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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, Raif; Ercan, Esra; Fıratlı, Yiğit; Fıratlı, Erhan; Tunalı, MustafaObjectives: The aim of the study was to evaluate the effect of injectable platelet-rich fibrin (i-PRF) on gingival thickness and gingival recession in individuals with thin periodontal phenotypes. Method and materials: In this prospective study, i-PRF was applied 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 ensure sustained exposure to angiogenetic growth factors and enhance 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, significant reductions in the amount of recession were observed in 83.3% of the 12 gingival recession areas (P = .005). Moreover, complete coverage was achieved in 60% of these regions. Conclusion: With the new i-PRF semisurgical method, it was shown that gingival thickness can be increased in tooth regions with thin gingiva, and that areas of gingival recession can be covered. Further comprehensive studies are needed to fully understand the role of i-PRF in enhancing angiogenesis and the histoconductive properties of this fully autogenous blood concentrate.Öğe Evaluating clinical and laboratory effects of ozone in non-surgical periodontal treatment: a randomized controlled trial(Univ Sao Paulo Fac Odontologia Bauru, 2019) Şeydanur Dengizek, Eltas; Serkan, Dündar; Abubekir, Eltas; Karabulut Bay, Aysun; Önder, Otlu; Arife, ÇiçekObjective: This study aims to evaluate the clinical and biochemical (oxidative stress and pro-inflammatory mediators) effects of the gaseous ozone use accompanied by scaling and root planning (SRP) in periodontal treatment. Material and Methods: The study population consisted of 40 patients with chronic periodontitis (CP) randomly sorted into two groups of 20. The experimental group received SRP plus 3 watts gaseous ozone in two separate applications five days apart, whereas the control group received SRP plus placebo. Clinical periodontal parameters were assayed and saliva samples were taken before the initial and one month after the second treatment. Periodontal examination assessed plaque index (PI), gingival index (GI), probing depth, and clinical attachment level (CAL). Total antioxidant status (TAS), total oxidant status (TOS), nitric oxide (NO), 8-hydroxy-2'-deoxyguanosine (8-OHdG), myeloperoxidase (MPO), glutathione (GSH), malondialdehyde (MDA), and transforming growth factor-beta (TGF-beta) levels were evaluated from saliva samples. Results: Changes following treatment in PI, GI, probing depth, and CAL scores were similar for both groups (p>0.05). Of note, TGF-beta levels were observed to be higher in the treatment group than in controls (p<0.05). Changes in 8-OHdG, TAS, TOS, NO, MPO, GSH and MDA levels, however, were not significantly different between groups (p>0.05). Conclusion: The findings of this study indicate that SRP plus gaseous ozone versus SRP alone does not correlate to a significant improvement in periodontal recovery.Öğe Fibrin clot adherence on cleaned and decontaminated titanium abutment surfaces: An in vitro study(Wiley, 2024) Öztürk Ulusoy, Habibe; Ercan, Esra; Özatik, Orhan; Tunalı, MustafaStatement of Problem Osseointegration 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. Purpose The 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 Methods Forty-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. Results Residual 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. Conclusions This 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 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.Öğe The artificial intelligence revolution in dentistry: transformation in patient education(Korean Acad Periodontology, 2023) Alan, Raif; Alan, Betül Melek[Anstract Not Available]Öğe Nano-titanium coating on glass surface to improve platelet-rich fibrin (PRF) quality(Springer, 2024) Tunalı, Mustafa; Ercan, Esra; Pat, Suat; Sarıca, Emrah; Güven Bağla, Aysel; Aytürk, Nilüfer; Sıddıkoğlu, Duygu; Bilgin, VildanThe 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 Utilizing ChatGPT-4 for Providing Information on Periodontal Disease to Patients: A DISCERN Quality Analysis(Springernature, 2023) Alan, Raif; Alan, Betül MelekBackground: Due to their ability to mimic human responses, anthropomorphic entities such as ChatGPT have a higher likelihood of gaining people's trust. This study aimed to evaluate the quality of information generated by ChatGPT-4, as an artificial intelligence (AI) chatbot, on periodontal disease (PD) using the DISCERN instrument. Methods: Using Google Bard, the topics related to PD that had the highest search volume according to Google Trends were identified. An interactive dialogue was created by placing the topics in the standard question pattern. As a patient with PD, detailed information was requested from ChatGPT-4 regarding the relevant topics. The 'regenerate response' feature was not employed, and the initial response generated by ChatGPT-4 was carefully considered for each topic as new prompts in the form of questions were entered. The response to each question was independently assessed and rated by two experienced raters using the DISCERN instrument. Results: Based on the total DISCERN scores, the qualities of the responses generated by ChatGPT-4 were 'good', except for the two responses that rater-2 scored as 'fair'. It was also observed that the 'treatment choices' section of both raters had significantly fewer scores than the other sections. In both weighted kappa and Krippendorff alpha measures, the strength of agreement varied from 'substantial' to 'almost-perfect', and the correlation between values was statistically significant. Conclusion: Despite some limitations in providing complete treatment choice information according to the DISCERN instrument, it is considered valuable for PD patients seeking information, as it consistently offered accurate guidance in the majority of responses.Öğe GCF LEVELS OF sRAGE AND MCP-1 IN TYPE-2 DIABETIC PATIENTS WITH PERIODONTITIS: A PRELIMINARY REPORT(Hacettepe Üniversitesi Diş Hekimliği Fakültesi, 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 Efficacy of injectable platelet-rich fibrin in the erosive oral lichen planus: a split-mouth, randomized, controlled clinical trial(Faculdade De Odontologia De Bauru, 2021) Sağlam, Ebru; Özsağır, Zeliha Betül; Ünver, Tuğba; Alınca, Suzan Bayer; Toprak, Ali; Tunalı, MustafaObjective: Our study compared the effects of injectable platelet-rich fibrin (i-PRF) with those of corticosteroids in the treatment of erosive oral lichen planus (EOLP). Methodology: This split-mouth study included 24 individuals diagnosed histopathologically with bilateral EOLP. One bilateral lesion was injected with i-PRF, whereas the other was injected with methylprednisolone acetate in four sessions at 15-day intervals. Visual analog scale (VAS) for pain and satisfaction, oral health impact profile scale-14, and the lesion size were used. Results: The intragroup comparisons showed a significant decrease in VAS-pain and lesion size in both the i-PRF group (from 81.88 +/- 17.74 to 13.33 +/- 18.34, and from 4.79 +/- 0.41 to 1.88 +/- 1.08, respectively) and the corticosteroid group (from 80.21 +/- 17.35 to 23.33 +/- 26.81, and from 4.71 +/- 0.46 to 2.21 +/- 1.35, respectively) in the 6th month compared to baseline (p<0.001). Moreover, VAS-satisfaction increased significantly in both the i-PRF group (from 26.67 +/- 17.8 to 85.63 +/- 16.24) and the corticosteroid group (from 28.33 +/- 17.05 to 74.38 +/- 24.11) in the 6th month compared to baseline (p<0.001). However, no significant difference in any value occurred in the intergroup comparisons. Conclusion: In patients with EOLP, both methods decreased pain and lesion size similarly, and both increased satisfaction. Therefore, the use of i-PRF may be considered an option in cases refractory to topical corticosteroid therapy. Biochemical and histopathological studies are required to reveal the mechanism of i-PRF action in EOLP treatment.Öğe 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 Evaluation of children with disabilities: BMI indicators and difficulties experienced by parents Evaluation of disabled children(Bayrakol Medical Publishing, 2021) Çağ, Yakup; Tunalı, Esra; Ataş, Cafer; Orhan, Ahmet Lutfullah; Tunalı, Mustafa; Özen, BuğraAim: The aim of this study was to analyze the disability categories and sociodemographic characteristics of disabled children to stratify their risks in terms of body mass index (BMI), obesity and underweight, and to identify the problems of affected children and their families.Material and Methods: A total of 1229 children younger than 7 years of age were identified to be surveyed with home visits by a dedicated team. BMI param-eters were obtained for 330 children. Functional impairment was classified into six groups according to the ICD-10 (International Statistical Classification of Diseases and Related Health Problems) codes.Results: Children with orthopedic disabilities accounted for 34.9%, with intellectual disability 34.1%, developmental disorders of speech and language 15.6%, autistic disorders 15.5%, hearing loss 8%, and visual disturbances and blindness 0.8%.According to the BMI percentile curves of the 330 children, 25.8% were considered obese, 5.4% were overweight, and 18.5% were underweight. The risks for obesity and underweight were significantly increased in children with autistic disorders and orthopedic disabilities, respectively (p<0.05). Discussion: Children with disabilities are at an increased risk for obesity and underweight, which requires the evaluation and close monitoring of nutritional problems and provision of nutritional support.Öğe Effect of Passive Tobacco Smoking Exposure on the Periodontal Status of Turkish Children(Faculty of Dentistry, Universitas Indonesia, 2021) Alan, Raif; Gezgin, Onur; Korkut, Emre; Türkoğlu, Şükriye; Çelik, Esra; Haliloğlu, SeyfullahObjective: This study aimed to assess the effect of passive tobacco smoking (PTS) through the comparison of the periodontal status and the C-reactive protein (CRP) and cotinine levels in the biologic fluids in children who are exposed and unexposed to PTS. Methods: A total of 148 participants, whom had smokers (PTS-exposed, n=82) and non-smokers (PTS-unexposed, n=66) in their families, respectively, were included in the study. Gingival index, plaque index, probing depth, and bleeding on probing were recorded. Moreover, saliva, urine, and gingival crevicular fluid samples were collected. CRP and cotinine levels in the biological fluids were determined by the enzyme-linked immunosorbent assay method. Results: Both groups exhibited similar values for periodontal parameters and salivary CRP levels were higher in PTS-exposed group but not significant. The mean urinary cotinine level was significantly higher in children exposed to PTS than in unexposed children. Conclusions: There was no evidence for causative role of PTS in periodontal disease in this study. Longitudinal studies including large populations should be conducted to provide stronger evidence for the causative role of PTS in periodontal disease. Also, further epidemiological studies on the social context of smoking should be performed to improve the quality of life and lifespan of the society.
