Diş Hekimliği Fakültesi Makale Koleksiyonu
Bu koleksiyon için kalıcı URI
Güncel Gönderiler
Öğe Trimethylamine n-oxide (tmao) and tnf-α levels in periodontal disease associated with smoking(2025) Bal, İpek; Balcı, Nur; Sorguç, Cem; Uslu Toygar, Hilal; Ceran Serdar, Ceyhan; Kurgan, Şivge; Serdar, MuhittinAims: Trimethylamine N-oxide (TMAO) is a compound involved in the pathogenesis of various systemic inflammatory diseases, including cardiovascular conditions. The aim of this study was to determine differences in saliva and serum levels of TMAO between periodontitis and healthy patients according to smoking status. Methods: The study included four systemically healthy groups: periodontally healthy non-smokers (NS-Control; n = 25), non-smokers with Stage-III-Grade-B periodontitis (NS-Periodontitis; n = 25), periodontally healthy smokers (S-Control; n = 25), and smokers with Stage-III Grade-C periodontitis (S-Periodontitis; n = 25). Periodontal parameters were recorded. TMAO levels were determined in saliva and serum samples using liquid chromatography-mass spectrometry (LC–MS/MS). TNF-α levels were measured by the ELISA method. Results: Salivary TNF-α and TMAO levels were significantly elevated in the smoking periodontitis group compared to other groups (p < 0.001 and p = 0.003, respectively). Serum TMAO levels were also significantly higher in the smoking periodontitis group compared to non-smoking controls and non-smoking periodontitis. TMAO/SFR ratios were notably higher in the smoking periodontitis group compared to other groups, and a strong positive correlation was observed between salivary TMAO and TNF-α levels (r = 0.892, p < 0.001). Conclusion: The data suggested that TMAO and TNF-α are associated with inflammatory mechanisms of periodontitis in cases where periodontitis coexists with smoking. Trial Registration: NCT06580431.Öğe Dental pulp stem cells (DPSCs), stem cells from human exfoliated deciduous teeth (SHEDSCs), and periodontal ligament stem cells (PDLSCs) isolation, characterization and the effectiveness of allantoin as bioactive molecule for dental regeneration(2025) Mutlu Özçınar, Betül; Özükoç, Can; Türkmen, Emrah; Çakır, RabiaIntroduction: Dental stem cells are valuable tools in regenerative medicine due to their pluripotency and self-renewal properties. This study aimed to investigate the effects of allantoin (Al) on Dental pulp stem cells (DPSCs), stem cells from human exfoliated deciduous teeth (SHEDSCs), and periodontal ligament stem cells (PDLSCs) regarding cytotoxicity, proliferation, wound healing, and osteogenic differentiation. Methods: Human dental stem cells were isolated from three dental tissues using the explant culture method and cultured in DMEM-F12 medium supplemented with 15 % fetal bovine serum (FBS) and antibiotics. The cytotoxicity and proliferation of allantoin were assessed using the XTT cell viability assay at concentrations ranging from 0.25 to 5 mg/mL. Wound healing was evaluated through a scratch assay at 1 mg/mL, and osteogenic differentiation was assessed using Alizarin Red S staining at 0.5 mg/mL and 1 mg/mL. Results: Al exhibited no cytotoxic effects across the tested concentrations. It enhanced cell proliferation, particularly in SHEDSCs at 5 mg/mL. DPSCs also showed significant improvement in wound healing in the scratch assay. At 1 mg/mL, Al inhibited osteogenic differentiation in DPSCs and PDLSCs, as indicated by reduced mineralization. Conclusion: Al shows potential as a non-cytotoxic agent for enhancing the proliferation of dental stem cells, especially SHEDSCs. However, its limited effect on wound healing of SHEDSCs and PDLSCs and inhibition of osteogenic differentiation at higher concentrations suggest that further optimization is required for its application in bone regeneration. Statement of Clinical Relevance: Evaluation of the effects of plant-based therapeutic compounds on various types of dental stem cells may have the potential to increase the success of stem cell-based therapies in clinical applications in regenerative dentistry.Öğe Modelling intra-sinus fluid movements and drainage through computational fluid dynamics before and after maxillary sinus augmentation: a simulation-based pilot study(2025) Güldiken Sarıkaya, İpek Necla; Tekin, Alperen; Suda, Fatih; Çukurova Yilmaz, Zeynep Gülen; Özcan, MutluObjectives: Sinus lifting, a procedure to augment bone in the maxilla, may cause complications such as sinusitis due to impaired drainage. This study aimed to assess how sinus lifting impacts airflow in the sinus cavity, which is essential for patients undergoing dental implants. Using computational fluid dynamics (CFD), this research analyzed airflow changes after sinus floor elevation, offering insights into the aerodynamic consequences of the procedure. Methods: Digital modeling and CFD analysis were performed using patient cone-beam computed tomography data. Three different sinus elevation scenarios, each with varying implant heights, were simulated. Airflow simulations were conducted to assess how reshaping the sinus cavity affects aerodynamics and airflow dynamics. Nasal resistance, calculated through pressure drops and flow rates, and wall shear stress, indicating potential mucosal damage, were evaluated. Results: Although some airflow changes occurred post-surgery, the implants primarily affected the front and rear of the elevated area, with little impact being seen on air entry points. Conclusions: Maxillary sinus lifting for dental implant placement may impair sinus drainage, especially at higher elevations, increasing the risk of mucosal damage due to intensified airflows in the reduced sinus volume. A more uniform, simplified intra-sinus structure may enhance fluid dynamics and reduce complications.Öğe Evaluation of mandibular and maxillary second molar root canal anatomy in a Turkish subpopulation using cbct: comparison of briseno-marroquin and vertucci classifications(2025) Güneç, Hüseyin Gürkan; Öreroğlu, İpek; Çağlar, Kemal; Cesur Aydın, KaderBackground: This retrospective study aims to characterise the root canal morphology of maxillary and mandibular second molars using cone-beam computed tomography (CBCT). The number of roots and canal configurations were evaluated using both the Vertucci and Benjamı´n Brisen˜ o Marroquı´n classification systems. Methods: A total of 1084 second molar images (523 maxillary; 266 right and 257 left side and 561 mandibular; 285 right and 276 left side) were evaluated from 320 CBCT scans analyzed for the Turkish subpopulation. CBCT imaging provided superior visualisation of root canal anatomy compared to periapical radiography. The findings revealed diverse root canal configurations, with variations observed even within the same population. Statistical analyses, including the chi-squared test, were used to assess correlations between root number and demographic variables such as age and sex. Results: According to Benjamı´n Brisen˜ o Marroquı´n classification system, the most common configuration for upper right three-rooted teeth mesial root was 3URM2−1 (n:66, 35.7%), for distal root was 3URM1 (n:169, 91.4%), and for palatal root was 3URM1 (n:165, 89.2%). Additionally, the most common configuration for upper left three-rooted teeth mesial root was 3271 (n:50, 28.4%), for distal root was 3ULM1 (n:160, 90.9%), and for palatal root was 3ULM1 (n:158, 89.8%). In lower left molars, the most common configuration in the two-rooted teeth mesial root was 2LLM2 (n:114, 49.4%), and for the distal root was 2LLM1 (n:170, 73.6%). For lower right the most common configuration for two-rooted teeth mesial root was 2LRM2 (n:125, 52.5%), and for distal root was 2LRM1 (n:173, 72.7%)(p < 0.05). Conclusion: The primary outcome was observed that the root canal anatomy of upper and lower second molars may differ in both classifications of Turkish subpopulation. While Vertucci's classification was inadequate in some cases, Briseno-Marroquin classification was able to classify all upper and lower second molars with a single code. This new classification is a more useful system for classifying all second molars. There is a statistically significant difference exists among the new configuration according to the distribution of the teeth analyzed.Öğe Two-year clinical performance of an alkasite direct restorative material in class I and II cavities without using an adhesive resin: a prospective single-arm clinical trial(2024) Öztürk Bozkurt, Funda; Toz Akalın, Tuğba; Özsoy Kaner, Alev; Kuşdemir, Mahmut; Özcan, MutluPurpose: To evaluate the clinical performance of an alkasite material for Class I and Class II cavities. Methods: 50 subjects (30 females, 20 males; mean age: 28.7) referred to the Department of Restorative Dentistry, Medipol University, Dental School, Istanbul, Turkey, received 89 Class I and II restorations (Cention N) by two trained operators. All restorations were made in bulk application without an adhesive resin and without photo-polymerization. Results: 65 restorations were followed in 37 subjects at a 2-year recall. The mean observation period was 27.6 months. 24 restorations (13 subjects) were not followed up at 2-year recall and were considered as drop out. The restorations were made either due to primary caries (n= 73) or restoration replacement (n= 16). 89 restorations were placed of which 51 were in the maxilla and 38 in the mandible. In deep cavities, a cavity liner was applied (with n= 53; without n= 36). Hypersensitivity was observed in nine cases that disappeared at the latest after 1 month. No debonding, no fracture, and no endodontic complications were observed at 6-month and 1-year recalls whereas four partial retention losses and one pulpal complication occurred at the 2-year recall. The overall survival rate was 88.9% with a mean observation time of 27.6 months (Kaplan-Meier, Log Rank; Mantel-Cox) (95%CI=31.07-32.25).Öğe Clinical outcomes of selective removal to soft dentin versus firm dentin for deep caries lesions: a randomized controlled trial up to 5 years(2024) Gözetici Çil, Burcu; Çetin, Tuba; Bittar, Ahmad; Özcan, MutluObjectives: This study aimed to compare the success of selective removal to soft dentine (SRSD) with or without calcium silicate (CS) and selective removal to firm dentine (SRFD) in permanent dentition. Materials and methods: Between November 2018 and March 2020, 165 posterior deep caries lesions in 134 patients were included in the study and randomly assigned into test (n = 101) and control (n = 64) groups. The control group (n = 46) received the treatment of SRFD with CS, while the test group was further randomized into two groups to receive SRSD with CS (n = 45) and SRSD without CS (n = 45). An additional group (PE) consisted of teeth with exposed pulps during caries removal (n = 29). The primary outcome of the study was to assess the vitality of the teeth based on clinical and radiographic examination after five years. The secondary outcome of the study was to evaluate the influence of baseline variables and CS application on treatment outcome. The success rates of different treatment strategies were compared (Pearson chi-squared and Log-rank tests). The impact of baseline variables and treatment strategies on failure and dentin bridge formation was analyzed using binary logistic regression model. Results: The success rate for SRSD with or without CS (94.1–100%) was significantly higher compared to SRFD (75.8%) and PE (81.8%) after five years (P = 0.012). Failure was less likely for premolars. Cavity type and depth had an influence on dentin bridge formation. Conclusion: A five-year follow-up in this study demonstrated better clinical outcome for SRSD with or without CS compared to SRFD technique, irrespective of age, pre-op sensitivity, cavity type, radiographic depth and activity of the caries. Application of CS after SRSD in deeper cavities provided better healing in terms of dentin bridge formation. Clinical relevance: SRSD might be more advantageous over SRFD for the management of deep caries lesions.Öğe Comparison of diagnoses made by dentistry students and by artificial intelligence dentists(2025) Bahadır, Hasibe Sevilay; Keskin, Neslihan Büşra; Kurşun Çakmak, Emine Şebnem; Güneç, Gürkan; Cesur Aydın, Kader; Sarı, Saliha KübraObjectives: The introduction of artificial intelligence (AI) about great changes in the field of dentistry, but it has not yet been fully determined in which areas it will make a positive contribution to dentistry students. The objective of our study was to compare the diagnostic accuracy of undergraduate students (fourth-year dentistry students [4DS] and final-year dentistry students [5DS]) and AI when examining panoramic radiographs. Methods: Fifty panoramic radiographs and 1602 teeth were examined by 50 4DS who had not received a clinical practice internship, 50 5DS, and an AI application. The participants and the AI application evaluated the teeth seen in each radiograph one by one in terms of caries, fillings, teeth with root canal treatment, periodontal loss, extractions, crowns, teeth with apical lesions, and impacted and extracted teeth. Findings were recorded in an Excel chart. Chi-square analysis was used to compare diagnostic success between the groups. Results: The results indicate that there was a statistically significant difference in the identified accuracy of caries, fillings, and extractions between the AI application and undergraduate students (p < 0.05). Although AI showed more identified accuracy in teeth with apical lesions, impacted teeth, and teeth with root canal treatment than in undergraduate students, there was no significant difference between them (p > 0.05). Conclusion: AI exhibited better results than undergraduate students especially in the detection of caries and fillings. AI could improve undergraduates’ accuracy in detecting caries, fillings, and extractions and help them make accurate treatment decisions. In cases where dentistry students are examining patients using panoramic radiographs, employing AI programs during their clinical training to confirm and strengthen the student's diagnosis may be a promising new development.Öğe Comparison of youtube and youtube shorts videos about clear aligners(2024) Yılancı, Hilal; Canbaz, BarışObjectives: The aim of this study was to compare the quality and characteristics of information about clear aligners between YouTube and YouTube Short videos. Material and Methods: YouTube video was searched using the keyword “aligner.” After ranking the results according to relevance, 100 of the first 157 YouTube videos and 100 of the first 140 YouTube Shorts were evaluated. Videos were classified into five groups as dentist/specialist, hospital/clinic/university, commercial, layperson, and other. The video information and quality index (VIQI) and DISCERN index were used to evaluate the quality and usefulness of the videos. Data were analyzed using International Business Machines(Ibm) Statistical Package for the Social Sciences (SPSS) statistics version 23. Level of significance was accepted as P < 0.05. Results: Only 9% of YouTube videos, content quality was found to be good. As DISCERN scores decreased, a significant decrease was present in the number of views, comments, likes and dislikes, total video length, VIQI, viewer interaction, and viewing rate. The United States of America (USA) was the leading country by producing 54% of YouTube videos. However, India was the predominant source of YouTube Shorts videos, with 83%. Invisalign was the most frequently mentioned brand of aligner in both YouTube and YouTube Shorts videos. Conclusion: Orthodontists should be aware that the data available on the internet is incorrect or insufficient and should guide their patients correctly with additional data. Likewise, they should guide them on how to access up-to-date and accurate data.Öğe Periradicular repair after single-visit root canal treatment using sonic irrigant activation of teeth with apical periodontitis(2024) Arıkan, Nur Sena; Erdem Hepşenoğlu, Yelda; Erşahan, Şeyda; Özçelik, FatihObjectives: This study aimed to explore whether using sonic irrigant activation during endodontic treatment favors periradicular repair in teeth with apical periodontitis. Materials & methods: One clinician treated 140 posterior (either premolar or molar) asymptomatic teeth with periapical lesions: 70 were randomly assigned to the sonic activation with EndoActivator (EA) group, and 70 were treated by conventional needle irrigation (CNI). Both groups underwent chemomechanical root canal preparation using 35/04 diameter rotary files and 2.5% NaOCl as the irrigant. NaOCl was sonically activated in the EA group, and the final irrigation with NaOCl was performed using a 30-gauge side-perforated needle in the CNI group. All root canal obturations were performed with lateral compaction. All patients were followed up for 12 months. Success was determined based on both healed and healing cases. The chi-square or Fisher’s exact test was used to compare success rates and outcome-influencing factors between groups. Results: The recall rate was 131 (94%). At 12 months, 50 teeth (77%) were considered healed, 12 teeth (18%) as healing, and three (5%) as failed in the EA group, while 43 teeth (65%) were considered healed, 17 (26%) as healing, and six (9%) as failed in the CNI group. Verbal Rating Scale scores were significantly lower in the EA group than in the CNI group on postoperative days 1 (p < 0.0001) and 2 (p = 0.0002). Postoperative Periapical Index scores were significantly lower in the EA group than in the CNI group (p = 0.0023). Postoperative lesion sizes were also significantly smaller in the EA group (0.7 [0.2–11.7] mm) than in the CNI group (1.7 [0.5–11.5] mm; p = 0.0118). While the success rate was higher in the EA group (62 [95%]) than in the CNI group (60 [91%]), the difference was not significant (p = 0.492). Conclusions: The periradicular repair of posterior teeth with apical periodontitis demonstrated the efficacy of EndoActivator on treatment outcomes and reduced postoperative pain. These results suggest the adjunctive use of sonic activation to enhance the decontamination of the root canal system during the chemomechanical stage. Clinical relevance: This clinical trial is the first to evaluate the effects of sonic activation on postoperative healing. Sonic activation with the EndoActivator can reduce postoperative pain and accelerate the healing of the periapical tissues.Öğe Unusual presentation of oral dlbcl resembling a canine fossa abscess(2025) Güzel, Ceylan; Münevveroğlu, Sümer; Arar, Elif Ezgi; Koçyiǧit Daştan, HayrunisaThis report aims to describe a unique case of diffuse large B-cell lymphoma originating from the oral cavity, which presented with symptoms mimicking a canine fossa abscess. It emphasizes the importance of accurate differential diagnosis and appropriate treatment. A 64-year-old female patient visited the authors' clinic with a painful swelling in the left anterior region of the maxilla, persisting for 1 month. Initially, an abscess drainage procedure was performed, accompanied by extraction of the maxillary left canine and parenteral antibiotherapy. However, no improvement was observed during the follow-up appointment after 3 days. An incisional biopsy was then conducted under local anesthesia, leading to a histopathologic diagnosis of diffuse large B-cell lymphoma. The patient is currently under the care of the hematology department and receiving maintenance chemotherapy. Lymphomas occurring in the oral cavity are uncommon and may exhibit non-specific clinical features that resemble benign oral and dental conditions. Therefore, a comprehensive clinical evaluation is necessary to achieve an early and accurate diagnosis, with histopathologic examination being essential for suspicious lesions.Öğe Regulatory issues related to the use of sodium hypochlorite solutions in endodontics(2025) Peters, Ove A.; Ballal, Nidambur V.; Abe, Shu; De Deus, Gustavo; Gündoğar, Mustafa; Camilleri, Josette; Zehnder, MatthiasAim: To assess the regulation of sodium hypochlorite (NaOCl) solutions for endodontic usage in some of the world's main dental markets, in view of the European Union's recent move to classify antimicrobial root canal irrigants as high-risk devices under their Medical Device Regulation (MDR). Methodology: The authors consulted legal texts available online and communicated with local health authorities wherever necessary to assess into which medical device category NaOCl solutions intended for endodontic application were subsumed. Furthermore, it was investigated whether there were sources outside the dental market to obtain NaOCl solutions for root canal treatments. Results: Upon completion of this text (mid 2024), NaOCl solutions for root canal irrigation had not been classified in the US and Canada, whilst in the European Union, they had just been upgraded to high-risk medical devices, with all the consequences for the dental supply market. This MDR rule was adopted by the EU's close trading partners, the United Kingdom, Switzerland and Turkey. In Japan, the legal hurdles were already high for manufacturers and importers of endodontic NaOCl solutions. Conversely, in China, these solutions were down-graded from a high-risk to a medium-risk status in 2017. A low-medium risk category was applied in the other countries under investigation, that is, Australia, India and Brazil. In some countries there was a possibility for dentists to procure plain NaOCl solutions from pharmacies. An alternative route to avoid buying NaOCl from dental suppliers was to use (household) bleach solutions for root canal irrigation wherever this practice was not prohibited explicitly. Conclusions: The legal situation to produce, import and use NaOCl solutions for root canal irrigation differs vastly around the globe. A sensible approach to regulate (yet not over-regulate) endodontic NaOCl solutions appears to be timely and necessary.Öğe Nasopharyngeal carcinoma masquerading as temporomandibular disorder(2024) Güzel, Ceylan; Münevveroğlu, Sümer; Erten, Fatma DilekTrismus, commonly associated with temporomandibular disorders (TMD), trauma, or infection, can occasionally manifest as a rare symptom of malignancy. The author present a case of misdiagnosed carcinoma initially presenting with features resembling TMD. A 72-year-old presented with left facial pain, earache, and progressive difficulty in mouth opening. Initial assessments suggested TMD, but further investigation revealed a nasopharyngeal mass indicating squamous cell carcinoma. This case underscores the need for a comprehensive approach in evaluating trismus to rule out malignancy. Early recognition and appropriate referral for further investigation, including imaging and biopsy, are essential for timely diagnosis and management of malignancy masquerading as TMD.Öğe Annexin levels in gcf determine the imbalance of periodontal inflammatory regulation(2024) Yılmaz, Melis; Bal, İpek; Hanlı, Sena; Türkmen, Emrah; Balcı, Nur; Uslu Toygar, HilalObjective: Annexin-1 (ANXA1), a member of the annexin family, plays a role in the resolution of inflammation and the regulation of anti-inflammatory responses, while annexin-2 (ANXA2) is involved in the initiation of the inflammatory responses. The aim of this study was to determine the effects of annexin family (ANXA1 and ANXA2) in periodontal disease. Methods: Healthy participants (n:25) and stage III, grade B periodontitis (n:25) patients enrolled for this study. Clinical periodontal parameters and the periodontal inflamed surface area (PISA) levels were noted. Serum, saliva, and gingival crevicular fluid (GCF) samples were collected to measure the ANXA1, ANXA2 and IL-1β levels. Results: Salivary and serum concentrations of ANXA1 was significantly lower in the periodontitis group than in the control group (respectively, p = 0.0177 and p = < 0.0001). Periodontitis patients demonstrated higher serum ANXA2 and IL-1β concentrations compared to controls (respectively, p = 0.0002 and p = 0.0017). As an inflammatory index; saliva, serum and GCF ANXA1/ANXA2 ratio were significantly lower in the periodontitis group compared to healthy controls. Conclusions: The data suggest that periodontitis is associated with a disruption of the balance between pro-inflammatory mechanisms (ANXA2 and IL-1beta) and inflammation resolution (ANXA1), in parallel with PISA levels. Clinical Trial Registration: ClinicalTrials.gov NCT06554756 (15/08/2024).Öğe Evaluation of flexural strength of additively manufactured resin materials compared to auto-polymerized provisional resin with and without hydrothermal aging(2025) Aycan Tavuz, Kübra; Al Haj Husain, Nadin; Mätzener, Kiren Jan; Ateş, Mehmet Muzaffer; Eyüboğlu, Tan Fırat; Özcan, MutluPurpose: Additive manufacturing (AM) technologies are used to fabricate 3D-printed provisional dental restorations. The purpose of this study was to investigate the flexural strength of 3D-printed resins and compare their mechanical performance with those of conventional resins indicated for provisional restorations. Materials and methods: This study included six different 3D-printed resin materials, namely (Nextdent (ND); Temp PRINT (TP); Optiprint temp (OT); 3Delta Etemp (DE); Saremco print | CROWNTEC (SA); MED690 (ST)), and one conventional (Protemp (PT)) (Control) provisional resin material. Specimens (N = 168) were prepared (25x2x2 mm3) following ISO 10477:2018 guidelines for temporary materials using a printer (Asiga MAX 3D). Post-processing was accomplished following each manufacturer's recommendation. While half of the specimens were tested after 24 H without aging, the other half was subjected to thermomechanical aging in a custom-made chewing simulator (1.200.000 cycles, 5 °C and 55 °C). Flexural strength of the specimens was determined using a Universal Testing Machine. Data were analyzed using two-way ANOVA followed by Tukey's post-hoc test (α = 0.05). Weibull modulus for each group was calculated based on parametric distribution analysis of censored data for maximum fracture load. Results: No significant difference was observed in mean flexural strength (MPa) when non-aged and aged conditions were compared in the OT and PT groups (p>0.05). Groups ND, SA, TP, DE, and ST presented significant differences ranging between 12.67 and 57.39 MPa (p<0.05). All groups presented lower shape and scale values in aged groups compared to their non-aged counterparts. While OT and PT maintained their flexural strength after aging, ND exhibited the highest decrease (30%), followed by DE (23.8%), SA (16.2%), TP (12%), and ST (8.6%) in descending order. Weibull modulus decreased as a function of aging except in group ST. Conclusion: Significant effect of themomechanical aging especially on ND and DE materials should be considered with caution when such materials are indicated as interim or long-term interim provisional restorations. SA and TP exceeded the expectations from a provisional material compared to that of the conventional control material PT.Öğe Comparison of electronic apex locator and simultaneous working length detection methods with radiological method in terms of postoperative pain(2024) Güzel, Emine; Uyan, Miray; Erşahan, Şeyda; Gündoğar, Mustafa; Özçelik, FatihBackground: Precise knowledge of the apical construction, which determines the end of the area for canal preparation and filling, is essential for the success of root canal treatment and the management of postoperative pain. For this purpose, devices based on various methods that determine the working length (WL) are used. However, it is still controversial which method provides the most accurate measurements. Aim: To investigate the compatibility of the electronic apex locator (EWL) and simultaneous working length determination (SWL) methods in single-root teeth in comparison with the radiographic working length determination (RWL) method and to determine which one produced more effective results in terms of postoperative pain. Materials & methods: One hundred patients scheduled for root canal treatment (RCT) were randomly assigned to one of the three groups according to the working length measurement method (EWL, SWL or RWL). After WL determination with assigned method, root canals were prepared and then obturated. Age, gender, simplified oral hygiene index (OHI-S), oral and dental examinations and Visual Analogue Scale (VAS) results of all participants were recorded. The incidence and intensity of postoperative pain were rated on a Visual Analogue Scale (VAS) by patients 6, 12, 24, 48 h and 7 days after RCT. The number of analgesic tablets (400 mg Ibuprofen) taken by patients was also recorded. Data were analyzed using the chi-square, One- way ANOVA and Kruskal-Wallis tests. Bland-Altman and Passing-Bablock regression analysis were used as method comparison techniques. Results: It was determined that the number of patients receiving analgesia and the total number of analgesia doses were higher in EWL and RWL groups compared to SWL group (p < 0.0001). When the WL values at which the treatment was applied were compared in the patient groups; WL values of EWL group were statistically lower than SWL group (p < 0.01). While there was no difference between the preoperative VAS scores of the groups (p = 0.7590), the postoperative 6th and 12th hour VAS scores of SWL group were lower than those of EWL and RWL groups (p = 0.005 and p = 0.0002, respectively). Again, the VAS scores of SWL group at the 24th and 48th postoperative hours were lower than those of RWL group (p < 0.05). According to the Bland-Altman and Passing-Bablock regression analysis results, although there was no statistically significant difference between the EWL and SWL methods (p = 0.471), the bias value of -0.1190 was well below the acceptable total error (0.1648). Additionally, a strong relationship was found between EWL and SWL methods (r = 0.9698, r2 = 0.9406, p < 0.001). Therefore, statistically these two methods were considered compatible with each other. It was determined that there was a statistically significant bias (0.340, p < 0.0001) between the RWL and SWL methods, exceeding the total error. Conclusions: As a result, it was determined that the SWL method, which is used to determine working length for the success of endodontic treatment, can be used as an alternative to the EWL method thus producing more effective results in the management of postoperative pain. However, in addition to the method used, the technology of the device developed for this method should not be ignored. Clinical relevance: Precise knowledge of the apical construction, which determines the end of the area for canal preparation and filling, is essential for the success of root canal treatment and the management of postoperative pain. For this purpose, devices based on various methods that determine the working length are used. However, it is still controversial which method provides the most accurate measurements. This study found that the simultaneous working length determination method can be used as an alternative to the electronic working length determination method and produces more effective results in the management of postoperative pain. Another important outcome of this study is that the Total Allowable Error (TEa) for the electronic apex locator method, which is accepted as the reference, has been calculated for the first time. Other methods have been evaluated according to this reference method. This is a first in literature.Öğe Flexural strength of modern cad/cam restoratives after artificial aging(2024) Melc, Thomas; Attin, Thomas; Eyüboğlu, Tan Fırat; Özcan, MutluBefore clinical trials are initiated, studying the mechanical performance of modern CAD/CAM restorative materials exposed to aging conditions would provide insights on their performance in service. This study evaluated the impact of thermomechanical aging on various resin composite, ceramic, hybrid, and nano-filled resin composite materials after two polymerization modes. Specimens (3 × 4 × 14 mm3) were fabricated using (n = 12 per group) a universal composite (Filtek Supreme XTE photo-polymerized for either 40 s or 120 s per layer), hybrid ceramics (BRILLIANT Crios, GC Cerasmart, Lava Ultimate, VITA ENAMIC), glass ceramics (IPS e.max CAD, VITA Suprinity PC, Straumann n!ce), or feldspar ceramics (VITABLOCS Mark II, GC Initial LRF). In each group, half of the specimens underwent thermomechanical aging. A three-point bending test was applied to all specimens and the results were statistically analyzed (α = 0.05). Glass ceramics and hybrid ceramics presented higher flexural strength values than feldspar ceramics and the universal composite before and after aging (p < 0.05). Thermomechanical cycling affected the flexural strength of all materials (p < 0.05) except Lava Ultimate, Straumann n!ce, and GC Initial (p > 0.05). The highest decrease in flexural strength after aging was found in the universal composite (40 s polymerization) (p < 0.001) and Vita Enamic (p < 0.001), while the lowest decrease was in the hybrid ceramics, Cerasmart and Lava Ultimate (p < 0.05). Extending polymerization duration reduced the aging effect on the universal composite tested. Thermomechanical aging affected the flexural strength of most materials tested. Universal composites and feldspar ceramics presented similar flexural strength values.Öğe Does different application modes of universal adhesives with universal resin composites affect the microleakage in class v cavities? an in vitro study(2024) Sarı, Ceyda; Akgül, Sinem; Bala, OyaAim: Composite restorations often have gingival margins near the cemento-enamel junction (CEJ), where the microleakage of these margins can significantly contribute to the restoration failure, especially in the cervical lesions. It is important to determine the microleakage is crucial, as it typically occurs through the interfacial gap between the tooth and the restoration. Various resin composites and techniques have been developed to minimize this gap and reduce the risk of microleakage. The aim of this in vitro study was to evaluate the levels of microleakage of different modes of a universal adhesive and two novel resin composites in restoring class V cavities in the central incisors. Methods: Sixty-six freshly extracted sound human central incisors of the similar size were randomly assigned to 2 groups (n = 33 per group) according to the brand of resin composite. Each group was further divided into 3 subgroups based on the Scotch Bond Universal (3 M ESPE, Saint Paul, MN, USA) application protocol used: (a) total etch, (b) self-etch and (c) selective etch. After composite restoration completed with Omnichroma (Tokuyama Dental Corp., Tokyo, Japan) and Filtek Universal Restorative (3 M ESPE, Saint Paul, MN, USA), each tooth was immersed in a 0.5% basic fuchsin dye solution at 37C0 for 24 h. After dye penetration, teeth were sectioned and evaluated with conventional (scoring) and digital methods (ImageJ). The intra- and inter-examiner agreement was estimated according to the Kappa statistics and the results were analyzed with the one-way ANNOVA and the Kruskal–Wallis test (p < 0.05). Results: The rates of microleakage of the gingival and incisal margins are statistically similar, regardless of the composite brand and the method of application of the universal adhesive. Conclusion: The microleakage exhibited by current adhesives and resins is independent of the adhesive application mode and measurement method.Öğe Clinical performance of 3d printed resin composite posterior fixed dental prosthesis a permanent solution(2025) Hobbi, Paniz; Ordueri, Tuğçe Merve; Öztürk Bozkurt, Funda; Toz Akalın, Tuğba; Ateş, Mehmet Muzaffer; Özcan, MutluObjectives: This clinical trial aimed to evaluate the clinical outcomes of 3D-printed resin composite posterior fixed dental prosthesis (FDP) restorations. Materials and Methods: Between October 2020 and August 2022, 49 patients (33 females, 16 males, aged 19-60) received 68 3-unit 3D-printed resin composite posterior FDPs (ELS Even Stronger, Saremco, Switzerland). Follow-ups were conducted at baseline (2 weeks) by independent observers using modified FDI criteria, assessing anatomical form, marginal adaptation, surface roughness, color match, fracture, retention, and patient feedback. Fifty FDPs completed a 1-year follow-up, and 18 reached 2 years. Results: The mean observation period was 14.15 months. Failures were categorized as mechanical or bio-logical, with 19 FDPs failing: 14 mechanical (12 cohesive fractures) and 5 biological (3 needing endodontic treatment, 2 periodontal issues). Two FDPs were recemented. Three FDPs showed surface luster loss, color mismatches, and staining. The survival rate based on mechanical failures was 69.5%, dropping to 61.0% when including biological com-plications. Conclusions: After 2 years, 3D-printed resin composite FDPs demonstrated acceptable performance, with most failures due to fractures in the connector region, suggesting the need for design revisions.Öğe Evaluation of alveolar bone destruction patterns in the posterior region of the maxilla through cone beam computer tomography on 361 consecutive patients effect of age and gender(2024) Namdar Pekiner, Filiz; Yılmaz, Gözde; Keser, Gaye; Eyüboğlu, Tan Fırat; Özcan, MutluObjectives: The aim of this retrospective study is to evaluate the effect of age and gender on the alveolar bone destruction pattern with cone beam computed tomography (CBCT) in the posterior region of the maxilla. Materials and Methods: The study group included CBCT image records of 361 consecutive patients (180 males and 181 females) aged 20 years and older. Alveolar crest morphology in the maxillary right and left first and second molar teeth on retrospective images was classified as a horizontal or vertical defect (one-walled, two-walled, three-walled, and combined bone defect) on four surfaces (mesial, distal, buccal, and palatinal). Bone crater defects were defined, and furcation involvements and combined periodontal–endodontic lesions (CPELs) were placed in another category. Results: In 361 patients, 1444 teeth were evaluated from adults between 20 and 63 years of age; 49.9% of the patients were male and 50.1% were female. Female patients had a considerably greater rate of one-walled horizontal damage in the right molar teeth than male patients (p = 0.002; p < 0.05). Patients with combined horizontal destruction in the right and left molar teeth, horizontal destruction in the palatinal, and horizontal three-walled destruction had a significantly higher mean age than patients without these periodontal destructions (p = 0.000; p < 0.05). Males were shown to have statistically higher frequencies of horizontal defects when defects were combined or distally and palatally located. Conclusions: Age and gender affect the alveolar bone loss pattern. Except for single-walled destructions, it has been found that the frequency of horizontal destruction increases with age. Horizontal destruction in the palatinal along with horizontal three-walled destruction increased with age.Öğe Effect of reference objects on the accuracy of digital implant impressions in partially edentulous arches(2024) Rutkūnas, Vygandas; Jegelevičius, Darius; Pletkus, Justinas; Auškalnis, Liudas; Akulauskas, Mykolas; Eyüboğlu, Tan Fırat; Gedrimienė, AgnėPURPOSE. This study assesses the impact of additional reference objects (RO) on the trueness and precision of distance and angle measurements between scan bodies in digital scans with four different intraoral scanners (IOS) in partially edentulous models. MATERIALS AND METHODS. Maxilla models (Frasaco, Frasaco GmbH, Tettnang, Germany) with one (3-U) and two (4-U) missing posterior teeth were 3D printed and fitted with dental implants and scan bodies. Four intraoral scanners (Primescan (Dentsply Sirona, Charlotte, NC, USA) (PS), Trios 3 (3Shape) (T3), Trios 4 (3Shape) (T4), and CS3600 (Carestream Dentistry) (CS)) captured digital implant impressions with and without additional RO. Scans were aligned and assessed for distance and angulation measurements between scan bodies. Statistical analyses compared trueness and precision across model groups using the Student t-test and Welch’s ANOVA. RESULTS. CS consistently showed the highest distance values across IOS devices in both the 4-U and 3-U models (P <.05), both with and without RO. The distance values were not considerably affected by the presence of RO (P >.05), except for a few isolated cases in the PS and CS groups of 3-U models. When measuring angles, CS usually showed greater values than the other IOS devices, especially when RO was present both in the 4-U and 3-U variants (P <.05). CONCLUSION. The influence of additional reference objects on accuracy varies with different scanner types, irrespective of edentulous area length.
