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Öğe Amelogenesis Imperfecta: Rehabilitation and Brainstorming on the Treatment Outcome after the First Year(Hindawi Ltd, 2015) Izgi, Ayca Deniz; Kale, Ediz; Nigiz, RemziAmelogenesis imperfecta (AI) affects enamel on primary and permanent dentition. This hereditary disorder is characterized by loss of enamel, poor esthetics, and hypersensitivity. Functional and cosmetic rehabilitation is challenging with variety of treatment options. This report presents the treatment of an AI patient using conventional fixed dentures and discusses issues related to posttreatment complications and prosthetic treatment outcome after 1 year of follow-up. A 19-year-old male AI patient with impaired self-esteem presented with hypersensitive, discolored, and mutilated teeth. Clinical examination revealed compromised occlusion and anterior open-bite. After hygiene maintenance full-coverage porcelain-fused-to-metal fixed restorations were indicated and applied. At the end of the treatment acceptable functional and esthetic results could be achieved. However, nearly a year after treatment a gingival inflammation in the esthetic zone complicated the outcome. Insufficient oral hygiene was to be blamed. Tooth sensitivity present from early childhood in these patients may prevent oral hygiene from becoming a habit. The relaxation due to relieve of hypersensitivity after treatment makes oral hygiene learning difficult. Continuous oral hygiene maintenancemotivationmay be crucial for the success of the treatment of AI patients. Treatment of AI patients should be carefully planned and an acceptable risk-benefit balance should be established.Öğe Effect of cement space on the marginal fit of CAD-CAM-fabricated monolithic zirconia crowns(Mosby-Elsevier, 2016) Kale, Ediz; Seker, Emre; Yilmaz, Burak; Ozcelik, Tuncer BurakStatement of problem. Monolithic zirconia crowns fabricated with computer-aided design and computer-aided manufacturing (CAD-CAM) have recently become a common practice for the restoration of posterior teeth. The marginal fit of monolithic zirconia crowns may be affected by different cement space parameters set in the CAD software. Information is scarce regarding the effect of cement space on the marginal fit of monolithic zirconia crowns fabricated with CAD CAM technology. Purpose. The purpose of this in vitro study was to evaluate the effect of cement space on the marginal fit of CAD-CAM-fabricated monolithic zirconia crowns before cementation. Material and methods. Fifteen right maxillary first molar typodont teeth with standardized anatomic preparations for complete-coverage ceramic crowns were scanned with a 3-dimensional laboratory scanner. Crowns were designed 3-dimensionally using software and then milled from presintered monolithic zirconia blocks in a computer numerical control dental milling machine. The cement space was set at 25 mu m around the margins for all groups, and additional cement space starting 1 mm above the finish lines of the teeth was set at 30 mu m for group 25-30, 40 mu m for group 25-40, and 50 mu m for group 25-50 in the CAD software. A total of 120 images (3 groups, 5 crowns per group, 8 sites per crown) were measured for vertical marginal discrepancy under a stereoscopic zoom microscope and the data were statistically analyzed with 1-way analysis of variance, followed by the Tukey honestly significant difference test (alpha=.05). Results. The results showed that different cement space values had statistically significant effect on the mean vertical marginal discrepancy value of tested crowns (P<.001). The mean marginal discrepancy was 85 mu m for group 25-30, 68 mu m for group 25-40, and 53 mu m for group 25-50. Conclusions. Within the limitations of this in vitro study, it was concluded that the cement space had a significant effect on the marginal fit of CAD-CAM-fabricated monolithic zirconia crowns. The marginal fit improved as the cement space decreased.Öğe Effect of fabrication stages and cementation on the marginal fit of CAD-CAM monolithic zirconia crowns(Mosby-Elsevier, 2017) Kale, Ediz; Yilmaz, Burak; Seker, Emre; Ozcelik, Tuncer BurakStatement of problem. Monolithic zirconia crowns fabricated using computer-aided design and computer-aided manufacturing (CAD-CAM) technology have recently become an alternative dental prosthetic treatment. The marginal fit of monolithic zirconia crown may be affected by different stages of the fabrication procedures in the laboratory and cementation. Information regarding the accuracy of fit of monolithic zirconia crowns at different stages of fabrication and cementation is limited. Purpose. The purpose of this in vitro study was to evaluate the effect of different stages of fabrication and cementation on the vertical marginal discrepancy (VMD) of CAD-CAM fabricated monolithic zirconia crowns. Material and methods. Six ivorine right maxillary first molar typodont teeth with standardized anatomic preparations for complete coverage ceramic crowns were scanned with a 3-dimensional laboratory scanner. Crowns were designed using CAD software and milled from presintered monolithic zirconia blocks in a 5-axis dental milling machine. A cement space of 25 pm for the margins and a 50-gm space starting 1 mm above the finish lines of the teeth were virtually set in the CAD software. A total of 144 measurements were performed on 6 specimens with 8 measurement locations in 3 different stages using stereoscopic zoom microscopy; after initial production of the crowns (post-sintering group), after glazing (post-glazing group), and after cementation (post-cementation group). The VMD values were statistically analyzed with 1-way repeated measures ANOVA and the Holm-Sidak method (alpha=.05). Results. Different stages of fabrication and cementation significantly affected the VMD of tested crowns (P=.003). The mean VMD was 38 gm for post-sintering group, 38 pm for post-glazing group, and 60 mu m for post-cementation group, with statistical differences between the post-sintering group, the post-cementation group (P<.002), and the post-glazing group and post-cementation group (P<.003); there were no statistical differences between the post-sintering group and the post-glazing group (P=.966). Conclusions. Within the limitations of this in vitro study, glazing did not significantly change the VMD of CAD-CAM monolithic zirconia crowns. Cementation significantly increased the VMD values.Öğe Effect of feldspathic porcelain layering on the marginal fit of zirconia and titanium complete-arch fixed implant-supported frameworks(Mosby-Elsevier, 2018) Yilmaz, Burak; Alshahrani, Faris A.; Kale, Ediz; Johnston, William M.Statement of problem. Veneering with porcelain may adversely affect the marginal fit of long-span computer-aided design and computer aided manufacturing (CAD -CAM) implant-supported fixed prostheses. Moreover, data regarding the precision of fit of CAD-CAM fabricated implant-supported complete zirconia fixed dental prostheses (FDPs) before and after porcelain layering are limited. Purpose. The purpose of this in vitro study was to evaluate the effect of porcelain layering on the marginal fit of CAD-CAM fabricated complete-arch implant-supported, screw-retained FDPs with presintered zirconia frameworks compared with titanium. Material and methods. An autopolymerizing acrylic resin fixed complete denture framework prototype was fabricated on an edentulous typodont master model (all-on-4 concept; Nobel Biocare) with 2 straight in the anterior and 2 distally tilted internal-hexagon dental implants in the posterior with multiunit abutments bilaterally in canine and first molar locations. A 3-dimensional (3D) laser scanner (5600 ARTI; Zirkonzahn) was used to digitize the prototype and the master model by using scan bodies to generate a virtual 3D CAD framework. Five presintered zirconia (ICE Zirkon Translucent - 95H16; Zirkonzahn) and 5 titanium (Titan 5 - 95H14; Zirkonzahn) frameworks were fabricated using the CAM milling unit (M1 Wet Heavy Metal Milling Unit; Zirkonzahn).The 1-screw test was applied by fixing the frameworks at the location of the maxillary left first molar abutment, and an industrial computed tomography (CT) scanner (XT H 225 - Basic Configuration; Nikon) was used to scan the framework-model complex to evaluate the passive fit of the frameworks on the master model. The scanned data were transported in standard tessellation language (STL) from Volume Graphics analysis software to PolyWorks analysis software by using the maximum-fit algorithm to fit scanned planes in order to mimic the mating surfaces in the best way. 3D virtual assessment of the marginal fit was performed at the abutment-framework interface at the maxillary right canine (gap 3) and right first molar (gap 4) abutments without prosthetic screws. The facial or buccal aspects of the teeth on frameworks were layered with corresponding porcelain (Initial Dental Ceramic System; GC) and CT-scanned again using the same protocol. Marginal fit measurements were made for 4 groups: titanium (Ti) (control), porcelain-layered titanium (Ti-P) (control), zirconia (Zir), and porcelain-layered zirconia (Zir-P). 3D discrepancy mean values were computed and calculated, and the results were analyzed with a repeated measures 3-way ANOVA using the maximum likelihood estimation method and Bonferroni adjustments for selected pairwise comparison t-tests (alpha=.05). Results. The 3D fit was measured at gap 3 and gap 4. Statistically significant differences in mean 3D discrepancies were observed between Zir-P (175 gm) and Zir (89 mu m) and between Zir-P and Ti-P (71 mu m) (P<.001). Conclusions. Porcelain layering had a significant effect on the marginal fit of CAD-CAM fabricated complete-arch implant-supported, screw retained FDPs with partially sintered zirconia frameworks. 3D marginal discrepancy mean values for all groups were within clinically acceptable limits (<120 mu m), except for the layered zirconia framework.Öğe Epidermolysis Bullosa in dentistry: Report of three cases and review of the literature(University of Dicle, 2015) Arpag, Osman Fatih; Arslanoglu, Zeki; Altan, Halenur; Kale, Ediz; Bilgic, FundagulEpidermolysis Bullosa is a congenital, genetic, vesiculobullous disease. It may be autosomal dominant and recessively inherited. The major types of Epidermolysis Bullosa are Epidermolysis Bullosa Simplex, Junctional Epidermolysis Bullosa, and Dystrophic Epidermolysis Bullosa. Due to the systemic disorders specific to the Epidermolysis Bullosa patient, approach to dental care has gain importance in these cases. This article presents improving of patient comfort with oral health maintenance and atraumatic dental interventions in three cases diagnosed with Epidermolysis Bullosa and reviews the literature regarding clinical applications in brief. Three patients - one with Epidermolysis Bullosa Simplex and two with Dystrophic Epidermolysis Bullosa - were referred to our clinic by other medical institutions because of discomfort due to dental complaints. Intra and extra oral symptoms were examined and treatment plans were arranged for each one of them. Dental treatment was carried out mainly by means of establishing non-invasive methods like oral hygiene motivation along with professional debridement and radical methods like tooth extraction. All the treatments were done with precision by experienced specialists in the field of dentistry. Treated successfully the patients were taken under control for regular observation of the disease's oral symptoms.Öğe Evaluation of microhardness of newly developed glass carbomer-based dental filling material(İLİRYA LİMİTED ŞİRKETİ, 2019) Arslanoğlu, Zeki; Kale, Ediz; Meşe, Ayşe; Altan, HalenurAim: This study measured the microhardness of a newly developed glass carbomer dental filling material within the first 24 hours after setting and compared it against that of two different glass ionomers, with and without heating during setting, and a resin-modified glass ionomer. Methodology: Six cavities were prepared on acrylic resin discs. PMMA blocks were randomly divided into six groups of six cylinders and each cavity was filled with one of the tested materials according to their group. The groups were: Group1, Fuji Triage™ with heat; Group 2, GCP Glass Fill™; Group 3, Equia™ with heat; Group 4, Riva LC™; Group 5, Fuji Triage™; and Group 6, Equia™. Microhardness was measured by the Vickers hardness scale using a microindentation hardness tester at 2, 4, 6, 12 and 24 hours after initial setting of the materials. Results: Fuji Triage™ with heat applied during setting (Group 1) proved to be the hardest material, while Riva LC™ (Group 4) and GCP Glass Fill™ (Group 2) were the softest. Heating the Fuji Triage™ during the initial setting period significantly increased its physical strength after 24 hours. Conclusions: It was seen that microhardness of materials which used in our study was effected both time and heat.Öğe Güneydoğu Anadolu Bölgesi'nde diş destekli sabit protezlerde karşılaşılan başarısızlıkların değerlendirilmesi(2017) Meşe, Ayşe; Kale, Ediz; Özcan, Mutlu; Yıldız, Ayça Deniz; Kaya, EylemAmaç: Geleneksel diş destekli sabit protezlerin (GDSP) başarısızlığı pek çok araştırmaya konu olmuştur. Başarısızlıkların giderilmesi için yapılacak restorasyon ve bunun sonuçları hakkında öngörülü olunması önemlidir. Bu çalışmanın amacı GDSP'lerde başarısızlık düzeylerine ilişkin insidans sunmak ve prognoz açısından başarısızlık düzeyleri ile hasta cinsiyeti, yaşı, protez yapım materyali, üye sayısı ve kullanım süresi arasındaki ilişkiyi araştırmaktır. Yöntem: GDSP'sine bağlı şikayet ile başvuran 413 hasta muayene edildi. Protezlere ilişkin problemler, başarısızlık düzeyi sınıflaması kullanılarak cinsiyet, yaş, protez materyali, üye sayısı, ve kullanım süresi bakımından değerlendirildi. Aralarındaki ilişki, çapraz tablolar ile Pearson ki-kare, tekyönlü-ANOVA ve Spearman korelasyon testleri kullanılarak istatistiksel olarak analiz edildi (?=0.05). Bulgular: Başarısızlık sınıfı ile hasta cinsiyeti arasında ilişki bulunamazken (p>0.05), başarısızlık sınıfı ile protez yapım materyali arasında ilişki bulundu (p=0.014). Sınıf ile kullanım süresi, sınıf ile hasta yaşı ve sınıf ile protez üye sayısı arasında ileri düzeyde istatistiksel ilişki olduğu gözlendi (p<0,01). Yaş ile kullanım süresi (p<0.01) ve yaş ile üye sayısı arasında (p<0.05) da ilişki gözlenirken, kullanım süresi ile üye sayısı arasında ilişki bulunamadı (p>0.05). Sonuç: Bu araştırmanın sonuçları, belirgin GDSP şikayeti ile kliniğe başvuran hastaların, çözülmesi görece zor bir problemle hekimin karşısına çıkabileceğini, güncel olmayan yapım materyali kullanılmış GDSP'lerin yüksek sınıfta değerlendirilme ihtimalinin yüksek olduğunu, uzun süreli kullanımda olan GDSP'lerde başarısızlık şiddetinin yüksek olacağını, protez üye sayısı ve hasta yaşı arttıkça GDSP'lerde gözlenen başarısızlık düzeyinin artacağını göstermiştir.Öğe Marginal discrepancy of CAD-CAM complete-arch fixed implant-supported frameworks(Mosby-Elsevier, 2018) Yilmaz, Burak; Kale, Ediz; Johnston, William M.Statement of problem. Computer-aided design and computer-aided manufacturing (CAD-CAM) high-density polymers (HDPs) have recently been marketed for the fabrication of long-term interim implant-supported fixed prostheses. However, information regarding the precision of fit of CAD-CAM HDP implant-supported complete-arch screw-retained prostheses is scarce. Purpose. The purpose of this in vitro study was to evaluate the marginal discrepancy of CAD-CAM HDP complete-arch implant-supported screw-retained fixed prosthesis frameworks and compare them with conventional titanium (Ti) and zirconia (Zir) frameworks. Material and methods. A screw-retained complete-arch acrylic resin prototype with multiunit abutments was fabricated on a typodont model with 2 straight implants in the anterior region and 2 implants with a 30-degree distal tilt in the posterior region. A 3-dimensional (3D) laboratory laser scanner was used to digitize the typodont model with scan bodies and the resin prototype to generate a virtual 3D CAD framework. A CAM milling unit was used to fabricate 5 frameworks from HDP, Ti, and Zir blocks. The 1-screw test was performed by tightening the prosthetic screw in the maxillary left first molar abutment (terminal location) when the frameworks were on the typodont model, and the marginal discrepancy of frameworks was evaluated using an industrial computed tomographic scanner and a 3D volumetric software. The 3D marginal discrepancy at the abutment framework interface of the maxillary left canine (L1), right canine (L2), and right first molar (L3) sites was measured. The mean values for 3D marginal discrepancy were calculated for each location in a group with 95% confidence limits. The results were analyzed by repeated-measures 2-way ANOVA using the restricted maximum likelihood estimation and the Satterthwaite degrees of freedom methods, which do not require normality and homoscedasticity in the data. The between-subjects factor was material, the within-subjects factor was location, and the interaction was included in the model. Tukey tests were applied to resolve any statistically significant source of variation (overall alpha=.05). Results. The 3D marginal discrepancy measurement was possible only for L2 and L3 because the L1 values were too small to detect. The mean discrepancy values at L2 were 60 gm for HDP, 74 gm for Ti, and 84 gm for Zir. At the L3 location, the mean discrepancy values were 55 gm for HDP, 102 gm for Ti, and 94 gm for Zir. The ANOVA did not find a statistically significant overall effect for implant location (P=.072) or a statistically significant interaction of location and material (P=.078), but it did find a statistically significant overall effect of material (P=.019). Statistical differences were found overall between HDP and the other 2 materials (P <=.037). Conclusions. When the tested materials were used with the CAD-CAM system, the 3D marginal discrepancy of CAD-CAM HDP frameworks was smaller than that of titanium or zirconia frameworks.Öğe Marginal fit of 3-unit CAD-CAM zirconia frameworks fabricated using cone beam computed tomography scans: an experimental study(Springer, 2022) Belgin, Huseyin Berkay; Kale, Ediz; Ozcelik, Tuncer Burak; Yilmaz, BurakWhether cone beam computed tomography (CBCT) scans can be used for the fabrication of computer-aided design and computer-aided manufacturing (CAD-CAM) fixed dental prostheses (FDPs) is not known. The purpose of the present study was to compare the marginal fit of 3-unit zirconia FDPs fabricated by using CBCT or 3-dimensional (3D) laboratory scanning. Extracted second premolar and molar teeth in a maxillary typodont model were prepared. The first molar was removed and the typodont model was scanned with a laboratory or a CBCT scanner to generate two virtual 3D cast groups (3DL and CBCT). Forty four 3-unit zirconia FDPs were designed on virtual casts and milled. The vertical marginal discrepancy (VMD) was measured by x100-magnification microscopy at seven locations on each abutment. A total of 616 measurements were made at 14 fixed locations in two groups of 22 specimens. The VMD data for 3DL and CBCT groups were statistically analyzed using the Mann-Whitney U test (alpha = 0.05). The mean VMDs on premolar ranged between 44 and 55 mu m (median: 43-55 mu m) in 3DL, and 74 and 100 mu m (median: 72-93 mu m) in CBCT; and on the molar, between 47 and 114 mu m (median: 46-114 mu m) in 3DL, and 91 and 162 mu m (median: 93-156 mu m) in CBCT. There was a significant difference between the gaps in 3DL and CBCT groups (p < 0.001). FDPs fabricated using 3D laboratory scanner had significantly smaller VMDs. Nevertheless, the 3-unit zirconia FDPs fabricated using CBCT scans presented promising marginal integrity.Öğe Marginal fit of CAD-CAM monolithic zirconia crowns fabricated by using cone beam computed tomography scans(Mosby-Elsevier, 2020) Kale, Ediz; Cilli, Mesutcan; Ozcelik, Tuncer Burak; Yilmaz, BurakStatement of problem: Information regarding the precision of monolithic zirconia crowns fabricated by using a standard computer-aided design and computer-aided manufacturing (CAD-CAM) workflow is available. However, information on the effect of a modified workflow using 3D laboratory scanning and/or cone beam computed tomography (CBCT) for monolithic zirconia crown fabrication is lacking. Purpose: The purpose of this in vitro study was to evaluate the effect of different scans on the marginal fit of CAD-CAM monolithic zirconia crowns fabricated by 3D laboratory scanning and CBCT. Material and methods: An extracted maxillary left first molar was prepared and digitized by using a 3D laboratory scanner (D900; 3Shape A/S) (control group). The tooth was also scanned by CBCT (i-CAT; Imaging Sciences) to generate a second virtual 3D model (CBCTscan group). A tooth cast out of polyurethane (PU) (Zenotec Model; Wieland) was reproduced from the CBCT data by using a CAD software program (Dental System 2.6; 3Shape A/S) and milling machine (CORiTEC 550i; imes-icore) and further scanned by using the 3D laboratory scanner to generate a third virtual 3D model to represent a clinical scenario where a patient's cast is needed (PU3DLab group). A monolithic zirconia crown design (cement space: margin 40 mu m, 1 mm above 70 mu m) was used on the virtual models, and crowns were fabricated out of presintered zirconia blocks (ZenostarT4; Wieland) by using a 5-axis milling machine (CORiTEC 550i; imes-icore). The crowns were sintered (Sinterofen HT-S Speed; Mihm-Vogt), and the vertical marginal discrepancy (VMD) was measured by x100-magnification microscopy. Measurements were made at 384 points in 3 groups of 16 specimens. The measurements for each specimen were averaged, and VMD mean values were calculated. The Kruskal-Wallis test was used for the statistical analysis (alpha=.05). The Mann-Whitney U test and Bonferroni adjustment were further used to compare the pairs (alpha=.017). Results: The mean VMD value was 41 mu m (median: 38 mu m) for the control group, 44 mu m (median: 42 mu m) for the CBCTscan, and 60 mu m (median: 58 mu m) for the PU3DLab. No significant difference was found between control and CBCTscan groups (P=.274). However, there was a significant difference between control and PU3DLab and CBCTscan and PU3DLab groups (P<.001). Conclusions: Marginal fit of the crowns fabricated by using the 3D laboratory scanner and through the direct use of CBCT was better than that of the crowns fabricated by using the workflow that combined the use of CBCT, PU cast, and 3D laboratory scanner. All tested protocols enabled the fabrication of monolithic zirconia crowns with a marginal discrepancy smaller than 120 mu m.Öğe Türk diş hekimliği fakültelerinde CAD/CAM üzerine eğitimin değerlendirilmesi(2018) Kale, Ediz; Özçelik, Tuncer BurakAmaç: Günümüzün dijital çağında, gelişmelere bağlı olarak restoratif ve protetik diş hekimliği eğitim müfredatında değişiklik ve iyileştirmeler yapma ihtiyacı doğmuştur. Yeni diş hekimliği teknolojilerinin ülkemiz eğitim müfredatlarında hangi oranda mevcut olduğu bilgisi kısıtlıdır. Bu çalışmanın amacı, Türk Diş Hekimliği Fakülteleri eğitiminin hangi oranda CAD/CAM teknolojisi ile ilgili olduğunu değerlendirmektir.Çalışma Planı: Lisans eğitimi faaliyetlerini sürdürmekte olup 2015-2016 eğitim-öğretim yılında mezun verecek olan Türkiye Cumhuriyeti Diş Hekimliği Fakülteleri, çalışmaya dahil edildi. Toplam 29 fakülteye posta yoluyla ulaşılarak, 15 sorudan oluşan anket sunuldu. Protetik Diş Tedavisi Anabilim Dalı Başkanlarına hitaben hazırlanmış anketin amacı, CAD/CAM konusunun ilgili anabilim dalındaki eğitim müfredatına hangi alanda ve ne oranda dahil edildiğini anlamak ve anabilim dallarının bu eğitimin gerekliliği hakkındaki görüşlerini almaktı. Sonuçlar betimsel istatistik araçları kullanılarak analiz edildi.Bulgular: Anketin geri dönüş oranı %41 (n=12) olarak gerçekleşti. Ankete katılan fakültelerin %50'si 2000 yılından sonra kurulmuş ve bunların %67'si CAD/CAM cihazına sahipti. Fakültelerden hiçbiri preklinik aşamasında CAD/CAM ile ilgili ödev yaptırmıyordu, %33'ü, böyle bir eğitimin, lisans düzeyi müfredatında yer almasına gerek olmadığını belirti. Kurumların yarısından fazlası uygulamalı CAD/CAM eğitiminin lisansüstü müfredatının konusu olduğunu vurguladı. Buna karşın, yarısı, lisansüstü uygulamalı CAD/CAM eğitimi vermediğini beyan etti. Kurumların %58'i, kliniklerinde %25 oranına kadar CAD/CAM'dan yararlandıklarını belirtti. Hepsi, CAD/CAM teknolojisinin diş hekimliği alanındaki kullanımının gelecekte daha da yaygınlaşacağını düşündüğünü beyan ettin. Bu teknolojinin en önemli avantajlarının; hız (%67), standart üretim (%67) ve az hata (%67) olduğu vurgulanırken, önde gelen dezavantajı; maliyet (%67) olarak sayıldı.Sonuç: Bulgulardan, CAD/CAM'ın lisans düzeyinde uygulamalı eğitme henüz dahil edilmediği, fakat bu konuda yeterli bir farkındalık geliştiği ve bunun için yüksek oranda istek olduğu sonucuna varıldı.
