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dc.contributor.advisorTurgut , Melek Dilek
dc.contributor.authorSerdar Eymirli , Pınar
dc.date.accessioned2017-03-14T05:00:27Z
dc.date.available2017-03-14T05:00:27Z
dc.date.issued2017
dc.date.submitted2017-02-13
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dc.identifier.urihttp://hdl.handle.net/11655/3253
dc.description.abstractSerdar-Eymirli P. Evaluation of the Effects of Er; Cr: YSGG Laser, Fluoride and Remineralization Agents in Increasing the Caries Resistance of Primary Enamel, Hacettepe University Health Sciences Institute PhD Thesis in Pediatric Dentistry, Ankara, 2017. The remineralization agents, fluorides and calcium-phosphate compounds (CPP-ACP) along with laser, have been used for prevention of tooth decay. The aim of the present study is to determine the protective effect against caries of four different remineralization agents used with or without laser. After measuring the initial microhardness values of 150 non-caries primary molars, the teeth were randomly assigned to 10 groups of Control (C), NaF, APF, Fluoride Varnish (FC), CPP-ACP, Laser (L), L+NaF, L+APF, L+FC, L+CPP-ACP (n = 15). The microhardness measurements were repeated after the treatments and the pH cycle. The obtained data were analyzed statistically. One sample from each group was examined before treatment, after treatment and after the pH cycle with a scanning electron microscope. In the study, in all experimental groups, microhardness after treatment increased compared to baseline (Δ1), but decreased after the pH cycle compared to after treatment (Δ2) (p<0.05). With respect to Δ1, among all the experimental groups, there was no significant difference between group L and group C (p>0.05). There were significant differences between groups C and APF, L, L+NaF, L+APF, L+FC, L+CPP-ACP in terms of Δ2 (p <0.05). There were no statistically significant differences between groups C and NaF; C and CPP-ACP in regard to the difference in microhardness after the pH cycle compared to the baseline (Δ3) (p> 0.05). There was a significant difference between groups L and L+FC (p <0.05), while no significant difference was noted between groups L and L+NaF, L+APF, L+CPP-ACP (p>0.05). Statistically significant differences between the groups L+FC and NaF, CPP-ACP, L were noted (p<0.05). As a conclusion, FC, which is one of the commonly used remineralization agents in pediatric dentistry practice, is more effective when used in combination with laser than laser alone. Of the other remineralization agents, NaF, CPP- ACP and laser may be insufficient in protecting the primary teeth against acid attacks compared to FC used with laser. Keywords: Remineralisation, Demineralisation, Fluoride, Laser, CPP-ACP Supported by the Scientific Research Department of Hacettepe University (Project Number: TDK-2016-12277).en
dc.description.tableofcontentsONAY SAYFASI iii YAYIMLAMA VE FİKRİ MÜLKİYET HAKLARI BEYANI iv ETİK BEYAN v TEŞEKKÜR vi ÖZET vii ABSTRACT viii İÇİNDEKİLER ix SİMGELER VE KISALTMALAR xii ŞEKİLLER xv TABLOLAR xvii 1. GİRİŞ 1 2. GENEL BİLGİLER 3 2.1. Diş Çürüğü 3 2.1.1. Diş Çürüğünün Mikrobiyolojisi 3 2.1.2. Diş Çürüğünün Sınıflandırılması 5 2.2. Demineralizasyon 8 2.3. Remineralizasyon 9 2.4. Koruyucu Diş Hekimliği Uygulamaları 9 2.4.1. Plağın Uzaklaştırılması 10 2.4.2. Diyetin Düzenlenmesi 10 2.4.3. Fissür Örtücü Uygulamaları 10 2.4.4. Probiyotikler 11 2.4.5. Kazein Fosfopeptid Uygulamaları 11 2.4.6. Florür Uygulamaları 13 2.4.7. Lazer Uygulamaları 20 2.5. Remineralizasyon Ajanlarının Çürüğe Karşı Etkinliğini Değerlendirme Yöntemleri 30 2.5.1. Enerji Dağıtıcı X-ray Spektroskopisi (EDAX) 30 2.5.2. Flor İyonlarının Kimyasal Analizi 31 2.5.3. İndüktif Eşleşmiş Plazma-Atomik Emisyon Spektrometresi (ICP-AES) 31 2.5.4. Polarize Işık Mikroskopisi 31 ix 2.5.5. Tarama Elektron Mikroskobu (SEM) Analizi 32 2.5.6. Mikrosertlik Testi 32 3. GEREÇ VE YÖNTEM 34 3.1. Örneklerin Hazırlanması 34 3.2. Kontrol ve Deney Grupları 36 3.3. Çalışmada Kullanılan Materyaller ve Solüsyonlar 37 3.3.1. Yapay Tükürük Solüsyonu 38 3.3.2. Demineralizasyon Solüsyonu 38 3.3.3. Remineralizasyon Solüsyonu 38 3.4. Mikrosertlik Ölçümleri 39 3.5. Kontrol ve Deney Gruplarının İşlem Basamakları 40 3.6. pH Siklusu 42 3.7. Örneklerin Tarama Elektron Mikroskobu ile İncelenmesi 42 3.8. İstatistiksel Değerlendirme 43 4. BULGULAR 44 4.1. Mikrosertlik Testi Bulguları 44 4.1.1. Tüm Grupların İşlem ve pH Siklusu Sonrasındaki Mikrosertlik Değişimleri 44 4.1.2. Δ1, Δ2 ve Δ3 Açısından Gruplar Arası Karşılaştırmalar 46 4.2. SEM Bulguları 54 4.2.1. Kontrol Grubu 54 4.2.2. NaF Grubu 55 4.2.3. APF Grubu 56 4.2.4. FC Grubu 57 4.2.5. CPP-ACP Grubu 58 4.2.6. Lazer Grubu 59 4.2.7. L+NaF Grubu 60 4.2.8. L+APF Grubu 61 4.2.9. L+FC Grubu 62 4.2.10. L+CPP-ACP Grubu 63 5. TARTIŞMA 64 6. SONUÇLAR 75 x 7. KAYNAKLAR 8. EKLER Ek 1 : Etik Kurul Onay Belgesi 9. ÖZGEÇMİŞtr_TR
dc.language.isoturtr_TR
dc.publisherSağlık Bilimleri Enstitüsütr_TR
dc.rightsinfo:eu-repo/semantics/openAccesstr_TR
dc.subjectRemineralizasyontr_TR
dc.subjectDemineralizasyon
dc.subjectFlorür
dc.subjectLazer
dc.subjectCPP-ACP
dc.titleER; CR: YSGG Lazer ve Farklı Remineralizasyon Ajanlarının Süt Dişi Minesinin Çürüğe Karşı Direncini Artırmadaki Etkilerinin İncelenmesitr_TR
dc.typeinfo:eu-repo/semantics/doctoralThesistr_TR
dc.description.ozetSerdar-Eymirli P. Er; Cr: YSGG Lazer ve Farklı Remineralizasyon Ajanlarının Süt Dişi Minesinin Çürüğe Karşı Direncini Artırmadaki Etkilerinin İncelenmesi, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü Pedodonti Programı Doktora Tezi, Ankara, 2017. Diş çürüğünün önlenmesinde; remineralizasyon ajanları olan florürler, kalsiyum-fosfat bileşikleri (CPP-ACP) ve lazer kullanılmaktadır. Çalışmamızın amacı, dört farklı remineralizasyon ajanının yalnız veya lazerle birlikte kullanımının çürüğe karşı koruyucu etkisini değerlendirmektir. Çalışmamızda 150 adet çürüksüz süt azı dişinin başlangıç mikrosertlik değerleri ölçüldükten sonra dişler rastgele olarak Kontrol (K), NaF, APF, florür cilası (FC), CPP-ACP, Lazer (L), L+NaF, L+APF, L+FC, L+CPP-ACP olmak üzere 10 gruba ayrılmıştır (n=15). Gruplardaki işlemler ve pH siklusu sonrasında mikrosertlik ölçümleri tekrarlanmış ve veriler istatistiksel olarak analiz edilmiştir. Her gruptan birer örnek; işlem öncesi, sonrası ve pH siklusu sonrasında tarama elektron mikroskobunda incelenmiştir. Çalışmamızda, tüm deney gruplarında başlangıca göre işlem sonrasındaki mikrosertlik (Δ1) artarken, işlem sonrasına göre pH siklusu ardından mikrosertlik (Δ2) azalmıştır (p<0.05). Δ1 açısından, K grubu ile deney gruplarından sadece L grubu arasında anlamlı bir fark yoktur (p>0.05). Δ2 açısından, K ile APF, L, L+NaF, L+APF, L+FC, L+CPP-ACP grupları arasında anlamlı fark bulunmuştur (p<0.05). pH siklusu sonrası ile başlangıç arasındaki fark (Δ3) açısından, K ile NaF, CPP-ACP grupları arasında istatistiksel olarak anlamlı fark saptanmamıştır (p>0.05). L ile L+NaF, L+APF, L+CPP-ACP arasında anlamlı fark yokken (p>0.05), L ile L+FC arasında anlamlı fark vardır (p<0.05). L+FC ile NaF, CPP-ACP, L grupları arasında anlamlı fark vardır (p<0.05). Sonuç olarak, çocuk dişhekimliği pratiğinde sık kullanılan remineralizasyon ajanlarından FC, lazerle beraber kullanıldığında, lazerin tek kullanımına göre daha etkilidir. Diğer remineralizasyon ajanlarından NaF, CPP-ACP ve lazer, lazerle beraber kullanılan FC’ye göre süt dişlerini asit ataklarına karşı korumada daha yetersiz kalabilmektedir. Anahtar kelimeler: Remineralizasyon, Demineralizasyon, Florür, Lazer, CPP-ACP Hacettepe Üniversitesi Bilimsel Araştırmalar Birimi tarafından desteklenmiştir (Proje No: TDK-2016-12277).tr_TR
dc.contributor.departmentPedodontitr_TR
dc.contributor.authorIDTR161286tr_TR


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