Diş Hekimliği Fakültesi Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11499/45989
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Article Determining the Optimal Irrigation Activation or Agitation Techniques for Postoperative Pain Control: A Network Meta-Regression of Clinical Trials(Elsevier Sci Ltd, 2026-12) Hatipoglu, Fatma Pertek; Oksuzer, Merve Coban; Karobari, Mohmed Isaqali; Hatipoglu, OmerPostoperative pain after root canal treatment remains a frequent clinical problem despite advances in instruments and irrigants. This Bayesian systematic review and network meta-regression compared seven irrigation activation/agitation techniques-positive pressure, manual dynamic, sonic, ultrasonic, multisonic, negativepressure and laser-activated irrigation-with respect to Day-1 postoperative pain. Electronic searches of PubMed, Cochrane Library, Scopus and Web of Science were conducted up to 10 December 2024; 57 trials (2595 patients) were included qualitatively and 31 contributed to the quantitative network. Pain scores were rescaled to a 0-10 scale and analysed as mean differences, with symptomatic status modelled as an ordinal covariate and treatment rankings summarised using SUCRA values. Laser-activated irrigation (LAI) produced the lowest Day-1 pain and showed a clinically important advantage over manual dynamic irrigation (MDI) exceeding the 1.0-point minimal clinically important difference, while also outperforming positive pressure and ultrasonic irrigation with smaller, statistically but not clinically important effects. Multisonic and negative-pressure irrigation also ranked favourably, whereas MDI consistently showed the highest pain scores and the lowest SUCRA values. Baseline symptomatic status was a strong effect modifier, with symptomatic teeth experiencing substantially higher pain irrespective of technique. Overall CINeMA confidence was low to very low for most contrasts, indicating that these findings should be interpreted cautiously and highlighting the need for larger, better-designed trials with standardised pain-assessment protocols.Article Dentinal Tubule Penetration of Ah Plus, Mta Fillapex, and Bioroot Flow: A Confocal Laser Scanning Microscopy Study(BMC, 2025-11-25) Tosun, Samet; Karataslioglu, Emrah; Culha, Emre; Cetinkaya, Oguz Burhan; Uzun, IsmailAim This in vitro study aimed to compare the dentinal tubule penetration of a conventional epoxy resin-based sealer (AH Plus) and two bioceramic-based sealers (MTA Fillapex and BioRoot Flow). Methodology Thirty extracted human single-rooted premolars were randomly divided into three groups (n = 10): AH Plus, MTA Fillapex, and BioRoot Flow. Root canals were instrumented using the ProTaper Universal rotary file system. Sealers were labeled with 0.1% Rhodamine Bprior to obturated with the single-cone technique. Roots sectioned at coronal, middle, and apical levels into 1 mm thick slices. The sealer penetration area (mm(2)) and maximum penetration depth (mm) were analyzed using confocal laser scanning microscopy (CLSM). Data were statistically evaluated using one-way ANOVA and LSD post hoc tests (p < 0.05). Result AH Plus demonstrated statistically significantly lower penetration in both penetration area and maximum penetration depth compared to both MTA Fillapex and BioRoot Flow (p < 0.05). Among the bioceramic-based sealers, MTA Fillapex exhibited the highest penetration values in the coronal and middle regions. Furthermore, a pronounced decrease in both penetration area and depth was observed from the coronal to the apical regions in all groups (p < 0.05). Conclusion MTA Fillapex and BioRoot Flow exhibit a superior performance in the coronal and middle regions compared to AH Plus. While the differences in the apical region were less distinct, a consistent decrease in penetration values from coronal to apical was observed across all materials. These findings indicate that material composition and root canal region play critical roles in dentinal tubule penetration.Article Deep Learning-Based Prediction of Buccal, Middle and Palatal Orientations of Impacted Maxillary Canines Using Panoramic Radiographs: A Pilot Study(BMC, 2025-11-26) Cokakoglu, Serpil; Tosun, Samet; Ozic, Muhammet UsameObjectiveThe aim of this pilot study was to compare the performance of deep learning models in detecting and classifying the buccal, middle, and palatal orientations of impacted maxillary canines using panoramic radiographs.MethodsA total of 200 panoramic radiographs were collected from patients' records with a history of unilateral and/or bilateral impacted maxillary canines. The images were preprocessed for resizing, bit depth, and file format. Data augmentation was performed by horizontal flipping to increase the total dataset size from 200 to 400 images. The images were randomly divided into three subsets as 80% training, 10% validation and 10% testing. The annotation was made by two experienced dentists. The dataset was trained and tested using two state-of-the-art deep learning models based on the YOLO11x and YOLO12x architectures. Model performance was evaluated using standard metrics, including precision, recall, F1-score, mAP@0.5, and mAP@0.5:0.95. In addition, confusion matrices and visual predictions from the test images were analyzed to assess class-specific performance and localization accuracy.ResultsThe YOLO11x model demonstrated superior performance compared to the YOLO12x model. During the training phase, the mAP@0.5 values were 0.723 and 0.639, respectively, while in the testing phase, they were 0.468 and 0.435, respectively. While both models achieved accurate localization in a limited number of test samples, the YOLO12x model exhibited a higher rate of false negatives. Visual inspection revealed that palatal orientations were classified more reliably, whereas classification performance was lower for buccal orientations and particularly limited for middle orientations.ConclusionThis pilot study presented certain challenges in accurately classifying the spatial orientation of impacted maxillary canines due to methodological limitations (e.g., small sample size, preliminary nature). While satisfactory performance was achieved for palatal orientations, reduced classification accuracy and frequent misclassifications were observed for buccal and middle orientations. Given the inherent limitations of panoramic imaging, future studies incorporating larger datasets and 3D imaging techniques would be warranted to improve classification accuracy and clinical applicability.Article Chronological Age Estimation by Measuring Pulp Chamber Volume in Teeth with Open Apices: A CBCT Analysis(Wroclaw Medical Univ, 2025-06-09) Kolcakoglu, Kevser; Amuk, Mehmet; Kizilci, Esra; Saribal, Gamze Sirin; Askaroglu, Ozlem; Korkut, Damla IzelBackground. In the domain of forensic medicine, the estimation of age is a critical aspect of human identification, including that of adolescents. Objectives. The study aimed to examine the relationship between the pulp chamber volume of teeth with open apices and the chronological age of adolescents from theTurkish population. Material and methods. The study was conducted by examining cone beam computed tomography (CBCT) images of 51 pediatric patients who visited the Department of Pedodontics for routine dental examinations. All CBCT images were captured using a NewTom 5G unit (QR, Verona, Italy). The measurements were recorded in DICOM format using the SimPlant Pro 16 software (Materialise NV, Leuven, Belgium). Results. A moderate and positive significant correlation was observed between the age of the premolar group patients and impacted pulp volume (IMPV). The increase in volume measurements of the patients in the premolar group indicates that their age is significantly higher (r = 0.561, p = 0.030). A moderate and negative significant relationship was identified between the age of the premolar group patients and erupted pulp volume (EPV). The increase in the EPV measurements of the patients in the premolar group indicates that their age is significantly lower (r = -0.491, p = 0.041). Conclusions.The pulp chamber volume of premolars, which narrows due to secondary dentin deposition, served as the physical marker for chronological age estimation of adolescents in the Turkish population. The measurement of the mature and immature premolar pulp volume could be used for age estimation, particularly in the context of CBCT analysis.Article Preoperative Dental Anxiety Across Menstrual Cycle Phases in Women Undergoing Root Canal Treatment(Nature Portfolio, 2025-10-10) Oksuzer, Merve Coban; Hatipoglu, Omer; Cikman, Ahter Sanal; Hatipoglu, Fatma Pertek; Pertek Hatipoğlu, Fatma; Çoban Öksüzer, Merve; Şanal Çıkman, AhterObjective Dental anxiety is a significant barrier for patients seeking oral healthcare and can be influenced by biological, psychological, and demographic factors. This study aimed to investigate how different phases of the menstrual cycle affect dental anxiety in women immediately before undergoing root canal treatment, using both psychometric scales and physiological indicators. Gender-based comparisons were also included for contextual understanding. Methods An analytical cross-sectional study was conducted with 259 participants (aged 18-50 years, 191 women) requiring root canal treatment. Women were categorized into menstrual, proliferative, and secretory phases based on self-reported cycle data. The Severity of anxiety were assessed using the Modified Dental Anxiety Scale (MDAS) and the State-Trait Anxiety Inventory (STAI), alongside physiological measures such as blood pressure and oxygen saturation. In addition to Kruskal-Wallis and Chi-squared tests, multiple linear regression analyses were performed to adjust for potential confounders, including age, education, preoperative pain, and physiological parameters. Results Women in the menstrual and secretory phases reported significantly higher MDAS and STAI-T scores compared to men (p < 0.001). Regarding the STAI-S, scores in all three menstrual phases were significantly higher than those of men (p = 0.001). Multiple regression analysis confirmed that these associations remained significant after adjustment for potential confounders, while age, education, preoperative pain, and physiological parameters showed no significant effects. Physiological parameters, including blood pressure and oxygen saturation, showed no significant variations across groups (p > 0.05). A strong positive correlation was observed between MDAS and both STAI-S and STAI-T scores. Conclusion Women in the menstrual and secretory phases reported higher levels of dental anxiety compared to men, but no significant differences were observed in physiological markers. These findings suggest that estrogen reduction during certain phases of the menstrual cycle may increase anxiety and highlight the potential clinical value of individualized anxiety management during these phases.Article Surface Roughness and Biofilm Formation on Tooth-Colored Restorative Materials Immersed in Food-Simulating Liquids(BMC, 2025-10-06) Sahin, Mehmet Alperen; Yenidunya, Ozge Gizem; Kaleli, Ilknur; Atca, MehmetBackground This study aimed to evaluate the surface roughness and biofilm formation of different restorative materials immersed in food-simulating liquids (FSLs), and to investigate the relationship between these parameters. MethodsA total of 220 disc-shaped specimens (8 mm diameter x 2 mm depth) were prepared using five restorative materials: alkasite [Cention N], giomer [Beautifil II], ormocer [Admira Fusion], direct composite [G-ae nial A'Chord], and indirect composite [Gradia Plus] (n = 44 per material). Each material group was divided into four subgroups (n = 11), immersed in one of four solutions-heptane, ethanol, citric acid, or artificial saliva (control)-for 7 days, resulting in a total of 20 experimental subgroups. In each subgroup of 11 specimens, 10 were used for both surface roughness measurements (before and after immersion) and bacterial adhesion assessment using the colony-forming unit (CFU) method, while one was reserved for scanning electron microscopy (SEM) analysis. Additionally, data were tested for normality using the Shapiro-Wilk test, and statistical analyses were performed using robust ANOVA and Bonferroni post hoc tests (p < 0.05). ResultsAlkasite and giomer exhibited significantly higher surface roughness values, whereas indirect composite presented the lowest (p < 0.001). Regarding the immersion solutions, citric acid led to the most pronounced increase in surface roughness compared to the other solutions, while heptane had the least impact (p < 0.001). Consistent with these findings, alkasite and giomer demonstrated the highest levels of bacterial adhesion, in contrast to direct and indirect composite, which showed the lowest (p = 0.008). Furthermore, citric acid resulted in the greatest microbial retention among the solutions, and heptane the least (p < 0.001). ConclusionsThe restorative materials exhibited varying degrees of susceptibility to the tested solutions. Alkasite and giomer showed the most pronounced surface changes, whereas the indirect composite group was the least affected. Among the solutions, citric acid caused the greatest surface alterations, while heptane had the least impact. Surface roughness emerged as a key factor influencing microbial retention on restorative materials.Article Citation - WoS: 2Citation - Scopus: 2The Effects of Abaloparatide on Alveolar Bone Loss in Postmenopausal Osteoporotic Rats with Periodontitis(BMC, 2025-09-29) Kizildag, Alper; Alpan, Aysan Lektemur; Ozdogan, Zeynep; Ozmen, Ozlem; Zavrak, Necati; Terzi, MithatBackground: Abaloparatide is a second-generation osteoporosis drug that prevents bone loss and stimulates bone fromation. This study evaluated the effects of abaloparatide treatment on alveolar bone loss (ABL) in osteoporotic rats with periodontitis by immunohistochemical and microcomputed tomography (micro-CT) in rats with periodontitis and osteoporosis. Methods: Forty adult female rats were divided into five equal groups: non-ligated (controls), periodontitis (P), periodontitis + osteoporosis (PO), PO treatment with 10 mu g/kg abaloparatide (PO-10), and PO treatment with 80 mu g/kg abaloparatide (PO-80). Bilateral ovariectomy was conducted in the osteoporosis groups. Three weeks after ovariectomy, experimental periodontitis was induced via Ligature. Abaloparatide was performed at the same time as the induction of experimental periodontitis. All rats were sacrificed at 30 days. ABL was determined via micro-CT and histological analyses. Bone morphogenetic protein 2 (BMP-2), alkaline phosphatase (ALP), receptor ligand for nuclear factor-kappa B (RANKL), osteocalcin (OCN), osteoprotegerin (OPG), and collagen 1 (Col-1) were evaluated immunohistochemically. In addition, the levels of C-terminal telopeptide of type I collagen (CTX), which is related to bone turnover, were analyzed. Results: Periodontitis with osteoporosis significantly increased ABL in the PO versus the P group. Abaloparatide treatment significantly reduced ABL in the treatment groups and significantly increased BMP-2, ALP, Col-1, OPG, OCN, and CTX levels. In particular, 80 mu g/kg abaloparatide treatment significantly modulated the RANKL, OPG, and CTX levels in the PO-80 group. The micro-CT results indicated that abaloparatide treatment significantly enhanced the percentage of bone, trabecular thickness, trabecular number, and bone surface density. Conclusion: Abaloparatide treatment regulates bone formation dose-dependently by decreasing ABL in rats with periodontitis and osteoporosis.Article Citation - WoS: 1Citation - Scopus: 1Ultrasonographic and CBCT Analysis of Foreign Bodies and Dental Materials(BMC, 2025-08-29) Yuce, Hasret; Acikgoz, GozdeBackgroundTo reveal the radiodensity and sonographic characteristics of various foreign bodies and dental materials to aid in the diagnosis of these materials.MethodsThe study included 41 objects consisting of various foreign bodies and dental materials. The objects were examined by embedding them in bovine gelatin, an in vitro environment and their radiodensity was evaluated using cone-beam computed tomography (CBCT). Additionally, their visibility and posterior acoustic behaviors were examined using ultrasonography (USG).ResultsWhen the radiodensity of the objects was examined in CBCT images, 27 objects (65.9%) were found to be hyperdense, while 14 objects (34.1%) were identified as isodense. All foreign bodies and dental materials included in the study were successfully visualized using USG. When the acoustic behaviors of the objects were examined, it was found that 24 materials (58.5%) caused posterior acoustic shadowing on USG. While no artifacts were detected in eight materials (19.5%), comet tail artifacts were observed in seven materials (17%), and reverberation artifacts were seen in two materials (5%).ConclusionsCBCT is an important technique for imaging foreign bodies and dental materials. Nonetheless, in an in vitro environment, USG can visualize objects that cannot be seen with CBCT. These findings may assist clinicians in selecting the most appropriate imaging method for identifying accidentally ingested or embedded foreign bodies and dental materials, especially in emergency or surgical settings.Trial registrationWe would like to clarify that our study is an in vivo experiment that does not involve human participants. Therefore, it does not fall within the scope of clinical trial registration requirements under current international guidelines.Article Awareness and Attitudes Toward Medication-Related Osteonecrosis of the Jaw Among Physicians: A Cross-Sectional Study(Wiley, 2025-01) Dere, Kadriye Ayca; Gullu, AyseBackground: The aim of this study was to evaluate the knowledge and attitudes of medical physicians who prescribe antiresorptive and antiangiogenic drugs toward medication-related osteonecrosis of the jaw (MRONJ), a devastating complication.Methods: This cross-sectional study included physicians in the fields of internal medicine, orthopedics and traumatology, rheumatology, physical medicine and rehabilitation, oncology, hematology, and urology working in university hospitals, training and research hospitals, and private health institutions. Participating physicians were asked to answer a survey consisting of 25 questions to determine their knowledge, attitudes, and awareness about MRONJ.Results: Of the physicians participating in the study, 45% were academicians, 30.9% were specialists, and 24.2% were assistant physicians. 30.3% of the participate had never heard of the concept of MRONJ. The specialties most aware of the concept of MRONJ were internal medicine (21.74%), physical medicine and rehabilitation (18.26%), and orthopedics and traumatology (17.39%), respectively. In our study, it was determined that 38.78% of the participants did not receive information on this subject through lectures/presentations/seminars, etc., and 10.8% reported that they were not informed about the side effects of drugs that can cause MRONJ. 37% of the physicians never consulted their patients with a dentist before starting treatment with drugs that can cause MRONJ.Conclusions: The study results showed that physicians who prescribe drugs that can cause MRONJ have low awareness of preventing MRONJ and that their knowledge and sensitivity on this issue should be increased.Article Effect of Different Sealer Placement and Activation Techniques on Sealer Penetration Depth and Penetration Area(Wiley, 2025-06-30) Karataslioglu, Emrah; Tosun, SametThis study evaluated the effect of different activation methods (no activation, sonic, ultrasonic, and XP-Endo Finisher) on the penetration depth and area of AH Plus and MTA Fillapex sealers. Two hundred single-rooted teeth were prepared and randomly divided into eight groups (n = 25). Sealers stained with rhodamine B were inserted and activated as follows: Group 1 (control, no activation, G1A, G1M), Group 2 (sonic: G2A, G2M), Group 3 (ultrasonic: G3A, G3M), and Group 4 (XP-Endo Finisher: G4A, G4M). The single cone technique was used for filling, and specimens were sectioned perpendicularly. Confocal laser scanning microscopy (CLSM) measured penetration depth, while penetration area was calculated as the sealer's penetration relative to the canal area. Two-way ANOVA was used for statistical analysis. Ultrasonic and XP-Endo Finisher activation significantly increased the penetration depth of MTA Fillapex compared to the control group (p < 0.05), while no significant difference was found for AH Plus (p > 0.05). MTA Fillapex also demonstrated a significantly greater penetration area than AH Plus when ultrasonic and XP-Endo Finisher activation were applied (p < 0.05). No significant differences were observed between sealers in the control and sonic groups (p > 0.05). Activation methods did not significantly affect the penetration area of AH Plus (p > 0.05). XP-Endo Finisher and ultrasonic activation significantly improved both penetration depth and area for MTA Fillapex but had limited effect on AH Plus. These findings highlight the clinical importance of selecting the appropriate activation technique based on the type of sealer used, as enhanced penetration may contribute to improved sealing ability and long-term endodontic success.