA-NPC patients analyzed. The ideal pre-CCRT PLT cutoff which divided the patients into two significantly different ORNJ rate groups was 285,000 cells/mu L (PLT <= 285,000 cells/mu L (N = 175) vs. PLT > 285,000 cells/mu L (N = 65)). A comparison of the two PLT groups revealed that the incidence of ORNJ was substantially higher in patients with PLT > 285,000 cells/L, than in those with PLT <= 285,000 cells/L, (26.2% vs. 2.3 %; P < 0.001). The presence of pre-CCRT >= 3 tooth extractions, any post-CCRT tooth extractions, mean mandibular dose >= 34.1 Gy, mandibular V57.5 Gy >= 34.7 %, and postCCRT tooth extractions > 9 months after CCRT completion were also associated with significantly increased ORNJ rates. A multivariate Cox regression analysis demonstrated that each characteristic had an independent significance on ORNJ rates after CCRT. Conclusion: An affordable and easily accessible novel biomarker, PLT> 285,000 cells/L, may predict substantially higher ORNJ rates after definitive CCRT in individuals with LA-NPC. (c) 2024 Elsevier Masson SAS. All rights reserved.Item Evaluation Of Different Machine Learning Algorithms For Extraction Decision In Orthodontic Treatment(Başkent Üniversitesi Diş Hekimliği Fakültesi, 2024-05-31) Kokturk, Begum; Pamukcu, Hande; Gozuacik, OmerIntroductionThe extraction decision significantly affects the treatment process and outcome. Therefore, it is crucial to make this decision with a more objective and standardized method. The objectives of this study were (1) to identify the best-performing model among seven machine learning (ML) models, which will standardize the extraction decision and serve as a guide for inexperienced clinicians, and (2) to determine the important variables for the extraction decision.MethodsThis study included 1000 patients who received orthodontic treatment with or without extraction (500 extraction and 500 non-extraction). The success criteria of the study were the decisions made by the four experienced orthodontists. Seven ML models were trained using 36 variables; including demographic information, cephalometric and model measurements. First, the extraction decision was performed, and then the extraction type was identified. Accuracy and area under the curve (AUC) of the receiver operating characteristics (ROC) curve were used to measure the success of ML models.ResultsThe Stacking Classifier model, which consists of Gradient Boosted Trees, Support Vector Machine, and Random Forest models, showed the highest performance in extraction decision with 91.2% AUC. The most important features determining extraction decision were maxillary and mandibular arch length discrepancy, Wits Appraisal, and ANS-Me length. Likewise, the Stacking Classifier showed the highest performance with 76.3% accuracy in extraction type decisions. The most important variables for the extraction type decision were mandibular arch length discrepancy, Class I molar relationship, cephalometric overbite, Wits Appraisal, and L1-NB distance.ConclusionThe Stacking Classifier model exhibited the best performance for the extraction decision. While ML models showed a high performance in extraction decision, they could not able to achieve the same level of performance in extraction type decision.Item Evaluation of the Consistency of Two Interproximal Reduction Methods in Clear Aligner Therapy: A Preliminary Study(Başkent Üniversitesi Diş Hekimliği Fakültesi, 2024-04-06) Ergun, Pelinsu Gulec; Ozcirpici, Ayca Arman; Kocabalkan, Azize Atakan; Tuncer, Nilufer IremObjective: To compare the consistency of two interproximal reduction (IPR) methods in terms of the amount of planned and performed IPR during clear aligner therapy (CAT). Methods: Thirty-four patients who received IPR using hand -operated abrasive strips (Group 1, 20 patients, 162 teeth) and motordriven 3/4 oscillating segmental disks (Group 2, 14 patients, 134 teeth) during CAT were included in this preliminary study. The consistency between the planned and performed IPR amounts was evaluated within and between groups for teeth and quadrants. Results: In Group 1, the amount of IPR performed on teeth numbers 22 and 43 and in the upper left quadrant was found to be statistically less than that of planned. On the other hand, the amount of performed IPR was statistically higher on tooth number 44 and in the upper right quadrant, whereas it was statistically less on tooth number 33 when compared with the planned amount in Group 2. The inconsistency between the planned and performed IPR amounts were statistically significant only in Group 1 and for teeth numbers 11, 21, 32, 33, and 43. No significant difference was found when the same parameter was compared between the groups. Conclusion: The consistency of IPR was found to be better with the motor -driven oscillating disk system than with the hand -operated IPR strip system.Item Tooth Extraction and Osteoradionecrosis(Başkent Üniversitesi Diş Hekimliği Fakültesi, 2024-04-08) Topkan, Erkan; Somay, Efsun; Selek, UgurItem Predictive Potential Of Pan-Immune-Inflammation Value / Hemoglobin Index As Biomarker For Osteoradionecrosis Risk In Locally Advanced Nasopharyngeal Carcinomas(JOURNAL OF STOMATOLOGY ORAL AND MAXILLOFACIAL SURGERY, 2024-03-27) Yilmaz, Busra; Somay, Efsun; Topkan, Erkan; Pehlivan, Berrin; Besen, Ali Ayberk; Mertsoylu, Huseyin; Selek, UgurObjective: We aimed to investigate whether the Pan-Immune-Inflammation-Value/Hemoglobin (PIV/Hb) index could predict the risk of osteoradionecrosis (ORN) in patients receiving concurrent chemoradiotherapy (CCRT) for locally advanced nasopharyngeal cancer (LA-NPC). Materials and methods: This retrospective analysis included LA-NPC patients who underwent CCRT and preCCRT oral exams at our institution's Departments of Radiation Oncology and Dentistry between January 2010 and December 2022. The relationship between ORN rates and PIV-Hb levels was explored using receiver operating characteristic curve analysis. The primary objective was to establish a correlation between pre-CCRT PIV-Hb levels and ORN rates, while the secondary objective was to identify other risk factors for ORN. Results: Of 249 eligible patients, 21 (8.4 %) were diagnosed with ORN. The optimal pre-CCRT PIV/Hb cutoff was 73.8, which divided patients into two subgroups with distinctive ORN risk estimates: Group 1: PIV/ Hb < 73.8 (N = 206), and Group 2: PIV/Hb >= 73.8 (N = 43). The results of the comparative analysis indicated that the cohort with PIV/Hb >= 73.8 exhibited substantially higher rates of ORN than the PIV/Hb < 73.8 cohort (44.2 % vs. 1.0 %; P < 0.001). The multivariate logistic regression analysis indicated that the pretreatment PIV/ Hb >= 73.8 was independently associated with higher ORN rates (P < 0.001). Conclusion: The results of our current investigation indicate that higher levels of pretreatment PIV/Hb were associated with a significant independent increase in ORN rates in LA-NPC patients who received CCRT. (c) 2024 Elsevier Masson SAS. All rights reserved.Item Effect Of Ultrasonic And Sonic Instrumentation On Shear Bond Strength Of Resin Composite To Enamel: An In Vitro Study(AMERICAN JOURNAL OF DENTISTRY, 2024-04-12) Adiguzel, Ruhsan Muduroglu; Mustafa, Abdelrahman; Oduncuoglu, Bahar Fusun; Colak, Mew Yavuz; Gulsahi, Aye; Arhun, NeslihanPurpose: To assess and compare the effects of sonic and ultrasonic instrumentation on shear bond strength (SBS) and investigate the influence of adhesive system application modes (etch&rinse/self-etch) on SBS. Methods: In this experimental study, 45 extracted sound human molars were selected. Mesial and distal surfaces of the teeth were abraded until 90 smooth enamel surfaces were obtained. Specimens were divided into two groups, with half (N= 45) conditioned in etch&rinse mode and the remaining (N= 45) in self-etch mode using Tetric N Bond Universal. Composite resin discs were produced on these surfaces by filling Teflon molds. All specimens were aged via thermocycling. Each group was further divided into three more groups (n= 15) according to the type of periodontal instrumentation (ultrasonic, sonic or none). SBS values were recorded and analyzed using two-way ANOVA. Fracture sites were examined under a stereomicroscope. Results: The type of periodontal instrumentation had no significant effect on SBS values, whether sonic, ultrasonic or their absence (P= 0.945). The type of adhesive system mode had a significant influence on the shear bond strength values. Etch&rinse groups had significantly higher shear bond strength values than self-etch groups (P< 0.001).Item Comparison Of The Accuracy Of Three Interproximal Reduction Methods Used In Clear Aligner Treatment(CLINICAL ORAL INVESTIGATIONS, 2024-01-15) Gulec-Ergun, Pelinsu; Arman-Ozcirpici, Ayca; Atakan-Kocabalkan, Azize; Tuncer, Niluefer IremObjectivesTo comparatively assess 3 interproximal reduction (IPR) methods used in clear aligner treatment with regard to accuracy, and patient perception of discomfort and anxiety.Materials and methodsA total of 42 patients, treated with the Invisalign (R) system, were included in this prospective trial and received one of the following IPR methods: hand-operated abrasive strips (group 1; 14 patients, 150 teeth), motor-driven 3/4 oscillating segmental discs (group 2; 14 patients, 134 teeth), or motor-driven abrasive strips (group 3; 14 patients, 133 teeth). Accuracy was evaluated using the difference between planned and executed IPR. Anxiety and discomfort levels experienced by the patients were evaluated using a questionnaire of 17 questions.ResultsThe accuracy of IPR was high in groups 2 and 3; however, it was low in group 1 with the executed IPR significantly less than the planned amount. On quadrant-level, executed IPR was significantly less in the upper left quadrant in group 1, and significantly more in the upper right quadrant in group 2. The difference between planned IPR and executed IPR was significant for teeth 11, 21, 32, 33, and 43 in group 1, indicating deficiency. The average difference between planned IPR and executed IPR was 0.08 mm for group 1, 0.09 mm for group 2, and 0.1 mm for group 3. Anxiety and discomfort levels did not differ between the methods, but a negative correlation was observed between age and discomfort and anxiety levels.ConclusionsThe overall accuracy of the 2 motor-driven IPR methods was found to be better than the hand-operated system. Maxillary central incisors and mandibular canines were more prone to IPR deficiency when hand-operated abrasive strips were utilized. Patients were similarly comfortable with all 3 methods, and discomfort and anxiety levels decreased with age.Clinical relevanceMotor-driven methods have proven to be more effective when compared to the hand-operated ones by means of precision, speed, and patient comfort. If the clinician favors a hand-operated method, it may be advised to perform slightly more IPR especially on mandibular canines and maxillary central incisors.