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Öğe 3D modelling and x-ray depth analysis map of the pulp with computer software via digital periapical radiography and cone beam computed tomography(2025) Felek, Turgut; Şatır, Samed; Özel, ŞelaleObjective: Periapical radiographs (PAR) offer information about the pulp and periodontal health of teeth. However, intraoral radiographs are insufficient for diagnosing buccolingual anomalies and variations such as bifid canals due to their two-dimensional nature. Cone beam computed tomography (CBCT) is the gold standard for 3D imaging in the clinic but requires additional radiation. The aim of this study was to create a software (XPAR) which obtains x-ray depth analysis and 3D modelling of the pulps of single-rooted teeth by converting the grey values in the original radiographs into numerical data. Materials and methods: Two single-rooted teeth were included in the experimental part of the study. Chicken fibula bone was preferred for alveolar bone simulation because it could simulate cortical and trabecular structures due to similarity. A total of four images (60kVp & 70kVp; single alveolar bone & double alveolar bone) were obtained. The aim of this experimental part is to test the repeatability and realism of the algorithm to be created for pulp modelling. Retrospectively, 31 single-rooted teeth with both periapical radiography and cone-beam computed tomography imaging were included in the retrospective part of the study. According to XPAR, depth increase areas were interpreted as root resorption and accessory canal. Depth decrease areas were evaluated as the transformation of the pulp from an elliptical to an oval form, pulp stone, bifid canal formation and the presence of thick alveolar bone. The diagnostic accuracy of XPAR application on pathological and morphological changes was evaluated by comparing the obtained results with CBCT. Results: 80% of the analyses diagnosed as bifurcation by XPAR application were supported by CBCT. This rate decreased to 27% in the diagnosis of transitions from elliptical to oval form. A total of 5 and 19 linear formations observed in the form of depth decrease and increase, respectively, were accepted as image errors in XPAR. Conclusion: Buccolingual bifid canal formations and pulp obliterations can be diagnosed with a rate of nearly 50% with the depth decrease finding obtained in XPAR application. Imaging errors caused by deformed detectors are typically observed as linear formations.Öğe Brushing motion caused no microcracks: a micro-computed tomography study(2025) Yanık, Deniz; Özel, Şelale; Dağlı Taşman Cömert, FügenObjective: We evaluated the effect of brushing motion on microcrack formation in round distal canals after using multi-file rotary(MFR), single-file rotary(SFR), and single-file reciprocation(SFRc) systems via micro-computed tomography(micro-CT). Materials and methods: Thirty-six mandibular molars were used. Samples were allocated according to files and preparation patterns (n = 12); pecking (P) and brushing (B): Group-MFR-P, Group-MFR-B, Group-SFRc-P, Group-SFRc-B, Group-SFR-P, Group-SFR-B. MFR was ProTaper Next, SFR was TruNatomy, and SFRc was WaveOne Gold. Mesial and distal were prepared using pecking motion, and additional brushing motion. Brushing motions were performed after the pecking motions with 6 strokes. Pre-and-post-instrumentation scans were obtained. Wilcoxon, Krukal-Wallis, and Mann-Whitney-U were performed. Results: No differences were between pre-and-post-instrumentation scans (p > 0.05). Post-instrumentation microcracks were not different in Group MFR-P and Group MFR-B, Group SFRc-P and Group SFRc-B, Group SFR-P and Group SFR-B (p > 0.05). Conclusion: The brushing motion followed by the pecking motion did not cause microcracks. None of the file systems examined in the study induced microcracks.Öğe Comparison of calcium silicate-based materials in pulpotomies of primary molars: a randomized clinical trial(Istanbul University Press, 2025) Koruyucu, Mine; İlisulu, Sabiha Ceren; Yardımcı, Sıla; Seymen, FigenPurpose The primary objective of this investigation is to evaluate the clinical and radiographic findings of mineral trioxide aggregate (MTA) and Biodentine (BD) as pulpotomy agents in primary molars. Materials and Methods Two hundred primary molars (N=200) were treated with pulpotomy. Clinical and radiographic outcomes, including both successes and failures, were documented throughout a 36-month follow-up period. Statistical analyses were performed using the Fisher Exact, McNemar, and Chi-Square tests. Results No statistically significant differences in success rates were found between the 1-, 3-, 6-, 24-, and 36-month assessments for each material when evaluated independently. However, at the twelfth month, the clinical and radiographic success rates for MTA (98% and 92%, respectively) were significantly higher than those for BD (90% and 80%, respectively) with a p-value of less than 0.05. Conclusion In this study, MTA demonstrated greater success than BD at 36 months. Nevertheless, higher quality randomized controlled trials with longer follow-up periods are necessary to obtain more reliable results.Öğe Optimizing the primary stability of dental implants in type IV bone: in-vitro comparison of machine-driven and ratcheting insertion protocols(Istanbul University Press, 2025) Tayşi, Nuri Mert; Tayşi, Ayşegül Erten; Erçal, Pınar; Şişmanoğlu, SonerPurpose The objective of this study was to assess the effects of various implant insertion techniques on the primary stability of dental implants in both type II and type IV cadaveric bovine. Materials and Methods A total of 48 dental implants (BEGO Semados RSX, BEGO Implant Systems GmbH & Co. KG, Germany) with a diameter of 3.75 mm and a length of 12 mm were used in the experiments. Bovine bone ribs were adjusted to mimic type II and type IV bone characteristics. Following the preparation of recipient sites, implants were inserted using three different protocols: machine-driven insertion (Standard group, Std group), ratchet insertion (Ratcheted, R Group), and a combination of both (Std + R group). The Osstell® Beacon device was used to record the implant stability quotient (ISQ) of each implant immediately after insertion. Two-way analysis of variance and Bonferroni tests were used for statistical evaluation. Results Bone type significantly influenced the ISQ values (p<0.05). However, when comparing insertion protocols separately for type II and type IV bone, no significant differences were observed. In type IV bone, both the Std group and R group exhibited significantly lower ISQ values compared to the same groups in type II bone (p<0.05 for each). Nevertheless, there were no significant differences in the ISQ values when employing the Std+R technique between the two types of bone. Conclusion Combining machine-driven and ratchet insertion techniques may prove beneficial in optimizing ISQ values in bovine samples simulating type IV bone.Öğe A COMPARISON OF THE EFFICACY OF DIFFERENT REMINERALIZATION AGENTS: AN IN VITRO STUDY(2025) Düzgün, Seçil Özkurt; Görürgöz, Cansu; Ocak, Mert; Seymen, Figen; Koruyucu, MinePurpose: The objective of this study was to evaluate and compare the remineralizing efficacy of a solution containing silver diamine fluoride (SDF) with agents containing sodium fluoride (NaF) and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on artificial caries lesions using laser fluorescence (DIAGNODent) and micro-computed tomography (-CT). Methods: Artificial caries lesions were created on extracted primary incisors without any lesions or defects in the enamel tissue. The teeth were randomly divided into four groups (n = 8): Group 1: SDF (Advantage Arrest, Elevate Oral Care, USA); Group 2: NaF (Clinpro, 3M ESPE, USA); Group 3: CPP-ACP (GC Tooth Mousse, Recaldent, USA); Group 4: control. After applying remineralization agents, the samples were kept in an artificial saliva solution and measured by DIAGNODent at regular intervals. When the remineralization process was complete, enamel surfaces were analyzed by-CT for mineral density, lesion depth, and area using the computer program. Data obtained were statistically analyzed. Results: In the comparison of DIAGNODent values between the groups, a statistically significant difference was found between the values measured on the fourteenth day (p-value=0.003). A significant difference was found between the mineral density (g/cm3) values measured by-CT on the fourteenth day after remineralization according to the groups (p-value=0.001). Conclusions: All agents used in this study provided remineralization. The DIAGNODent and-CT measurements demonstrated that the SDF group had a higher remineralization value than the other groups. Considering the ease of use as well as its effectiveness, it is thought that the SDF solution can be used successfully to arrest early childhood caries. SDF application positively influences enamel remineralization.Öğe Genome resequencing and comparative analysis of Streptococcus mutans in adults with high and low caries risk(2025) Yıldırım Üçüncü, Merve; Üçüncü, Musa Kazım; Karacan, İlker; Topçuoğlu, NurşenStreptococcus mutans, is considered the main microbial etiological agent of dental caries, therefore it has been proposed as a useful predictor of caries risk as well as a target for caries prevention strategies. We aimed to compare the genomic characteristics of S. mutans strains isolated from individuals with high and low caries risk, in order to determine their genotypic features related to dental caries in adults. A total of 25 S. mutans isolates, obtained from the saliva of 13 volunteers with high dental caries activity and 12 caries-free individuals, were analysed using whole-genome sequencing techniques. A total of 2904 protein-coding gene sequences were detected as a result of the pan-genome analysis. The number of core genes detected in all genomes sequenced in the study was found to be 1563. A total of 50584 mutations were detected using ATCC 25175 strain as a reference. This is a large genome dataset of 25 S. mutans strains which can be further used for all S. mutans genome analysis.Öğe Assessment of oral hygiene parameters in association to eating behaviors and healthy eating self-efficacy in school-aged children(2024) Gökçek, Seda Ceren; İlisulu, Sabiha CerenBackground: Eating behavior are a broad category influenced by a various personal, social, cultural, environmental, and economic factors. The objective of this study was to evaluate the oral hygiene status of school-aged children in relation to their eating behavior and healthy eating self-efficacy. Methods: The study was carried out with the participation of 225 children aged 7-9 years. Parents carried out the Children's Eating Behavior Questionnaire (CEBQ) to assess eating behaviors and provided sociodemographic information. Oral examinations of the children were provided according to plaque index (PI), gingival index (GI), simplified oral hygiene index (OHI-S), dmft and DMFT and, the Healthy Eating Self-Efficacy Scale (HESES) was administered to the children. For statistical analysis, a consistent partial least squares structural equation model (PLS-SEM) technique was utilized. Results: A statistically significant negative correlation was found between the Healthy Eating Self-Efficacy Scale and the PI, GI, OHI-S, dmfs (p < 0.001) and DMFS (p = 0.002). Emotional undereating significantly negatively affected dmfs (p = 0.021), while emotional overeating had a significant positive effect on DMFS (p = 0.036). None of the eating behavior subgroups in children showed a significant relationship with self-efficacy. Additionally, higher self-efficacy (p = 0.001) and food fussiness (p = 0.001) were found in children from high-income families, while emotional overeating (p < 0.001) and desire to drink (p = 0.009) were observed in children from middle-income families. Conclusion: This study reveals a significant relationship between healthy eating self-efficacy and oral hygiene in children. Higher self-efficacy correlates with better oral health, while emotional eating negatively impacts dental outcomes. Socioeconomic factors also play a role, suggesting that interventions should target self-efficacy and emotional eating to improve both eating behaviors and oral health in school-aged children.Öğe Examination of the effect of treatment of severe early childhood caries and fluoride varnish applications on salivary oxidative stress biomarkers and antioxidants(2024) Birant, Sinem; İlisulu, Sabiha Ceren; Özcan, Hazal; Yanar, KarolinBackground: Saliva contains a variety of biochemical compounds, including antioxidants, and serves as the body's first line of defense against oxidative stress caused by free radicals. The aim of this study was to investigate the effects of dental treatments on salivary oxidative stress biomarkers in children aged 3-5 years with severe early childhood caries (S-ECC) compared to children without caries. Method: This study was conducted on 20 children aged 3-5 years with severe early childhood caries (S-ECC) and 20 children without caries. Salivary oxidative stress biomarkers and antioxidants were measured after the initial examination (T0), after the end of restorative treatments (T1), and after fluoride varnish applications (T2). Post hoc Bonferroni test was used to compare normally distributed parameters between T0-T1-T2 times. Pearson correlation analysis was used to examine the relationships between parameters that conform to normal distribution. The Mann-Whitney U test was used to compare the parameters in the control and experimental groups. Significance was evaluated at the p < 0.05 level. Results: The mean dmft of the participants in the study group was 8.86 ± 14.5. Advanced oxidation protein products (AOPP), dityrosine (DT), kynurenine (KYN), advanced glycation end products (AGE), lipid hydroperoxides (LHP) and malondialdehyde (MDA) values decrease after the treatment of dental caries and protective fluoride varnish applications, while an increases in total thiol (TSH) and Cu/Zn-superoxide dismutase (Cu/Zn-SOD) values were observed after protective varnish applications compared to pre-treatment values. Antioxidant parameters at time T2 in the study group were statistically significantly higher than in the control group (p < 0.05). In the study group, there was no correlation between TSH and oxidative stress mediators in terms of changes at time T1 post-treatment compared to the pre-treatment period, while an inverse moderate relationship was found with AGE and LHP in terms of changes at time T2 post-treatment (p < 0.05). Conclusions: An increase in salivary antioxidants was detected after dental restorations were completed and protective fluoride varnish application, while a decrease in oxidative stress markers was detected. Clinical relevance: Fluoride varnish applications applied in the study group may further reduce the oral microbiome load and cause salivary oxidative stress markers to be significantly lower than in the control group.Öğe Clinical and radiographic assessment of the association between orthodontic mini-screws and periodontal health(2024) Yıldız, Mehmet Selim; Acar Ulutaş, Pelin; Özenci, İlknur; Akçalı, AliyeObjectives: Proper anchorage control is crucial for predictable tooth movement and preventing inadequate torque during orthodontic treatment. Through clinical and radiographic parameters; this study assesses the association between mini-screws and periodontal health. Materials and methods: A prospective observational study included 16 systemically healthy non-smoking individuals requiring mini-screws. Mini-screws with a rough, titanium oxide-coated surface were placed. Periodontal assessments (Plaque index, gingival index, probing pocket depth, gingival recession, bleeding on probing, mucosal discomfort, mucosal redness, keratinized tissue width, supracrestal tissue height, and transmucosal soft tissue thickness) were performed at 2nd week and 3 months post-placement. Radiographic evaluations measured distances between mini-screws and adjacent teeth using Image J software. Results: The study included 13 females and 3 males (mean age 21.9 ± 1.8 years) with 24 mini-screws. Early mini-screw loss was not observed. Significant reductions in site-level Gingival Index and bleeding on probing (p < 0.05) and full-mouth bleeding on probing (p < 0.05) were noted over time. Absence of significant differences was found in mucosal discomfort and redness, keratinized tissue width, or transmucosal soft tissue thickness, but supracrestal tissue height decreased significantly (p < 0.05). Radiographically, significant bone reduction around mini-screws was observed at 3 months, with torque gauge values significantly decreased as well (p < 0.05). Conclusions: Orthodontic mini-screws can be effectively utilized in orthodontic treatment with proper planning and monitoring. While improvements in gingival health were observed with targeted oral care, the study underscores the need for careful consideration of potential risks to periodontal tissues, such as reductions in supracrestal tissue height and bone levels. A balanced approach that integrates preventive strategies with precise screw placement is essential to maximize the benefits of mini-screws while minimizing potential periodontal complications. Clinical relevance: While proper oral hygiene can help control inflammation around mini-screw sites, clinicians must also be mindful of potential risks, such as reductions in bone levels and tissue height. Careful patient selection, precise placement, and regular follow-up are crucial to ensure the stability of mini-screws' stability and to prevent complications, ultimately contributing to better treatment outcomes in orthodontic care. Trial registration: This study was registered on ClinicalTrials.gov with the registration number NCT06491849 on June 28, 2024.Öğe Knowledge and attitude of dentistry, medicine and pharmacy students related to HIV/AIDS(Ataturk Universitesi, 2024) Özenci, İlknur; Alshalabi, Firas Mamoun; Yıldız, Mehmet Selim; Dirikan İpci, Şebnem; Çakar, GökserObjective: HIV is one of the main infectious diseases threatening world health for a long time. It is critical that today's healthcare students have the right knowledge and perspectives on HIV/AIDS, as they are the first line of defense against such a threat locally and globally. This cross-sectional study was carried out to evaluate the knowledge and attitudes of healthcare students toward HIV/AIDS. Method: In this study, a 4-part questionnaire consisting of 50 questions was administered to 450 healthcare students. Participants’ sociodemographic status, general knowledge of HIV/AIDS, their attitude to patients, and their knowledge related to oral manifestations of it were evaluated. Results: With the participation of 100 students from each of the faculties of dentistry, medicine, and pharmacy, a response rate of 66.7% was achieved. The mean knowledge of HIV/AIDS score percentage was 44.2% in dentistry, 43.3% in medicine, and 44.6% in pharmacy. It was determined that they had a positive attitude towards HIV/AIDS patients, and their mean attitude percentage was 78.6% in dentistry, 75.9% in medicine, and 76.2% in pharmacy. When it comes to the oral manifestations of HIV/AIDS, as expected, dentistry students were found to have higher scores on the most common oral manifestations. Still, it was observed that students of all three faculties were not aware of most lesions. Conclusion: Although students' knowledge levels were lower than expected, it was determined that most students displayed a professional attitude towards HIV/AIDS. The results obtained from this study revealed that dentistry, medicine, and pharmacy students need more detailed relevant education.Öğe Dentin thickness model : A novel method for dental age estimation using panoramic radiography(2024) Yanık, Deniz; Özel, ŞelaleThe study aims to evaluate the reliability of the novel dentin thickness model based on root parameters when applied to panoramic radiography images of mandibular first molar in the southern Turkish subpopulation. A total of 946 panoramic images were analyzed for the study. The samples were allocated into four age groups: Group 1(between 10 and 18), Group 2(between 19 and 30), Group 3(between 31 and 50), Group 4(between 51 and 78). The dentin thickness model measurements consisted of root dentin thickness of the mesial aspect of the distal root and distal canal width. Regression, intraclass correlation coefficient, and Durbin-Watson analyses were used for statistics. A medium correlation was detected in the dentin thickness model (R = 0.398). Root dentin thickness and canal width had a significant effect (p < 0.05), but gender did not (p > 0.05). Group 3 showed the highest accuracy (p < 0.001). Group 4 presented the lowest correlation with chronological age compared to other age groups (p < 0.001). The dentin thickness model showed a promising result for the dental age estimation with a medium correlation. The dentin thickness model included root measurements of the mesial aspect of the mandibular first molar without any crown parameters in the southern Turkish subpopulation. Gender did not affect the dentin thickness model.Öğe The impact of a-tomatine on shear bonding strength in different dentin types and on cariogenic microorganisms: an in vitro and in silico study(2024) Üçüncü, Musa Kazım; Yıldırım Üçüncü, Merve; Topçuoğlu, Nursen; Kitin, Emine; Yazıcıoğlu, Oktay; Ortaakarsu, Ahmet Buğra; Aydın, Mustafa; Erol, AyşeIntroduction: The objective of this study is to investigate the shear bonding strength of a glycoalkaloid, also a novel matrix metalloproteinase enzyme known as α-tomatine, on two different surfaces of dentin (sound & caries-affected) and its efficacy against cariogenic microorganisms using in vitro and in silico methods. Methods: The effect of a-tomatine at different concentrations (0.75 / 1 / 1.5 µM) on shear bonding strength in caries-affected and sound dentin was also investigated (n = 10; each per subgroup). The analysis of shear bonding and failure tests was conducted after a 24-hour storage period. Fracture surfaces were examined under a scanning electron microscope. A stock solution 3 mM of a-tomatine was prepared for antimicrobial evaluation. Antimicrobial activities of the agents against Streptococcus mutans ATCC 25175, Lactobacillus casei ATCC 4646, and Candida albicans ATCC 10231 standard strains were investigated by microdilution method. In addition, through the method of molecular docking and dynamic analysis, the affinity of a-tomatine for certain enzymes of these microorganisms was examined. Results: The pretreatment agent and dentin type significantly influenced shear bonding strength values (p < 0.05). As the molarity of a-tomatine increased, the bonding value decreased in sound dentin, while the opposite was true in caries-affected dentin. According to molecular docking and dynamic analysis, the highest affinity was observed in L. casei's signaling protein. Microdilution assays revealed a-tomatine to exhibit fungicidal activity against C. albicans and bacteriostatic effects against S. mutans. No antimicrobial effect was observed on L. casei. Conclusion: a-tomatine demonstrates a positive impact by serving as both a pretreatment agent for bonding strength and an inhibitor against certain cariogenic microorganisms.Öğe Analyzing effects on anterior open bite in twins by PLS-SEM and sobel test(2024) Birant, Sinem; Veznikli, Mert; Kasımoğlu, Yelda; Koruyucu, Mine; Evren, Atıf Ahmet; Seymen, FigenObjective: This study aimed to assess the different pathways between predictor factors such as zygosity, atypical swallowing, mouth breathing, breastfeeding and bottle feeding related to anterior open bite (AOB) in twins. Methods: The study was conducted in monozygotic (MZ) and dizygotic (DZ) twin children aged 3-15 years. AOB, atypical swallowing, mouth breathing, feeding type, duration of bottle use, and mouth opening status during sleep were recorded during oral examination. Partial least squares structural equation model (PLS-SEM) and sobel tests were performed to assess the total and indirect effects among the variables on AOB. Results: A total of 404 children (29.2% MZ;70.8% DZ) participated in this study. The effect of zygosity on mouth breathing in the PLS-SEM model was statistically significant. Conversely, it was determined that mouth breathing effected that atypical swallowing (p = 0.001). Atypical swallowing triggered AOB (p = 0.001). The atypical swallowing has a mediation effect between AOB and mouth breathing (p = 0.020). Mouth breathing causes atypical swallowing and therefore indirectly increases the likelihood of AOB. While breastfeeding decreases AOB incidence (p = 0.023), bottle feeding increases AOB incidence (p = 0.046). The sobel tests show that the fully mediator variable feature of mouth breathing is statistically significant in the negative relation between zygosity and atypical swallowing. Conclusion: The PLS-SEM model showed that mouth breathing triggers atypical swallowing and atypical swallowing triggers AOB. As a result of this chain of relationships, an indirect effect of zygosity on AOB was observed. According to sobel tests, zygosity has an indirect effect on atypical swallowing through mouth breathing, while mouth breathing has a positive indirect effect on AOB through atypical swallowing. Clinical relevance: This study identified the relationships between different factors and the presence of AOB. The findings of this study demonstrate in detail the relationships between AOB and zygosity, atypical swallowing, mouth breathing, breastfeeding and bottle feeding. Brestfeeding has a reducing effect on the frequency of AOB. Among the nutritional forms, breastfeeding ensures the proper development of the stomatognathic system by working the oro-facial muscles.Öğe Evaluation of the frequency and reasons for requesting cone-beam computed tomography by endodontists in Turkey(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Gündüz, Hüseyin; Özlek, Esin; Kadı, GizemThis study aimed to evaluate the frequency and reasons for requesting Cone-beam computed tomography (CBCT) by endodontists in Turkey. 213 endodontists in Turkey participated in this survey research. Participants were asked 12 questions regarding their age, gender, the year since they completed their endodontic specialization or doctorate, the institution they work, their title and CBCT use cases. The descriptive statistics of the data are presented as percentages and frequencies. The chi-square test was used for pairwise comparisons (p<0.05). The rate of participants using a CBCT evaluation in their diagnosis and treatment was 77.9%. 81.7% of participants reported that the frequency of CBCT requests was less than 20% compared to the monthly total number of patients treated. 27.7% of participants indicated that the reason for requesting CBCT was to evaluate root resorption, and 36.6% indicated that they needed CBCT most frequently in the maxillary anterior region. It was determined that the majority of the participants, whose frequency of CBCT request was below 20%, did not have sufficient knowledge about CBCT. The majority of study participan ts use CBCT in their clinical practice. Although most participants have CBCT in their facility, they indicated that they do not have enough information about the use of CBCT. Most participants indicated that the frequency of CBCT use was lower than the number of cases studied. The reasons for using CBCT were complications in resorption and retreatment cases where two-dimensional imaging was inadequate for diagnosis and treatment.Öğe Remineralization efficiency of three different agents on artificially produced enamel lesions: A micro-CT study(2024) İlisulu, Sabiha Ceren; Gürcan, Aliye Tuğçe; Şişmanoğlu, SonerObjective: This study aimed to assess the remineralization efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), silver diamine fluoride/potassium iodide (SDF/KI), and sodium fluoride with functionalized tricalcium phosphate (NaF/fTCP) on artificial early enamel lesion using laser fluorescence and micro-CT analysis. Methodology: On extracted impacted third molars, artificial enamel lesions were prepared. Twenty-eight specimens were randomly assigned to four groups (n = 7 per group): a control group (artificial saliva), CPP-ACP (GC Tooth Mousse), SDF/KI (Riva Star), and NaF/fTCP (Clinpro White varnish). Following the manufacturer's instructions, the remineralization agents were applied to demineralized surfaces. Laser fluorescence and micro-CT were used to evaluate the remineralization efficacy of the agents and analyzes were performed during four stages: before demineralization, after demineralization, 1st day of remineralization and 30th day of remineralization. Shapiro-Wilk test, repeated measures two-way ANOVA, and Spearman correlation tests were used for statistical analysis. A significant level of p < 0.05 was established. Results: SDF/KI significantly reduced the lesion area and lesion volume on the demineralized enamel surface after 30 days of remineralization. In the T3 period, SDF/KI increased the mineral density statistically significantly compared to the T1 period. The laser fluorescence values for all three remineralizing agents exhibited a linear decrease. A significant correlation between the fluorescence values and the mineral density was found (p = 0.01). Conclusion: All three investigated agents were showed positive remineralization efficacy on artificial enamel lesion. However, SDF/KI, containing silver diamine fluoride and potassium iodide exhibited superior than other agents in promoting remineralization. Clinical significance: Although all three remineralization agents showed positive remineralization efficacy on artificial enamel lesions, SDF had higher remineralization performance over the other two agents. SDF has potential to prevent progression of demineralization in treating children with high caries risk in the long-term.Öğe Utility of gingival crevicular fluid components for periodontal diagnosis(2024) Buduneli, Nurcan; Bıyıkoğlu, Başak; Kinane, Denis F.Periodontal diseases are highly prevalent chronic diseases, and severe periodontitis creates functional and esthetic problems and decreases self-esteem for a large percentage of the older population worldwide. In many cases of periodontitis, there is no distinct tell-tale pain that motivates a patient to seek treatment, rather the signs become clinically detectable late, and typically when the disease has progressed to a problematic level for the life of the dentition. Early periodontal screening and diagnostics tools will provide early recognition of periodontal diseases and facilitate timely management of the disease to reduce tooth loss. To this goal, gingival crevicular fluid is easily sampled, can be repeatedly and non-invasively collected, and can be tested for potential biomarkers. Moreover, the site specificity of periodontal diseases enhances the usefulness of gingival crevicular fluid sampled from specific sites as a biofluid for diagnosis and longitudinal monitoring of periodontal diseases. The present review aimed to provide up-to-date information on potential diagnostic biomarkers with utility that can be assayed from gingival crevicular fluid samples, focusing on what is new and useful and providing only general historic background textually and in a tabulated format.Öğe AMELX mutations and genotype-phenotype correlation in x-linked amelogenesis imperfecta(2024) Wang, Shih-Kai; Zhang, Hong; Lin, Hua-Chieh; Wang, Yin-Lin; Lin, Shu-Chun; Seymen, Figen; Koruyucu, Mine; Simmer, James P.; Hu, Jan C.-C.AMELX mutations cause X-linked amelogenesis imperfecta (AI), known as AI types IE, IIB, and IIC in Witkop's classification, characterized by hypoplastic (reduced thickness) and/or hypomaturation (reduced hardness) enamel defects. In this study, we conducted whole exome analyses to unravel the disease-causing mutations for six AI families. Splicing assays, immunoblotting, and quantitative RT-PCR were conducted to investigate the molecular and cellular effects of the mutations. Four AMELX pathogenic variants (NM_182680.1:c.2T>C; c.29T>C; c.77del; c.145-1G>A) and a whole gene deletion (NG_012494.2:g.307534_403773del) were identified. The affected individuals exhibited enamel malformations, ranging from thin, poorly mineralized enamel with a "snow-capped" appearance to severe hypoplastic defects with minimal enamel. The c.145-1G>A mutation caused a -1 frameshift (NP_001133.1:p.Val35Cysfs*5). Overexpression of c.2T>C and c.29T>C AMELX demonstrated that mutant amelogenin proteins failed to be secreted, causing elevated endoplasmic reticulum stress and potential cell apoptosis. This study reveals a genotype-phenotype relationship for AMELX-associated AI: While amorphic mutations, including large deletions and 5' truncations, of AMELX cause hypoplastic-hypomaturation enamel with snow-capped teeth (AI types IIB and IIC) due to a complete loss of gene function, neomorphic variants, including signal peptide defects and 3' truncations, lead to severe hypoplastic/aplastic enamel (AI type IE) probably caused by "toxic" cellular effects of the mutant proteins.Öğe Restoration of posterior teeth by narrow diameter implants in hyperglycemic and normoglycemic patients - 4-year results of a case-control study(2024) Diehl, Daniel; Bespalov, Angelina; Yıldız, Mehmet Selim; Friedmann, AntonObjectives: To investigate the four-year clinical outcome and marginal bone loss around narrow-diameter implants in patients with uncontrolled diabetes mellitus type 2 (T2DM) and normo-glycemic individuals. Materials and methods: In 11 T2DM patients with a concentration of glycated hemoglobin (HbA1C) > 6.5% (test group) and 15 normoglycemic patients (HbA1C < 6.0%; control group), one narrow-diameter tissue level implant, placed in the posterior maxilla or mandible, was investigated. The clinical parameters probing depth (PD), bleeding on probing (BOP), attachment loss (CAL), recession, and papilla bleeding index (PBI) were assessed manually after 24 and 48 months of function. The paired digital periapical radiographs were analyzed regarding the change in marginal bone level (MBL) from baseline to 48 months post-op. The technical complications were recorded. Results: In the T2DM group, 11 patients were available for follow-ups. The overall implant survival rate after 48 months was 100%. The differences in means for the clinical parameters and the MBL between the T2DM and normo-glycemic patients for the observation period were statistically non-significant. No technical complications were recorded. Conclusions: The study demonstrated an encouraging clinical outcome with ND implants in patients with uncontrolled T2DM compared to non-diabetics after 48 months' post loading. Clinical relevance: Patients with HbA1C > 6.5% may benefit from the treatment with narrow-diameter implants by avoiding complex surgical interventions with augmentation procedures. Registration number (clinicaltrials.gov): NCT04630691.Öğe Investigation of the degree of monomer conversion in dental composites through various methods: an in vitro study(2024) Üçüncü, Musa Kazım; Çeliksöz, Özge; Şen, Emine; Yücel, Yasemin Yücel; Dinç, BircanThe degree of monomer conversion (DC) values of three different dental composites were examined using three different methods: surface microhardness (ratio of bottom/top), Fourier-transform infrared (FT-IR), and differential scanning calorimetry (DSC). Two of the dental composites included in the study were nanohybrid (Dentsply Neo Spectra ST HV and Omnichroma), and one was a microhybrid-labeled newly marketed composite containing nanoparticles (Dentac Myra). Composite discs were prepared according to the methodology for all methods and analyzed (2 mm thickness x 5 mm diameter). Surface microhardness values were measured in Vickers Hardness Number (VHN), while FT-IR and DSC values were obtained in percentage (%). Significant differences were observed in both bottom/top surface microhardness values and DC values obtained from FT-IR. However, there was no statistical difference in the ratio of bottom/top microhardness values. Neo Spectra ST HV exhibited superior performance in both microhardness and monomer conversion compared to the other two composites. Newly marketed Myra showed values close to Omnichroma. It was found that the values obtained by the DSC method were parallel to those obtained by FT-IR. In conclusion, the structure of dental composites leads to different mechanical properties. Additionally, DSC measurements and FTIR spectra were found to be complementary techniques for characterizing monomer conversion values.Öğe Evaluation of the clinical performance of different occlusal device materials(2024) Peçenek, Duygucan; Gökçen-Rohlig, Bilge; Öngül, Değer; Çağıl Ayvalıoğlu, DemetStatement of problem: Computer aided technologies have been used to fabricate occlusal devices. However, the clinical behavior of the newly developed materials developed for occlusal devices is unknown. Purpose: The purpose of this prospective, double-blind study was to assess the clinical efficacy of recently introduced computer-aided design and computer-aided manufacturing (CAD-CAM) materials for the fabrication of occlusal devices. Material and methods: A total of 24 participants were divided randomly into 2 study groups; polyetheretherketone (PEEK) and polymethyl methacrylate (PMMA), and a control group (CG). Conventional impressions and gypsum casts were obtained from all participants. In the study groups, the casts were digitalized with an extraoral digital scanner, designed with a software program (Bite Occlusal Device Module; exocad GmbH) and milled from PEEK and PMMA blocks. Clear resin sheets were used for occlusal device fabrication in the CG. The baseline measurements were made during the initial appointments. After 6 months, the participants returned for follow-up evaluations. Clinical performance based on surface roughness, wear of the antagonist teeth, occlusal device fit and therapeutic effect, as well as participant satisfaction were compared using the 1-way ANOVA test between the main groups (α=.05). The post hoc and Kruskal Wallis-H tests were used to compare the nonparametric group. Results: The therapeutic effects of the occlusal devices did not differ. All participants showed improvement in palpation and mandibular movement scores, but no statistically significant differences were found among the groups (P>.05). PEEK and PMMA had statistically less surface wear than CG (P<.001) and led to less antagonist tooth wear. No significant participant satisfaction difference was seen among the groups (P>.05). The control group had the best fit (P<.001). Conclusions: Recent CAD-CAM materials exhibit clinically acceptable outcomes, and their performance is comparable with that of traditional materials. CAD-CAM materials appear suitable in terms of accuracy, surface wear, and therapeutic efficacy.
