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Öğe Comparison of clinical efficacy and patient acceptance of interdental brush and silicone coated interdental pick: a randomized split-mouth, prospective clinical trial(Springer Heidelberg, 2020) Ustaoglu, Gulbahar; Ercan, Esra; Gumus, Kerem CaglarObjectives The aim of this split-mouth, prospective controlled study was to compare the effects of two different interdental devices on clinical plaque elimination, gingival bleeding and patient acceptance and comfort. Materials and methods Thirty participants who had been diagnosed with gingivitis were included in the study. After professional oral prophylaxis and a 3-day washout period, patients were advised to use two test devices (TePe Interdental Brushes Original and TePe EasyPick (TM), Malmo, Sweden) according to instructions. The plaque index (Turesky modification of the Quigley and Hein Index) and bleeding index (Papillary Bleeding Index) were recorded at baseline and after 2 weeks. Patient satisfaction and comfort were assessed with a questionnaire. Results Both of the tested devices improved the plaque and bleeding index scores. There were no differences between the two sides in terms of time-dependent changes. The patients felt more satisfied with the cleansing capacity and more comfortable with the use of SCIP compared with IDB (p = 0.001). Pain sensation with the use of SCIP was significantly lower than with IDB (p = 0.002). Conclusion The clinical efficiency of the tested interdental devices was similar in terms of removing plaque and decreasing bleeding. However, SCIP were found to be more comfortable and preferable to IDB.Öğe Diş eti fenotipi ve alveolar kemik morfolojisi arasındaki ilişkinin değerlendirilmesi(Doğu Karadeniz Deri ve Zührevi Hastalıklar Derneği, 2019) Ercan, Esra; Bilgin, Elif; Koprucu, Saliha; Kayipmaz, SaadettinAmaç Son yıllarda diş hekimliği alanında, diş eti fenotipinin belirlenmesi oldukça önem kazanmıştır. Ayrıca kemik vediş eti ilişkisi, pek çok tedavinin başarısını doğrudan etkilemektedir. Bu çalışmanın amacı, diş eti çekilmeleri, fenotipiile destek alveoler kemik kalınlığı arasındaki ilişkinin araştırılmasıdır.Yöntem Bu çalışmada üst-alt kesici ve kanin olmak üzere toplam 207 dişe ait son 3 ayda çekilen konik ışınlı bilgisayarlıtomografi görüntüsü üzerinde gerçekleştirilen radyolojik ölçümler ile klinik periodontal parametreler ve diş etifenotiplerinin birbirleriyle ilişkileri incelendi. Diş eti fenotipi, yeni geliştirilmiş Hu-Friedy Colorvue® fenotip sonduile “ince” / “orta” / “kalın” olarak belirlendi. Klinik periodontal parametreler, keratinize doku genişliği ve çekilmederinliği değerleri kaydedildi. Bukkal kemik kalınlığı, konik ışınlı bilgisayarlı tomografi görüntüsü üzerinde,krestal 1, 2 ve 4 mm seviyelerinden olmak üzere üç noktadan ölçüldü.Bulgular Gruplar arası karşılaştırma sonuçlarına göre, ince fenotipte keratinize doku genişliği ve üç seviyedekikemik kalınlıkları kalın fenotipe göre istatistiksel olarak anlamlı derecede daha az bulundu (p<0.016). Ortafenotipte ise krestal 2 ve 4 mm’de kemik kalınlığı kalın fenotipe göre istatistiksel olarak anlamlı derecede dahaaz bulundu (p<0.016). Ayrıca diş eti çekilmesi ile krestal 2 ve 4 mm seviyelerindeki kemik kalınlıkları arasındanegatif korelasyon görüldü (p<0.05).Sonuçlar Bu çalışmanın sonucunda, diş eti fenotipi ile bukkal alveoler kemik kalınlığı arasında anlamlı pozitifkorelasyon olduğu ve kemik kalınlığı miktarının diş eti çekilmesi üzerinde etkili olabileceği söylenebilirÖğe Effects of titanium prepared platelet rich fibrin on facial nerve regeneration: an experimental study([Brazilian Association of Otorhinolaryngology and Cervico-Facial Surgery], 2022) Şentürk, Fatma; Bahadır, Osman; Aktaş, Osman; Bıyık, Ayşe Firuze; Ercan, EsraIntroduction: Facial nerve damage is a condition that causes functional, psychological, and cosmetic problems; and treatment methods need to be improved. Objective: We investigated the efficacy of titanium-prepared platelet-rich fibrin as a healing enhancer at the region of transection of the facial nerve. Methods: Twenty-seven New Zealand male rabbits were used in this study, divided into three experimental groups. Group 1, the sham group (n = 7); Group 2, the suture group (n = 10); and Group 3, the suture + T-PRF group (n = 10). In Group 1, the facial nerve trunk was dissected, and no additional surgical intervention was performed. For Group 2, a transection was made to the facial nerve trunk and the nerve endings were sutured together. In Group 3, nerve endings were sutured after transection, and a titanium-prepared platelet-rich fibrin membrane was wrapped in a tube around the damaged area. All animals were followed up weekly for the presence of corneal reflex, whisker movement and low ears. Bilateral facial electromyography was performed both preoperatively and postoperatively at the 1st, 3rd, 5th, 7th, 10th weeks. Tissue samples obtained at the 10th week were histopathologically examined, and intra-group and inter-group comparisons were performed. Results: Subjects in Group showed improvement in whisker movement and ear drop one week earlier than Group 2. In Group 3, the nerve stimulation threshold required to trigger the compound muscle action potential had returned to values similar to the preoperative control values (11.31 ± 2.16 V) by 5 weeks postoperatively (12.51 ± 3.97 V), (p = 0.249). Conclusion: Titanium-prepared platelet-rich fibrin administration contributed to partial nerve healing both on a functional and an electrophysiological level.Öğe Fibrin clot adherence on cleaned and decontaminated titanium abutment surfaces: An in vitro study(Wiley, 2024) Ulusoy, Habibe Ozturk; Ercan, Esra; Ozatik, Orhan; Tunali, MustafaStatement of ProblemOsseointegration is now primarily established, but soft tissue integration is still susceptible to failure and problematic on implant surfaces. So, implant dentistry is increasingly focusing on improving peri-implant soft tissue integration.PurposeThe present study aimed to evaluate the blood fibrin clot formation and adhesion on the abutment after cleaning and decontamination and determine the suitable abutment surface associated with fibrin clot attachment.Materials and MethodsForty-two abutments (14 per group) were used in the present study: a brand-new (BN), contaminated with biofilm (CO) and decontaminated with an enzymatic cleaner and autoclave sterilization (DEC). For a fibrin clot, 9 mL of whole human blood and abutments was centrifuged at 2700 rpm for 12 min. Clots were divided into two parts for histomorphometry and scanning electron microscopy (SEM) analysis. Twelve abutments disconnected from the clot and two not treated with blood were observed under SEM.ResultsResidual debris and biofilm were observed on the abutment surface in the CO group but not in other groups. Healthy and organized fibrin clots formed on all abutments. The fibrin extension areas are distributed uniformly in BN and DEC groups but irregularly in CO. The surface percentage of the fibrin clot extensions was 41.76% +/- 6.73, 26.99% +/- 6.40, and 37.83% +/- 9.72 for the BN, CON, and DEC groups, respectively. The blood clot-attached areas in the CO group were statistically lower than the other groups. No difference was observed between the BN and DEC groups.ConclusionsThis study confirmed that surface contamination could influence blood clot attachment on the abutment surfaces. Cleaning and sterilization can have a favorable effect on soft tissue healing on abutment surfaces.Öğe GCF LEVELS OF sRAGE AND MCP-1 IN TYPE-2 DIABETIC PATIENTS WITH PERIODONTITIS: A PRELIMINARY REPORT(2024) Yıldırım, Yağmur Deniz; Ercan, Esra; Güncü, Güliz Nigar; Karabulut, Erdem; Berker, EzelBackground and Aim: Diabetes mellitus-related chronic complications can affect multiple organs, including the macrovascular and microvascular systems, as well as the periodontium. Advanced glycation end products (AGE), its receptor (RAGE) and soluble receptor (sRAGE) interaction is critically involved in the pathobiology of both diseases. Monocyte chemoattractant protein-1 (MCP-1) is an essential chemokine responsible for the recruitment of monocytes to inflammatory lesions in the vasculature, an initial step of atherosclerosis. This study aimed to compare the levels of MCP-1 and sRAGE in the gingival crevicular fluid (GCF) of periodontitis patients with type 2 diabetes and those without, hypothesizing that these levels may vary based on diabetic status Materials and Methods: Nine patients with periodontitis and diabetes (DP), 12 periodontitis (P) patients without diabetes, 12 systemically and periodontally healthy subjects (HC) were enrolled in this case-control study. Clinical periodontal parameters and HbA1c values were evaluated. Gingival crevicular fluid samples were analysed for sRAGE and MCP-1 by an enzyme-linked immunosorbent assay. The significance of differences were assessed with Kruskall-Wallis test. Pairwise comparisons were made with Dunn test. Results: sRAGE and MCP-1 levels were significantly higher in periodontitis group than healthy controls (p<0.05). There was no difference between DP and P groups (p>0.05). Positive correlation was detected between sRAGE and MCP-1 levels in disease groups (p=0.000, r=0.976 for DP group; p=0.000, r=0.982 for P group respectively). Conclusion: MCP-1 and sRAGE may have a functional role in the diabetic-periodontal pathogenesis. Further studies must be carried out to understand the contribution of sRAGE and MCP-1 in periodontal inflammation with or without diabetes.Öğe Innovative i-PRF semisurgical method for gingival augmentation and root coverage in thin periodontal phenotypes: a preliminary study(Quintessence Publishing Co Inc, 2023) Alan, Ralf; Ercan, Esra; Firatli, Yigit; Firatli, Erhan; Tunali, MustafaObjectives: The aim of the study was to evaluate the effect of in-jectable platelet-rich fibrin (i-PRF) on gingival thickness and gingi-val recession in individuals with thin periodontal phenotypes.Method and materials: In this prospective study, i-PRF was ap-plied via a semisurgical method to augment 53 tooth regions with thin periodontal phenotypes. In order to ensure that sufficient blood clot formed on the side of the gingiva facing the bone and that i-PRF reached the area, a minimal incision was made with the help of a scalpel in the apical region of the relevant region, and the periosteum was elevated with a microsurgical instrument. To en-sure sustained exposure to angiogenetic growth factors and en-hance the histoconductive properties, i-PRF injection was applied to the relevant areas in four sessions at 10-day intervals.Results: An increase in gingival thickness was achieved in 92.5% of the areas treated with i-PRF, and the desired gingival thickness (0.8 mm) was achieved in 44.9% of these areas. In addition, signif-icant reductions in the amount of recession were observed in 83.3%ofthe 12 gingival recession areas (P= .005). Moreover, com-plete coverage was achieved in 60% of these regions.Conclusion: With the new i-PRF sem isu rgica I method, it was shown that gingi-val thickness can be increased in tooth regions with thin gingiva, and that areas of gingival recession can be covered. Further com-prehensive studies are needed to fully understand the role of i-PRF in enhancing angiogenesis and the histoconductive properties of this fu lly autogenous blood concentrate. (Quintessence Int2023;54: 734-743; doi:10.3290/j.gi.b4328831)Öğe Management of Deep Gingival Recessions by Modified Coronally Advanced Tunnel Technique with Titanium Platelet Rich Fibrin Membrane or Connective Tissue Graft: 36 Months Follow-up Clinical Study(Marmara Univ, Inst Health Sciences, 2020) Koyuncuoglu, Cenker Zeki; Ercan, Esra; Uzun, Bilge Cansu; Tunali, Mustafa; Firatli, ErhanObjective: The goal of the study is to evaluate the results of Titanium-Platelet Rich Fibrin (T-PRF) membrane and Connective Tissue Graft (CTG) with modified coronally advanced tunnel technique (MCATT) in treatment of deep gingival recession defects. Methods: Twenty-one systemically healthy patients displaying 62 Miller Class I/II gingival recession defects >= 3.0 mm in depth, treated either with MCATT with CTG or with T-PRF membrane were included in this retrospective study. The periodontal parameters were assessed at baseline, and at 6 and 36 months after surgery. The percentages of the mean root coverage (MRC) and complete root coverage (CRC) were calculated. Results: The probing depth values were decreased at 36 months according to baseline values for both groups (p<0.05). Keratinized tissue (KT) was increased at 6 months according to baseline for both groups (from 1.69 +/- 0.74 mm to 3.61 +/- 0.67 mm for T-PRF; and 3.40 +/- 1.60 mm to 4.52 +/- 2.33 for CTG). The 36th month measurement of KT showed an increase in the T-PRF group compared to the 6th month measurement, while the CTG group showed a significant decrease (3.86 +/- 0.76 mm and 2.76 +/- 1.45 mm, respectively). The CRC ratios were 80% and 56% at 6 and 36 months, respectively for the CTG group. However, this ratio remained the same (64.86%) for the T-PRF group. There was statistically significant difference between CRC ratios of both groups at 36 months (p<0.05). Conclusion: T-PRF membrane with MCATT procedure is as predictable as CTG with MCATT for management of deep gingival recessions. However, future prospective studies about this topic with a split-mouth design are needed.Öğe Nano-Hydroxyapatite Airborne-Particle Abrasion System as an Alternative Surface Treatment Method on Intraorally Contaminated Titanium Discs(Quintessence Publishing Co Inc, 2020) Gumus, Kerem Caglar; Ustaoglu, Gulbahar; Kara, Levent; Ercan, Esra; Albayrak, Onder; Tunali, MustafaThe aim of this study was to test the nano-hydroxyapatite powder decontamination method on intraorally contaminated titanium discs and to compare this method with current decontamination methods in the treatment of peri-implantitis. Contaminated discs were assigned to six treatment groups (n = 10 each): titanium hand curette; ultrasonic scaler with a plastic tip (appropriate for titanium); ultrasonic scaler with a plastic tip (appropriate for titanium) + H2O2; short-term airflow system (nano-hydroxyapatite airborne-particle abrasion for 30 seconds); long-term airflow system (nano-hydroxyapatite airborne-partide abrasion for 120 seconds); Er:YAG laser (120 mJ/pulse at 10 Hz). There were also two control groups (n = 10 each): contaminated disc (negative control) and sterile disc (positive control). Scanning electron microscopy, energy-dispersive x-ray spectroscopy, and dynamic contact angle analysis were used to determine the most effective surface-treatment method. The highest percentage of carbon (C) atoms was observed in the negative control group, and the lowest percentage of C atoms was found in the long-term airflow group, followed by the short-term airflow, laser, ultrasonic + H2O2, ultrasonic, and mechanical groups. When the groups were examined for wettability, the lowest contact angle degree was observed in the long-term airflow, short-term airflow, and laser groups. Nano-hydroxyapatite and laser treatments for detoxifying and improving infected titanium surfaces may show the most suitable results for reosseointegration.Öğe Nano-titanium coating on glass surface to improve platelet-rich fibrin (PRF) quality(Springer, 2024) Tunali, Mustafa; Ercan, Esra; Pat, Suat; Sarica, Emrah; Bagla, Aysel Guven; Ayturk, Nilufer; Siddikoglu, DuyguThe quality of platelet-rich fibrin (PRF) is contingent on the surface characteristics interfacing with blood. Titanium's superior platelet activation, surpassing silica, has made Titanium-platelet-rich fibrin (T-PRF) a favored autogenous bone graft material due to its extended degradation time. Pioneering a novel approach, this study aims to achieve an enhanced fibrin structure using glass tubes coated with nano-titanium, marking the surface's debut in our PRF production endeavors. Employing a rapid thermionic vacuum arc (TVA) process under high vacuum, we conducted comprehensive analyses of the tubes. Comprehensive analyses, including X-ray diffraction (XRD), atomic force microscopy (AFM), scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDS), were conducted on the nano-titanium-coated glass tubes. Three PRF types were formulated: silica-activated leukocyte- and platelet-rich fibrin (L-PRF, control group), machined-surface titanium tubes (T-PRF), and nano-titanium-coated tubes (nanoT-PRF). Analyses unveiled denser fibrin areas in nanoT-PRF than T-PRF, with the least dense areas in L-PRF. Cell distribution paralled between nanoT-PRF and T-PRF groups, while L-PRF cells were embedded in the fibrin border. NanoT-PRF exhibited the densest autogenous fibrin structure, suggesting prolonged in vivo resorption. Additionally, we explore the potential practicality of single-use production for nanoT-PRF tubes, introducing a promising clinical advancement. This study marks a significant stride in innovative biomaterial design, contributing to the progress of regenerative medicine.Öğe Titanium platelet-rich fibrin (T-PRF) as high-capacity doxycycline delivery system(Springer Heidelberg, 2022) Ercan, Esra; Sağbaş Suner, Selin; Sılan, Coşkun; Yılmaz, Selehattin; Sıddıkoğlu, Duygu; Şahiner, Nurettin; Tunalı, MustafaObjectives Titanium platelet-rich fibrin (T-PRF), a second-generation autogenous blood concentrate with tough and thick fibrin meshwork activated by a titanium tube, was used as a drug carrier for doxycycline (Doxy) by injection. The objective of this study is to evaluate the loading capacity of T-PRF, release kinetics of doxycycline-loaded T-PRF, and its antibacterial effects against S. aureus and P. aeruginosa. Materials and methods The T-PRF and collagen were loaded with Doxy as T-PRF/Doxy and Collagen/Doxy, and their release and antibacterial activities against S. aureus and P. aeruginosa were investigated. Chemical characterization and morphological analysis were performed. Results In comparison with collagen, approximately sevenfold more Doxy, 281 mg/g, was loaded into T-PRF. It was found that 25% of the loaded Doxy was released from T-PRF compared to only 12% from collagen within 72 h. The largest inhibition zone diameter (IZD) was observed for T-PRF/Dox with 32 +/- 6 mm and 37 +/- 5 mm for P. aereginosa and S. aureus, respectively. However, only 10 +/- 5 mm and 10 +/- 6 mm IZD were observed for bare T-PRF, and no inhibition zone was observed for the Collagen/Doxy group. A dense fibrin structure was visualized on SEM images of the T-PRF/Doxy group compared to the T-PRF group. Conclusions T-PRF has higher Doxy loading capacity and long-acting antibacterial effects compared to collagen. T-PRF was shown to have potential autogenous long-term drug-carrying capability for doxycycline. Also, the potential fibrinophilic properties of Doxy were observed to strengthen the structure of T-PRF.
