Fakülteler / Faculties
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Item In reply to Cheng et al. (DOI: 10.1186/s13550-023-00965-8)(2023) Somay, Efsun; Topkan, Erkan; Pehlivan, Berrin; Selek, Ugur; 0000-0001-8251-6913; 0000-0001-8120-7123; 37589948; AAG-2213-2021Item Systemic Inflammation Score for Predicting Radiation-Induced Trismus and Osteoradionecrosis of the Jaw Rates in Locally Advanced Nasopharyngeal Carcinoma Patients(2023) Somay, Efsun; Sezen, Duygu; Selek, Ugur; Besen, Ali Ayberk; Mertsoylu, Huseyin; Topkan, Erkan; 0000-0001-8120-7123; AAG-2213-2021We sought to determine the predictive value of the systemic inflammation score (SIS) for radiation-induced trismus (RIT) and osteora-dionecrosis of the jaw (ORNJ) in locally advanced nasopharyngeal carcinoma (LA-NPC) patients treated with concurrent chemoradio-therapy (C-CRT). LA-NPC patients (n= 188) who underwent C-CRT and pre-and post-C-CRT oral examinations from August 2010 to January 2022 were included. The three-tiered SIS groups were created using the serum albumin and lymphocyte-to-monocyte ratio (LMR) measures obtained on the first day of C-CRT: SIS-0: Albumin >= 40 g/dL and LMR >= 4.44); SIS-1: Albumin < 40 g/dL and LMR < 4.44 or albumin >= 0 g/dL and LMR >= 4.44; and SIS-2: Albumin < 40 g/dL and LMR <4.44. The primary objective was to ascertain whether there were irrefutable associations between pretreatment SIS groups and the respective post-C-CRT RIT and ORNJ rates. RIT and ORNJ were diagnosed in 33 (17.6%) and 21 (11.1%) patients, respectively. There were 12 (32.4%), 13 (12.7%), and 18 (45.0%) cases diagnosed with RIT in the respective SIS-0, SIS-1, and SIS-2 groups (p< 0.001). Similarly, there were 1 (2.7%), 11 (9.9%), and 9 (22.5%) cases with ORNJ diagnoses in the corresponding SIS groups (p< 0.001). The multivariate analysis's findings revealed that the SIS grouping was an independent predictor of RIT (p< 0.001) and ORNJ incidence rates (p< 0.001). Our study's findings indicate that the novel pretreatment SIS grouping is a dependable biomarker-based system, which can accurately predict the rates of RIT and ORNJ in LA-NPC patients who receive definitive C-CRT.Item In Reply to Bertl et al.(2023) Somay, Efsun; Topkan, Erkan; Selek, Ugur; 0000-0001-8087-3140; 0000-0001-8120-7123; 0000-0001-8251-6913; O-5474-2014; AAG-2213-2021Item Pretreatment Masseter Muscle Volume Predicts Survival in Locally Advanced Nasopharyngeal Carcinoma Patients Treated with Concurrent Chemoradiotherapy(2023) Pehlivan, Umur Anil; Somay, Efsun; Yilmaz, Busra; Besen, Ali Ayberk; Mertsoylu, Huseyin; Selek, Ugur; Topkan, Erkan; 0000-0001-5871-0695; 0000-0001-8251-6913; 0000-0001-8120-7123; 37959329; AAG-2213-2021Background and purpose: Muscle loss is a significant indicator of cancer cachexia and is associated with a poor prognosis in cancer patients. Given the absence of comparable studies, the current retrospective study sought to examine the correlation between the total masseter muscle volume (TMMV) before treatment and the survival outcomes in locally advanced nasopharyngeal cancer (LA-NPC) patients who received definitive concurrent chemoradiotherapy (CCRT). Methods: A three-dimensional segmentation model was used to determine the TMMV for each patient by analyzing pre-CCRT magnetic resonance imaging. The optimal TMMV cutoff values were searched using receiver operating characteristic (ROC) curve analyses. The primary and secondary endpoints were the relationship between the pre-CCRT TMMV measures and overall survival (OS) and progression-free survival (PFS), respectively. Results: Ninety-seven patients were included in this study. ROC curve analyses revealed 38.0 cc as the optimal TMMV cutoff: <= 38.00 cc (n = 42) and >38.0 cc (n = 55). Comparisons between the two groups showed that the TMMV>38.0 cc group had significantly longer PFS [Not reached (NR) vs. 28; p < 0.01] and OS (NR vs. 71; p < 0.01) times, respectively. The results of the multivariate analysis demonstrated that the T-stage, N-stage, number of concurrent chemotherapy cycles, and TMMV were independent associates of PFS (p < 0.05 for each) and OS (p < 0.05 for each) outcomes, respectively. Conclusion: The findings of the current retrospective research suggest that pretreatment TMMV is a promising indicator for predicting survival outcomes in LA-NPC patients receiving definitive CCRT.Item Predicting Teeth Extraction after Concurrent Chemoradiotherapy in Locally Advanced Nasopharyngeal Cancer Patients Using the Novel GLUCAR Index(2023) Somay, Efsun; Topkan, Erkan; Yilmaz, Busra; Besen, Ali Ayberk; Mertsoylu, Huseyin; Selek, Ugur; 0000-0001-8120-7123; 0000-0001-8251-6913; 38066835; AAG-2213-2021To evaluate the value of the newly created GLUCAR index in predicting tooth extraction rates after concurrent chemoradiotherapy (C-CRT) in locally advanced nasopharyngeal carcinomas (LA-NPCs). Methods: A total of 187 LA-NPC patients who received C-CRT were retrospectively analyzed. The GLUCAR index was defined as 'GLUCAR = (Fasting Glucose x CRP/Albumin Ratio) by utilizing measures of glucose, C-reactive protein (CRP), and albumin obtained on the first day of C-CRT. Results: The optimal GLUCAR cutoff was 31.8 (area under the curve: 78.1%; sensitivity: 70.5%; specificity: 70.7%, Youden: 0.412), dividing the study cohort into two groups: GLUCAR < 1.8 (N = 78) and GLUCAR >= 31.8 (N = 109) groups. A comparison between the two groups found that the tooth extraction rate was significantly higher in the group with a GLUCAR >= 31.8 (84.4% vs. 47.4% for GLUCAR < 31.8; odds ratio (OR):1.82; p < 0.001). In the univariate analysis, the mean mandibular dose >= 38.5 Gy group (76.5% vs. 54.9% for <38.5 Gy; OR: 1.45; p = 0.008), mandibular V55.2 Gy group >= 40.5% (80.3 vs. 63.5 for <40.5%, p = 0.004, OR; 1.30), and being diabetic (71.8% vs. 57.9% for nondiabetics; OR: 1.23; p = 0.007) appeared as the additional factors significantly associated with higher tooth extraction rates. All four characteristics remained independent predictors of higher tooth extraction rates after C-CRT in the multivariate analysis (p < 0.05 for each). Conclusions: The GLUCAR index, first introduced here, may serve as a robust new biomarker for predicting post-C-CRT tooth extraction rates and stratifying patients according to their tooth loss risk after treatment.Item Comparison of Temporomandibular Joint Disorders Between Patients Treated with Hemodialysis versus Peritoneal Dialysis(2022) Tekkarismaz, Nihan; Somay, Efsun; 0000-0001-8251-6913; AAP-9684-2021Objective: The primary aim of this study was to investigate the difference, if any, in the frequency of temporomandibular joint disorders between patients with end-stage kidney disease (ESKD) and healthy individuals. Our secondary aim was to compare the frequency of temporomandibular joint disorders between patients with end-stage kidney disease treated with hemodialysis versus peritoneal dialysis. Methods: All participants completed a questionnaire and underwent a dental evaluation to confirm temporomandibular joint disorder. Results: The frequencies of temporomandibular joint disorders were 13% and 8.9% in the patient and control groups (P =.35), respectively, and 13.4% and 12% in the hemodialysis and peritoneal dialysis groups, respectively (P = 0.85). Conclusions: We observed no difference in temporomandibular joint disorder frequency between patients with end-stage kidney disease who received hemodialysis and peritoneal dialysis as kidney replacement therapy and between patients with ESKD and healthy individuals. Further large-scale studies are warranted to gain a deeper understanding of this topic.Item A Rare Case of Burkitt Lymphoma in a 13-year-girl(2021) Yilmaz, Busra; Somay, Efsun; Hasbay, Bermal; orcid.org/0000-0003-0633-5648; orcid.org/0000-0001-8251-6913Burkitt lymphoma is rare Non-Hodgkin's lymphoma type in childhood. The differential diagnosis includes dental infection and osteomyelitis. Therefore, patients often refer to the dentist first. Early diagnosis has great importance on prognosis. We aimed to broaden the perspective of dentists about this disease and confirm the diagnosis radiographically and clinically.Item Is obesity a problem that threatens oral health in adults?(2021) Yilmaz, Busra; Somay, Efsun; 0000-0003-0633-5648Purpose: Obesity is one of the increasingly negative factors affecting oral and dental health directly or indirectly in many developed and developing countries. The aim of this study was to determine the relationship between obesity and dental problems in adults and to investigate the effect of obesity on oral and dental health. Materials and Methods: 200 patients over the age of 18 who applied with various dental complaints were examined clinically and radiologically. They were classified as 50 healthy females, 50 healthy males, 50 obese females, and 50 obese males according to the body mass index determined by the World Health Organization (healthy individual < 30.0 kg / m(2) and 30.0 kg / m(2) <= obesity individual). Sociodemographic characteristics, dental health status, and data of all patients were examined. Results: A statistically significant relationship was found between obesity and the number of tooth loss, the number of dental caries, educational status, and the frequency of applying to the dentist. Periodontitis was detected at a higher rate in the obesity group (58 %) compared to the control group, but the relationship between obesity and periodontal status was not statistically significant. Conclusion: Dental problems such as tooth loss, the number of dental caries, and periodontitis were higher in the obesity group, and this result showed that obesity threatens oral and dental health. To prevent these problems, there is a need for preventive strategies and increasing awareness of oral and dental health in obese patients.Item High pretreatment systemic immune-inflammation index values are associated with diminished short-term success after temporomandibular joint arthrocentesis procedure(2021) Somay, Efsun; Yilmaz, Busra; 0000-0003-0633-5648; 0000-0001-8251-6913; 34654426Background The systemic immune-inflammation index (SII) has been demonstrated to be a valid biomarker of a patient's immunological and inflammatory state, with the ability to accurately predict outcomes in a variety of disease conditions. In the absence of comparable studies, we intended to examine the relevance of pretreatment SII in predicting the success rates of temporomandibular joint arthrocentesis (TMJA) at 1-week, 1-month, and 6-month periods, defined as maximum mouth opening (MMO) > 35 mm and VAS <= 3. Methods A sum of 136 patients with disc displacement without reduction (DDwo-red) who underwent TMJA was included. For each patient, pre-TMJA SII was calculated as; SII = Platelets x neutrophils/lymphocytes. Additionally, baseline MMO and VAS measurements were recorded for each patient. The success criteria of TMJA included MMO > 35 mm and VAS <= 3. The optimal pre-TMJA SII cutoff that predicts TMJA success was determined using receiver operating characteristic (ROC) curve analysis. The primary endpoint was the link between the pre-treatment SII and TMJA success (simultaneous achievement of MMO > 35 mm and VAS <= 3). Results The median pre-TMJA jaw locking duration, maximum mouth opening (MMO), and visual analog score (VAS) were 7 days, 24 mm, and 8, respectively. The overall TMJA success rates were determined as 80.1%, 91.9%, and 69.1% at 1-week, 1-month, and 6-months, respectively. The results of ROC curve analysis exhibited the optimal SII cutoff at 526 (AUC: 67.4%; sensitivity: 66.7%; specificity: 64.2%) that grouped the patients into two subgroups: Group 1: SII <= 526 (N = 81) and SII > 526 (N = 55), respectively. Spearman correlation analysis revealed a strong inverse relationship between the pretreatment SII values and the success of TMJA 1-week (r(s): - 0.83; P = 0.008) and 1-month, (r(s): - 0.89; P = 0.03). Comparative analyses displayed that TMJA success rates at 1-week (87.7% vs. 69.1%; P = 0.008) and 1-month (96.2% vs. 80%; P = 0.03) were significantly higher in the SII <= 526 than SII > 526 group, respectively, while the 6-month results favored the SII <= 526 group with a trend approaching significance (P = 0.084). Conclusion The current study's findings suggested the SII as a unique independent prognostic biomarker that accurately predicts treatment outcomes for up to 6 months. Trial registration The results of this research were retrospectively registered.Item Pretreatment Systemic Immune-Inflammation Index Predict Needs for Teeth Extractions for Locally Advanced Head and Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy(2021) Yilmaz, Busra; Somay, Efsun; Topkan, Erkan; 0000-0001-8120-7123; 0000-0001-8087-3140; 0000-0001-8251-6913; 34703240; AAG-2213-2021Background: To evaluate the utility of pretreatment systemic immune-inflammation index (SII) in predicting the teeth caries and need for tooth extraction after concurrent chemoradiotherapy (C-CRT) for locally advanced squamous-cell head and neck cancer (LASCHNC) patients. Methods: The records of LA-SCHNC patients who underwent formal dental evaluations at pre and post-C-CRT periods were retrospectively analyzed. The pretreatment SII values were calculated using the platelet, neutrophil, and lymphocyte measures acquired on the first day of C-CRT: SII=Plateletsxneutrophils/lymphocytes. Receiver operating characteristic (ROC) curve analysis was employed to identify the ideal pre-C-CRT SII cutoff that may predict the teeth caries and the need for tooth extraction after the C-CRT. The primary endpoint was the link between the pre-C-CRT SII and the need for tooth extraction during the follow-up period. Results: A sum of 126 patients were included. Median follow-up was 4.9 years (range: 2.7-7.8). Nasopharyngeal and laryngeal cancers comprised the majority (75.4%) study cohort. Posttreatment teeth extractions were reported in 62.7% patients. The optimal cutoff was 558 [Area under the curve (AUC): %76.8 sensitivity: 72.3%; and specificity: 70.9%] that grouped the patients into two subgroups with significantly different post-C-CRT tooth extraction rates: Group 1: SII<558 (n = 70) and SII>558 (n = 56), respectively. Correlation analysis revealed a significant relationship between the pretreatment SII and the tooth extraction rates after the C-CRT (rs:0.89: P = 0.001). The comparative analysis displayed that the teeth extractions rates were significantly higher in the SII>558 group (77.1% versus 51.4% for SII<558; Hazard ratio: 1.68; P = 0.001). Further analyses showed that the pre-C-CRT SII>558 was the unique factor associated with meaningfully higher necessities for post-C-CRT teeth extractions. Conclusion: The present outcomes intimated that high pretreatment SII levels were linked to significantly increased post-treatment teeth extractions in LA-SCHNC patients undergoing definitive C-CRT.