Diş Hekimliği Fakültesi / Faculty of Dentistry
Permanent URI for this collectionhttps://hdl.handle.net/11727/2120
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Item Investigation of Antibacterial Prescribing Situations in Dentistry Faculties and Other Dental Health Institutions(2017) Kirmizi, N. Ipek; Aydin, Mehtap; Koyuncuoglu, Cenker Z.; Aksoy, Mesil; Kadi, Esma; Alkan, Ali; Akici, Ahmet; https://orcid.org/0000-0003-4044-9366; HLX-0937-2023Objective: The relationship between the institutions where dentists work and their prescribing performance is not known. This study aimed to investigate antibacterial prescribing practices of dentists working in different healthcare institutions. Material and Method: Dentists' antibacterial-containing prescriptions were analyzed by using Prescription Information System (PIS) of Turkish Medicines and Medical Devices Agency. Distribution of antibacterial-containing prescriptions that were prescribed by dentists in universities and other healthcare institutions, starting from January 2013 for a total of 32 months was examined in terms of diagnosis and time periods. Results: It was found that very few number of antibacterials (n=9,952) were prescribed in dentistry faculties (DF) while most of them (n=13,069,333) were prescribed in other dental health institutions (DHI). In both DF and DHI, the most common prescribed antibacterial group was "beta lactam antibacterials-penicillins" (93.7% and 71.3%, respectively) and as an antibacterial agent it was "amoxicillin + enzyme inhibitors" (69.7% and 57.9%, respectively). These were followed by amoxicillin (21.9%) and clindamycin (1.5%) in DF; spiramycin (10.4%) and amoxicillin (9.2%) in DHI. The most frequently prescribed diagnoses were "embedded teeth" and "periapical abscesses-without sinus" in DF and DHI, respectively. Conclusion: This study was the first to reveal similar and different aspects of antibacterial prescribing behaviors between the DF and DHI dentists in Turkey. Although preference of the most common drug was similar, detailed examinations showed variations in antibacterial prescribing behaviors of dentists practicing in universities and other institutions.Item Confirming the diagnosis of temporomandibular joint disorder by magnetic resonance imaging(2020) Yilmaz, Busra; Somay, EfsunPurpose: The aim of this study was to define the temporomandibular joint complaints of patients with different genders and educational levels and to investigate the accuracy of these complaints with the diagnosis of temporomandibular joint disorder (TJD) with magnetic resonance imaging (MRII). Material and Methods: Temporomandibular joint MRI and clinical examination findings and panoramic radiographs of 99 patients over 18 years of age who applied to the dental clinic between 2011-2018 with the complaint of jaw pain and limited mouth opening are evaluated. The cases which TJD was determined as a result of MRI, are accepted as MRI (+). The ones with the complaints of TJD, but the joint was within normal limits in the MRI, MRI is recorded as (-). Results: There is significant correlation between MRI results and gender but no correlation between MRI results and tooth loss. It is found education level did not have significant effect on the described joint complaints and MRI (+) findings. Conclusion: Women describe temporomandibular joint problems better than men. Even if the level of education is high, patients may not be able to convey their complaints correctly to the physician. Clinical findings should be supported by MRI results in order to diagnose this disease.Item Riga-Fede disease like ulcers in old age: A case report(2019) Mansur, Ayse Tulin; Deniz, Kagan; Ozdemir, KeremRiga-Fede disease (RFD) is a traumatic, reactive benign disorder characterized by persistent ulceration on the tip or ventral surface of the tongue, seen mainly in infants and children. Lesions tend to develop after the eruption of natal or primary incisors, resulting from repetitive traumatic damage due to backward and forward movements of the tongue over the lower incisors. A literature survey has revealed a very limited number of reported cases of RFD in adults. Herein we reported a 70-year-old female patient who developed RFD-like ulcers on the tongue and buccal mucosa during the previous two months, while under treatment of dental implants. Histopathological examination and direct immunofluorescence of the ulcers and periulcer area did not yield a specific diagnosis. The lesions were resistant to systemic steroid treatment, however, after applying for a soft dental plate nightly for protection of the tongue and buccal mucosa, all ulcers completely healed in two months. With regard to the presented patient, we have reviewed the cases of RFD or RFD-like ulcers reported in adults and discussed the factors contributing to ulcer formation in our patient.Item Effect of different prophylactic polishing procedures on the surface roughness of microhybrid and nanohybrid resin composites(2018) Yamanel, K.Objectives: The aim of the present study was to evaluate effects of different professional dental prophylaxis procedures on the surface roughness of a microhybrid (Charisma, Heraeus-Kulzer) and a nanohybrid (Ice, SDI Dental) resin composites. Materials and Methods: 45 disc shaped (2 mm thick /8 mm in diameter) specimens of each restorative materials (totally 90 specimens) were prepared using plexyglass mold. Specimens were polished with medium, fine and ultra-fine Sof-Lex (3M-ESPE) discs and 45 specimens of each composite were randomly divided into five groups (n=9). The first group received no prophylaxis treatment and served as control. The other groups received prophlaxis procedures including Detartrine paste (Septodont) with rotating rubber cup, Gelato paste (Keystone Industries) with rotating rubber cup, pumice-water slurry with rotating rubber cup and pumice-water slurry with rotating brush. After prophlaxis procedures surface roughness values of all specimens were measured using an optical prophylometer (Zygo New View 7200, Ametek). Data was statistically analyzed using Mann Whitney U and Kruskal-Wallis Tests at the 0.01 and 0.025 level of significance respectively. Results: The smoothest surfaces were observed in control groups for both resin composites (p < 0.001). Control groups' surface roughness values of resin composites tested were significantly different (p < 0.001). However there were no statistically significant differences between surface roughness values of microhybrid and nanohybrid resin composites that received same prophylaxis treatment. Gelato paste, pumice-water slurry with rotating rubber cup and pumice-water slurry with rotating brush caused significantly rougher surfaces than control group but surface roughness values obtained with Detartrine were not significantly different from the control group in both composites. Conclusions: All prophylaxis procedures tested in the study increased the roughness values of both composites to a level that would be retantive to bacteria. Because of that dental professional must be careful during prophylaxis procedures otherwise repolishing or rarely repair of the composite restoration would be necessary after prophylaxis. © 2018 Cumhuriyet University Faculty of Dentistry.Item 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, AlperBu 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.Item Dişeti ve dental folikül dokularında mezenkimal kök hücre araştırması ve plastisitelerinin karşılaştırılması(Başkent Üniversitesi Diş Hekimliği Fakültesi, 2008) Eroğlu, Tamer; Uçkan, SinanMezenkimal 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.Item Minivida destekli kütlesel (en-masse) retraksiyon vakalarında piezoinsizyon yönetiminin etkinliğinin değerlendirilmesi(Başkent Üniversitesi Diş Hekimliği Fakültesi, 2015) Tunçer, Nilüfer İrem; Arman Özçırpıcı, AyçaBu prospektif randomize kontrollü klinik çalışmanın amacı, üst çenede minivida destekli en-masse retraksiyon uygulanan vakalarda piezoinsizyon yönteminin etkinliğini değerlendirmektir. Çalışmaya üst 1. premolar çekim endikasyonu olup en-masse retraksiyon uygulanabilecek 30 birey dahil edilmiş ve rastgele 2 gruba ayrılmıştır. Bütün bireylerde keser ve kaninlerde 0,018x0,025 inç, 2. premolar, 1. ve 2. molarlarda 0.022x0.028 inç slotlu braket ve tüpler kullanılmıştır. Seviyeleme safhası tamamlandıktan sonra Grup I’deki bireylere (13 kız, 2 erkek; ortalama yaş 17,7±3,4 yıl) piezoinsizyonlar yapılmıştır. Grup II’deki (13 kız, 2 erkek; ortalama yaş 17,0±1,4 yıl) bireylerde piezoinsizyon işlemi atlanmış ve iki grupta da üst çenede sağ ve sol 2. premolar ve 1. molarlar arasına 1,5-1,4 mm çapında ve 7 mm uzunluğunda minividalar yerleştirilmiştir. Minividalardan, lateral-kanin arasındaki tele yerleştirilen, vertikal kancalara NiTi kapalı sarmal yaylar asılarak 0.016x0.022 çelik tel üzerinde en-masse retraksiyon yapılmıştır. Tüm bireylerden retraksiyon başı (T1) lateral sefalometrik film, maksillanın anterior bölgesine ait BT görüntüsü, ağız içi ve dışı fotoğraflar, alçı model ve anterior 3 dişten diş eti oluğu sıvısı (DOS) örneği alınmıştır. Retraksiyonun 1. ayında (T2) anterior 3 dişten alınan DOS örnekleri yinelenmiştir. Kaninlerin sınıf I ilişkiye oturduğu retraksiyon sonunda (T3) lateral sefalometrik film, maksillanın anterior bölgesine ait bilgisayarlı tomografi (BT) görüntüsü, ağız içi ve dışı fotoğraflar, alçı model ve sadece ağız hijyeni iyi olan 20 hastadan DOS örnekleri alınmıştır. Alınan materyallerde gerekli ölçümler ve istatistiksel analizler yapılmıştır.En-masse retraksiyon vakalarında piezoinsizyon yöntemi istatistiksel olarak anlamlı bir hızlanma sağlayamamıştır. Dört ay sonunda çekim boşluklarındaki kapanmamiktarı Grup I’de 2,19 mm, Grup II’de 1,70 mm’dir. Ortalama reseptör aktivatör nükleer κβ ligand (RANKL) yoğunluğu, miktarı ve DOS hacmi gruplar arasında benzer bulunmuştur. Grup I’deki 15 bireyin 6’sında piezoinsizyonların uygulandığı alanlarda klinik olarak gözlenebilen kemik büyümeleri meydana gelmiştir. Piezoinsizyonlar dişlerin doğrusal ve açısal değişimleri üzerinde etkili olmamış, iki grupta da keser ve molarlarda meydana gelen hareketler benzer bulunmuştur. Alveoler kemikteki değişimler sadece 12 numaralı dişte mine-sement sınırının 9 mm apikalinde yapılan palatinal kemik kalınlığı ölçümü için gruplar arasında anlamlıdır (p<0,05). Fenestrasyon ve dehisens yüzdelerindeki değişimlerde gruplar arasında fark bulunmamıştır. İnterkanin, interpremolar ve intermolar mesafeler ile kanin ve molar akslarındaki değişimler açısından gruplar arasında fark yoktur. Minividalar 250 gr kuvvete karşı %88,3 oranında başarı göstermiştir. The aim of this prospective randomized controlled clinical trial is to evaluate the efficiency of piezocision technique in miniscrew supported en-masse retraction cases. Thirty subjects requiring maxillary first premolar extractions and eligible for en-masse retraction of the anterior teeth were included in the study and randomly divided into two groups. 0.018x0.025-inch incisor and canine brackets and 0.022x0.028-inch premolar brackets and molar tubes were bonded in all patients. When the maxillary dental arches were fully leveled and aligned, piezocisions were performed only in subjects in Group I (13 females, 2 males; mean age 17.7±3.4 years). Subjects in Group II (13 females, 2 males; mean age 17.0±1.4 years) did not receive piezocisions. At the same session, 1.5-1.4 mm diameter and 7 mm long miniscrews were placed bilaterally between second premolars and first molars in both groups. From these miniscrews, NiTi closed coil springs were attached to the power hooks placed between the lateral and canine brackets. Anterior teeth were retracted on 0.016x0.022-inch stainless steel archwire. Lateral cephalometric radiographs, computerized tomography (CT) scans of maxillary anterior region, intraoral and extraoral photographs, study models and gingival crevicular fluid (GCF) samples were collected from each subject before en-masse retraction (T1). On the first month of retraction (T2), only GCF samples were collected. Retraction was completed (T3) when class I canine relationship was achieved and all the T1 materials except GCF samples were collected likewise. GCF samples were collected only from 20 subjects who successfully maintained good oral hygiene throughout the retraction period. Following the analyses of the collected materials, data were evaluated statistically.Piezocisions could not provide a statistically significant acceleration in the en-masse retraction of anterior teeth. At the end of the fourth month, amount of space closure were 2.19 mm and 1.70 mm in Group I and Group II, respectively. Average concentration and amount of the receptor activator of nuclear factor κβ ligand (RANKL) and GCF volume were similar between the groups. Six of the fifteen patients in Group I presented clinically observable bone growths where the piezoelectric cuts were performed. Piezocisions did not affect the linear and angular changes and similar amounts of incisor and molar movements were observed. Intergroup difference existed in only the palatal bone thickness, 9 mm apical to the cemento-enamel junction of the right lateral (p<0,05). Changes in percentages of dehiscence and fenestration prevelances were not significant between groups. Intercanine, interpremolar and intermolar distances did not differ between groups, as well as canine and molar axes. The overall success rate for miniscrews, loaded 250 gr per side, was 88.3% for this study.