Diş Hekimliğinde Uzmanlık Tezleri

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  • Item
    Open Access
    Obstrüktif uyku apne sendromu ve periodontal hastalık arasındaki ilişkinin oksidatif stres açısından değerlendirilmesi / Evaluation of oxidative stress levels in relationship between osas and periodontal disease
    KAVZA, HALİSE BAYDEMİR; SEZER, UFUK
    Bu kesitsel çalışma, kronik periodontitis (KP) ve obstrüktif uyku apne sendromu (OSAS) arasındaki olası ilişkiyi hem tükürük hem de serum oksidatif stres parametreleri olan TAS (total antioksidan seviye), TOS (total oksidan seviye) ve OSİ (oksidatif stres indeksi) açısından değerlendirmeyi amaçlamaktadır. Yaşları 22-67 arasında değişen ve polisomnografi kullanılarak OSAS açısından değerlendirilmiş 128 birey (90 erkek ve 38 bayan) çalışmaya dahil edilmiştir. Çalışmamızda basit horlaması olan bireylerden oluşan 2 kontrol ve OSAS hastalarından oluşan 6 çalışma grubu olmak üzere toplam 8 grup vardır. Her bir grup 16 bireyden oluşmaktadır. Kontrol grupları periodontal sağlıklı ve KP'li sistemik sağlıklı bireylerden, çalışma grupları ise; periodontal sağlıklı ve KP'li hafif, orta, ağır OSAS'lı bireylerden oluşturuldu. Çalışmaya katılan tüm bireylerden serum ve tükürük örnekleri alındıktan sonra klinik periodontal parametreler kaydedildi. Biyokimyasal olarak tükürükte ve serumda TAS, TOS ve OSİ değerleri ölçüldü. OSAS şiddetini gösteren AHİ değerlerinin artmasıyla birlikte gruplar arasında istatistiksel olarak anlamlı şekilde serum TAS değerleri azalırken, serum TOS ve OSİ değerlerinin arttığı görüldü. Basit horlama periodontal sağlıklı ve KP'li gruplar arasında istatistiksel olarak serum TAS, TOS ve OSİ değerleri açısından anlamlı bir farklılık bulunamadı. Orta ve ağır OSAS gruplarında, periodontal sağlıklı hastalarla karşılaştırıldığında KP'li hastaların serum TAS değerleri istatistiksel olarak anlamlı şekilde düşükken, serum TOS ve OSİ değerlerinin yüksek olduğu görüldü. Tükürük TAS, TOS ve OSİ açısından gruplar arasında istatistiksel olarak anlamlı bir farklılık bulunamadı. Kronik periodontitis, ağır ve orta OSAS gruplarındaki oksidatif stres seviyelerine; total oksidan seviyedeki yükselme ve total antioksidan seviyedeki düşme ile ilave katkıda bulunmuştur. Sistemik sağlıklı bireylerde KP'in oksidatif stres parametrelerine katkısı olmadığı saptanmıştır. OSAS şiddeti arttıkça oksidatif stresin arttığı görülmüştür. Tükürük örneklerinin çalışma gruplarında sistemik oksidatif stres artışını yansıtmadığı saptanmıştır. Anahtar kelimeler: Obstrüktif uyku apne sendromu, oksidatif stres indeksi, periodontitis, total antioksidan seviye, total oksidan seviye
  • Publication
    Open Access
    Gümüş eklenmiş çeşitli simanların antibakteriyel etkinliklerinin ve materyal bağlanma dayanımının invitro olarak incelenmesi / Evaluation of the antibacterial effectiveness and the bonding strength of various silveradded cement materials in vitro
    (Bezmialem Vakıf University, 2018-04) YILDIRIM, Zeynep Beyza
    The aim of this in-vitro work is to examine the physical and antibacterial properties of the orthodontic tapes by adding lyophilized Ag nanoparticles (silver) to the conventional glass ionomer, resin-modified glass ionomer adhesive cement and polyacid modified composite resin materials used for the cementation of orthodontic tapes. In our study, the orthodontic bands were composed of conventional glass ionomer (Ketac Cem), resin modified glass ionomer (Multi-Cure) and polyacid modified composite resin (Transbond Plus) band cements and a total of 138 teeth were formed by the addition of 0.1% lyophilized Ag nanoparticles. The six month aging procedure was applied to the specimens to be subjected to the mechanical test. The desynthesizing of the bands with the 'Instron device (TSTM 02500, Elista, Turkey) was carried out by applying tensile force. The maximum force exerted on the break was measured with the aid of a fixed force gauge attached to the upper part of the instrument and recorded in N (Newton) with the computer connected to the instrument. The values obtained in Newtonian terms were then converted to megapask using the equation Mpa = N / mm², and the statistical analyzes were evaluated as MPa (megapascal). Multi Cure cement without Ag nanoparticle showed the highest tensile strength values; The difference between all groups except the Multi-Cure cement containing Ag nanoparticle was found to be statistically significant (p<0,05). Ketac Cem cement containing Ag nanoparticle; Although higher tensile strength than the Transbond Plus groups and Ag nanoparticle-free the Ketac Cem group without Ag nanoparticles, the only statistically significant difference was seen with the Ag nanoparticles containing Transbond Plus cement (p <0.05). The Ketac Cem feldspar containing Ag nanoparticles is followed by the Transbond Plus groups which do not contain Ag nanoparticles and Ketac Cem and Ag nanoparticles with respectively. Statistically significant difference for both cements was obtained with Multi Cure groups (p <0.05). The lowest tensile strength values were recorded for the Transbond Plus cement containing Ag nanoparticles. At the same time, there was showed a statistically significant difference between the Multi Cure groups and the Ketac Cem groups containing Ag nanoparticles (p<0,05). When the intrinsic tensile strength values were examined, it was seen that the addition of Ag nanoparticle to cement materials did not significantly affect the in-group tensile strength values in the statistically significant level. The cementum residue remaining on the surface of the tooth after the desaturation was visually inspected and scored according to the residual adhesive index (ARI) used by Artun and Bergland. According to the results of the ARI score evaluation, the band cementation break was observed mostly in the Ketac Cem group with and without Ag nanoparticles. It was also seen that the band cement breakage was high in the glass ionomer groups with and without Ag nanoparticles. The highest tensile strengths are found in the adhesive over 50% of the tooth, and the lowest tensile strength is measured in samples that do not have any adhesive on the tooth. Disc diffusion method, liquid medium culture and biofilm formation methods were used for antibacterial evaluation. Discs were produced with the help of Teflon discs with a diameter of 2 mm and a diameter of 9 mm. Antimicrobial properties of all materials were examined by disk diffusion method and Ag nanoparticle was added and examined without addition and no inhibition zone was observed. No difference was observed in CIS as it appeared to reduce the St mutans colonization by RMCIS supplemented with Ag nanoparticles and PMKR added to the liquid medium. Most of the biofilm formation was observed with conventional glass ionomer, Ag nanoparticle-added conventional glass ionomer and component simulator, compared to the absorbance readings measured at 550 nm wavelength in the ELISA reader.
  • Publication
    Open Access
    Dişeti fenotipini kalınlaştırmak amacıyla ınjectable-platelet-rich-fibrin'in (I-PRF) kullanılması / Using the injectable-platelet-rich-fibrin (I-PRF)for enhancing the gingival phenotype
    (Bezmialem Vakıf University, 2018-12) ÖZSAĞIR, Zeliha Betül
    A thin gingival biotype is important predisposing factor for gingival recessions. There is still no way to improve the gingival thickness predictably. Platelet rich fibrin (PRF) was developed as a second generation autologous platelet concentrate without the use of anticoagulants or other additives. A liquid injectable-platelet-rich fibrin (I-PRF) was developed by modifying spin centrifugation forces and centrifugation time and utilizing non-glass centrifugation tubes. Wound healing which starts on holes as a result of a lot of microneedling to the tissue ends up with new collagen formation. The holes exist after microneedling increase penetration and efficacy of the applied substances. This randomized controlled clinical trial attempts to evaluate the effect to gingival thickness using I-PRF alone and with microneedle (MN) in individuals with thin gingival thickness. In this split mouth study, 33 systemically healthy patients with thin gingival biotype were randomly treated with MN+I-PRF, and I-PRF. I-PRF was injected on the one side and MN+I-PRF was performed on the other side of the same patient. Plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), gingival thickness (GT), and keratinized tissue width (KTW) were assessed before the treatment and every month for six months after the final injections. After evaluation of the GT between the groups, statistically significant difference was found in the MN+I-PRF group at the sixth month after the final injection. In the intra-group comparisons, a statistically significant increase in GT was observed within both I-PRF [GT increased from 0.43mm±0.14 to 0.62mm±0.11 (p<0.001)] and MN+I-PRF [GT increased from 0,4mm±0,14 to 0,66mm±0,12 (p<0.001)] groups at the sixth month after the final injection. In the intra-group comparisons, a statistically significant increase in KTW was observed within MN+I-PRF group [KTW increased from 2.94mm±1.21 to 2.99mm±0,22 (p<0.001)] at the sixth month after the final injection. In individuals with thin gingival phenotype, I-PRF alone and with MN increased gingival thickness. I-PRF with MN may play a role in increasing the keratinized gingival width.
  • Publication
    Metadata only
    ER:Yag lazerin laminate veneer ile diş yüzeyi arasındaki bağlantı dayanımına etkisi The effect of ER:Yag laser on bond strength between the laminate veneer and the tooth surface
    (Bezmialem Vakıf University, 2019) ÇETİN, Yeşim; DR. ÖĞR. ÜYESİ IŞIL TURP ; DR. ÖĞR. ÜYESİ ÖZGÜN YUSUF ÖZYILMAZ
    The purpose of the current study is to evaluate the effect of Er:YAG laser on the shear bond strengths of porcelain laminate veneer materials with different thickness and compositions. 96 non-carious extracted bovine permanent incisors were used. The teeth were randomly divided into eight groups (n=12). Ceramic discs having thicknesses of 0,5 mm and 1 mm and a diameter of 5 mm were fabricated from feldspathic ceramic and leucite-reinforced ceramic blocks. 96 ceramic discs were prepared for 8 groups consisting of 4 control ((feldspathic ceramic-0.5 mm (FK-0,5), feldspathic ceramic -1mm (FK-1), leucite-reinforced ceramic-0.5 mm (LK-0,5), leucite-reinforced ceramic (LK-1)) and 4 experimental groups ((feldspathic ceramic-0.5 mm (FL-0,5), feldspathic ceramic -1mm (FL-1), leucite-reinforced ceramic-0.5 mm (LL-0,5), leucite-reinforced ceramic (LL-1)). Ceramic disks were bonded to the tooth surfaces following the instructions of the manufacturer. Er:YAG laser was applied to the experimental groups with a power of 4.2 Watt (140 mJ x 30 Hz) for 6 s with scanning method. Shear strength test was performed 1 s after the laser application with a crosshead speed of 1 mm/min at universal testing machine. Failure mode was qualified as adhesive, cohesive or adhesive+cohesive by the aid of a stereomicroscope. The debonded tooth and ceramic surfaces of one sample from each group was analysed with scanning electron microscope (SEM). The data were subjected to statistical analysis by One-way Anova and Tukey HSD post hoc tests. p-value < 0,05 was considered significant. The results revealed statistically significant differences (p≤0.05) between the mean shear bond strength of the control groups and the laser groups. When the different porcelain veneer materials having the same thickness were compared, the difference between groups was not statistically significant (p>0.05). Similarly, there was no statistically significant difference between the groups with different thicknesses of same porcelain veneer materials (p>0.05). The Er:YAG laser application significantly reduces the shear bond strength between the porcelain laminate veneer and the tooth required for debonding. However, ceramic thickness and composition did not have any significant effect on the shear bond strength between the porcelain laminate veneer and the tooth after laser application.
  • Publication
    Open Access
    İnternet ortamındaki ortodontik bilgilerin doğruluğunun farklı ölçüm araçlarıyla değerlendirilmesi / Evaluating the accuracy of information about orthodontics avaible on internet using different measurement instruments
    (Bezmialem Vakıf University, 2017-10) AK, Rüstem; YRD. DOÇ. DR. BERZA YILMAZ
    Besides it is common use for communication purposes internet is also a comprehensive encyclopedic source of information. Health sites on internet are frequently considered as source of information. However, information pollution on the internet can sometimes mislead users. The aim of this thesis is to compare the websites providing information about orthodontic terms in Turkish and in English in matter of quality, accessibility, and usability, to determine the deficient parts of them and to create a guide of content for the sites to be established in the future. In this study, the specific orthodontic terms in Turkish and in English were searched using the Google (Google Inc., Mountain View, CA, ABD) search engine. These terms include; 'orthodontic treatment', 'orthognathic surgery', 'orthodontic appliances', 'orthodontic braces' and 'orthodontic elastics'. Based on the search results 50 sites (25 in Turkish and 25 in English) were selected for each term. The advertisement sites, duplicate websites and public discussion forums were excluded out of the study. Three different measurement tools were used for data evaluation; DISCERN was used to evaluate the quality of orthodontic information, LIDA was used for evaluating the accessibility, the design and reliability of the websites, and AChecker was used to determine the access errors of the websites. The collected data was evaluated between Turkish and in English term groups using Mann-Whitney U test, also Friedman and Wilcoxon Signed Ranks were used for group in evaluation. As a result, statistically significant differences were observed in terms of the quality of orthodontic information in sites both in Turkish and in English, in terms of reliability only in sites in English and in terms of access errors both in Turkish and in English sites. It has been concluded that most of the sites providing information about orthodontics are below the standards determined by the selected measurement tools.