Hacettepe Üniversitesi Açık Erişim Sistemi (HÜAES)

  • HÜAES, Hacettepe Üniversitesi bünyesinde üretilen kitap, makale, tez, bildiri, rapor gibi tüm akademik kaynakları uluslararası standartlarda dijital ortamda depolar, etkisini artırmak için telif haklarına uygun olarak Açık Erişime sunar.
 

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YENİ BİR İRRİGASYON SOLÜSYONU TRİTON’UN EPOKSİ REZİN VE KALSİYUM SİLİKAT ESASLI KÖK KANAL DOLGU PATLARININ İTME BAĞLANMA DAYANIMINA ETKİSİ
(2026) Esma Böken Kır; Endodonti
BÖKEN KIR E. The Effect of Triton, a Novel Irrigation Solution, on the Push-Out Bond Strength of Epoxy Resin-Based and Calcium Silicate-Based Root Canal Sealers. Hacettepe University Faculty of Dentistry, Department of Endodontics, Specialization Thesis, Ankara, 2026. This study evaluated the effect of Triton, a novel irrigation solution, on the push-out bond strength of epoxy resin-based and calcium silicate-based root canal sealers. A total of 90 extracted human single-rooted teeth were used in the study. Specimens were divided into two main groups based on the final irrigation protocol: Triton and conventional irrigation (n=45). Each main group was further subdivided into three subgroups based on the root canal sealer used: AH Plus (Dentsply, USA), MTA Fillapex (Angelus, Brazil), and CeraSeal (Meta Biomed, South Korea) (n=15). Root canals were prepared to size F4 using the ProTaper Gold rotary file system (Dentsply Maillefer, Switzerland). The corresponding irrigation protocols were applied, and the final irrigation solutions were activated with an EndoActivator (Woodpecker-Dte, China). After obturation with the assigned root canal sealers, coronal and middle root sections were obtained from each specimen. Push-out bond strength testing was performed on a universal testing machine (Lloyd LRX, England), and failure modes were evaluated under a stereomicroscope (Olympus, SZ-61, Japan). Data were analyzed using appropriate statistical methods. No statistically significant differences were observed between the Triton and conventional irrigation protocols in the coronal and middle sections of the AH Plus, MTA Fillapex, and CeraSeal groups (p>0.05). A statistically significant difference among root canal sealers was observed only in the coronal section of the conventional irrigation group (p=0.003), attributable to the comparison between the AH Plus and MTA Fillapex groups. MTA Fillapex exhibited lower bond strength values. A significant difference between the coronal and middle sections was observed only in the MTA Fillapex subgroup of the conventional irrigation group (p=0.047). Cohesive failure was the primary failure mode across all groups. Within the limitations of this study, the Triton irrigation solution performed comparably to the conventional irrigation protocol in terms of the push-out bond strength of root canal sealers. In addition, AH Plus and CeraSeal tended to exhibit higher bond strength values than MTA Fillapex, and cohesive failure was the predominant failure mode in all groups.
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AÇIK APEKSLİ DEVİTAL DİŞLERDE VAKA SEÇİMİ VE KLİNİK PROTOKOL AÇISINDAN DİŞ HEKİMLERİ, ENDODONTİSTLER VE PEDODONTİSTLERİN TEDAVİ YAKLAŞIMLARI
(2026) Pelin KARAYEL; Endodonti
KARAYEL, P., Evaluation of Treatment Approaches of General Dentists, Endodontists, and Pediatric Dentists Regarding Case Selection and Clinical Protocols for Non-vital Immature Teeth with Open Apices, Hacettepe University, Faculty of Dentistry, Department of Endodontics, Specialty Thesis, Ankara, 2026. This study aimed to evaluate and compare the knowledge levels, information sources, treatment-planning approaches, regenerative endodontic treatment (RET) protocols, success criteria, follow-up strategies, complications encountered, and treatment preferences among general dentists, endodontists, and pediatric dentists regarding the management of non-vital immature permanent teeth with open apices. This cross-sectional, questionnaire-based study included 230 dentists practicing in Türkiye, comprising general, endodontic, and pediatric dentists. A structured questionnaire was used to collect data on sociodemographic characteristics, self-reported knowledge level, information sources, factors influencing treatment planning, RET protocols, success criteria, follow-up approaches, complications, and responses to two clinical case scenarios. Statistical analyses were performed using appropriate statistical methods, and a p-value of <0.05 was considered statistically significant. Endodontists and pediatric dentists reported significantly higher levels of knowledge regarding RET than general dentists. These specialists also relied more frequently on current scientific literature and the clinical guidelines of the American Association of Endodontists (AAE) and the European Society of Endodontology (ESE). Root development stage, patient age, infection control, and apical diameter were considered important treatment-planning factors by all participants, whereas significant intergroup differences were observed only in the evaluation of periapical lesion size. Significant differences among specialties were also identified regarding irrigation solutions, intracanal medicaments, irrigation activation techniques, and coronal barrier materials. In the first clinical case scenario, which represents an ideal indication for RET, Endodontists and pediatric dentists more frequently preferred RET than general dentists. In contrast, MTA apexification was more commonly preferred in the second case scenario, which involved uncontrolled type 1 diabetes mellitus. Furthermore, specialists showed greater agreement with contemporary international guidelines on treatment success criteria and follow-up protocols. Clinical decision-making regarding regenerative endodontic treatment is influenced not only by professional specialty but also by knowledge level, use of evidence-based guidelines, professional experience, and case-specific characteristics. Clinicians with greater access to current scientific evidence and international guidelines were more likely to adopt biologically based treatment approaches. These findings underscore the importance of continuing professional education and broader dissemination of evidence-based clinical guidelines to promote standardized, contemporary, and predictable regenerative endodontic practice.
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GÜNCEL KULLANILAN KALSİYUM SİLİKAT ESASLI ENDODONTİK DOLGU MATERYALLERİNİN İNSAN DENTAL PULPA KÖK HÜCRELERİNDE SİTOTOKSİSİTE, OKSİDATİF STRES VE GENOTOKSİSİTE AÇISINDAN DEĞERLENDİRİLMESİ
(Sağlık Bilimleri Enstitüsü, 2026) Baransel Koç; Endodonti
In this study, the biosafety profiles of the calcium silicate-based materials used in endodontics — MTA Angelus White, Biodentine and NeoMTA 2 — on human dental pulp stem cells (hDPSC) were evaluated in a multiparametric and comparative manner through cytotoxicity, oxidative stress and oxidative DNA damage/repair parameters. Considering that direct application could create artifacts due to the setting tendency of the materials, exposure was carried out using a standardized extract approach. Cell viability was determined at serial dilutions by the MTT method. Oxidative stress was evaluated by reduced glutathione (GSH), malondialdehyde (MDA) and total antioxidant capacity (TAOC). General DNA damage was examined by the alkaline Comet assay, while oxidative DNA damage was evaluated by 8-hydroxy2'-deoxyguanosine (8-OHdG) levels and the DNA repair response by 8-oxoguanine DNA glycosylase 1 (OGG-1) levels. Biochemical parameters were normalized to the total protein amount. According to the obtained findings, the extracts of all three materials maintained cell viability above 80% throughout the entire tested dilution range and exhibited a non-cytotoxic profile according to ISO 10993-5 criteria. No statistically significant difference was found among the groups in the oxidative stress parameters, and the cellular redox balance was found to be preserved. In the Comet assay, the materials did not cause significant DNA damage compared to the negative control. No significant difference was found between the oxidative DNA damage and repair markers either; the similar trend of the two markers indicated that the balance between the formed base damage and the repair capacity was preserved. In conclusion, all three tested calcium silicate-based materials exhibited a similar and acceptable biosafety profile on hDPSC; no significant difference was detected in any of the measured parameters either among the materials or compared to the negative control. These findings support that NeoMTA 2, a relatively new material, is comparable to MTA Angelus White and Biodentine in terms of biosafety.
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Peri-implantitis ve Periodontitiste İnflamatuvar ve Koruyucu Yanıt: Dişeti Islaklığı, Dişeti Oluğu Sıvısı ve Peri-implant Oluk Sıvısının TNF-, IL-10 ve MUC4 Düzeylerinin İncelenmesi
(Sağlık Bilimleri Enstitüsü, 0023-07-26) Zeinep Gkizem MOUSTAFA; Periodontoloji
ABSTRACT MOUSTAFA, Z.G. Inflammatory and Protective Responses in Peri-implantitis and Periodontitis: Investigation of TNF-α, IL-10, and MUC4 Levels in Gingival Wetness, Gingival Crevicular Fluid, and Peri-implant Crevicular Fluid. Hacettepe University, Faculty of Dentistry, Department of Periodontology, Specialty Thesis, Ankara, 2026. The balance among components of the immunoinflammatory response plays a critical role in the pathogenesis of periodontal and peri-implant diseases. The site-specific characteristics of these diseases highlight the need for a more comprehensive understanding of the dynamics and characteristics of the local biological response. The aim of this study was to compare TNF-α, IL-10, and MUC4 levels in gingival crevicular fluid (GCF), peri-implant crevicular fluid (PICF), and local saliva among periodontal health, periodontitis, peri-implant health, and peri-implantitis groups, to evaluate the relationships between these biomarkers and clinical periodontal/peri-implant parameters, and to investigate the potential biological role of gingival wetness. A total of 80 teeth/implants from 38 individuals were included and allocated to four groups: periodontal health (n=20), periodontitis (n=20), peri-implant health (n=20), and peri-implantitis (n=20). Clinical periodontal and peri-implant parameters were recorded in all participants, and GCF/PICF volume and gingival wetness were assessed. TNF-α, IL-10, and MUC4 levels in GCF, PICF, and local saliva samples were analyzed using ELISA method. Non-parametric statistical methods were used for comparisons among groups. Independent predictors of disease status were evaluated using logistic regression analysis, while the relationships between biomarkers and clinical parameters were assessed using Spearman correlation analysis. All clinical periodontal and peri-implant parameters differed significantly among the groups (p<0.001). Disease groups exhibited greater probing depth, clinical attachment level, plaque index, gingival index, bleeding on probing, and GCF/PICF volume, whereas keratinized gingival width was significantly lower. GCF and salivary MUC4 levels were significantly lower in the periodontal health group than in the periodontitis and peri-implantitis groups, while PICF MUC4 levels were significantly higher in the peri-implantitis group than in the periodontitis group (p<0.05). GCF/PICF and salivary IL-10 levels were higher in the periodontal health group than in the other groups and were also higher in the periodontitis group than in the peri-implantitis group (p<0.05). Although GCF/PICF TNF-α levels did not differ significantly among the groups, salivary TNF-α levels were significantly higher in the peri-implantitis group than in both the peri-implant health and periodontitis groups (p<0.05). Multivariable logistic regression analysis identified GCF/PICF MUC4 level as an independent predictor of periodontitis, whereas the presence of systemic disease was identified as an independent predictor of peri-implantitis. Correlation analyses demonstrated group-specific association patterns between biomarkers and clinical inflammatory parameters. These findings suggest that although periodontal and peri-implant diseases exhibit similar inflammatory clinical characteristics, they may differ in terms of their local biological responses. Keywords: Periodontitis, peri-implantitis, gingival crevicular fluid, peri-implant crevicular fluid, gingival wetness, biomarkers
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Oklüzal Destek Kaybında Çeneler Arası İlişkinin Belirlenmesinde Ağız İçi Tarayıcı Ve Çene Hareket Takip/Analiz Cihazı İle Elde Edilen Klinik Verilerin Restoratif Olarak Değerlendirilmesi
(Sağlık Bilimleri Enstitüsü, 2025-08-27) Koçar Ece Selen; Protetik Diş Tedavisi
Determining the maxillomandibular relation in patients requiring functional occlusal rehabilitation is critical for the success of restorative treatment. In this study, the effects of centric relation records obtained by two different methods: bimanual manipulation with intraoral scanning, and anterior plateau with mandibular movement tracking/analysis device on restorative occlusal surface adaptation were compared both qualitatively and quantitatively. Twelve patients with posterior support loss were included. In the first method, centric relation determined by bimanual manipulation was transferred to the digital environment using an intraoral scanner. In the second, centric relation determined with anterior plateau was recorded and digitized via a mandibular movement tracking/analysis device. Based on these records, restorations were fabricated, and clinical adaptation was evaluated qualitatively by occlusal adjustment time, number of articulation papers, and adapted area, and quantitatively by calculating adapted surface area. Qualitative analysis showed restorations produced with anterior plateau and the mandibular movement tracking/analysis device had significantly lower adjustment scores. Quantitative analysis revealed these restorations exhibited smaller adapted surface areas compared to those produced using bimanual manipulation with intraoral scanning. In conclusion, repeated recording with the anterior plateau and use of a mandibular movement tracking/analysis device resulted in restorations with superior static occlusal adaptation, and may be considered an effective approach to improving restorative occlusal outcomes.