Gülsen Bayraktar

Stimulated Salivary Flow Rate in Chronic Hemodialysis Patients

Background: Reduced salivary flow has been reported in patients undergoing hemodialysis (HD) treatment. Our aim was to investigate the most important factors associated with stimulated salivary flow rate (ssfr) in chronic HD patients. Methods: Fifty HD patients (27 F, 23 M, mean age 46. 7 ± 13.2 years) were divided into two groups according to the duration of HD treatment as those receiving HD therapy less than or equal to (group I) or those more than (group II) 24 months. Fasting blood samples were obtained to determine hepatitis B and C serology, and biochemical and hematological parameters before a HD session. After prestimulation with a standard weight paraffin wax, stimulated saliva was collected in the HD patients and control group (23 F, 25 M, mean age 45.7 ± 19.1 years) and the flow rate was expressed as ml/min. Results: Both HD groups consisted of 25 patients. There was no significant difference between the two HD groups other than serum alkaline phosphatase (ALP) levels and presence of HCV. The ssfr was decreased than controls in both groups (0.8 ± 0.6 and 0.7 ± 0.4, respectively, vs. 1.5 ± 0.5 ml/min) and it did not correlate with any parameter. Smoking had a positive effect on ssfr in all groups. Conclusion: Although the salivary flow rate decreased significantly in chronic HD patients, the duration of therapy displayed no effect on the salivary changes in HD patients, but smoking increased ssfr.

Evaluation of periodontal parameters in patients undergoing peritoneal dialysis or hemodialysis

OBJECTIVE To analyze and compare periodontal parameters in chronic renal failure (CRF) patients undergoing peritoneal dialysis (PD) therapy with a group of patients on hemodialysis (HD) treatment and healthy controls (C). PARTICIPANTS Seventy-five PD patients (mean age: 44 +/- 12 years) were matched with 41 HD patients (mean age: 46 +/- 15 years) and 61 C (mean age: 46 +/- 18 years). METHODS Plaque (PI) and calculus (CSI) accumulation and gingival bleeding (GI) were recorded with the appropriate indices. Periodontal condition was assessed using the probing pocket depth (PPD). One-way anova test, Pearson chi-squared test, Mann-Whitney U-test and Kruskal-Wallis test were performed to compare PD patients with HD patients and healthy C. RESULTS Plaque Index values were significantly higher (P < 0.001) in the PD and HD groups than the C group. GI values were significantly higher (P < 0.01) in the HD group than the PD group. Finally, CSI values in the PD and HD groups were also significantly higher (P < 0.001) than the C group. CONCLUSIONS Chronic renal failure patients on PD treatment are more susceptible to periodontal diseases like HD patients. Thus, it is very important to maintain an optimal oral hygiene level. Further studies on periodontal parameters of only PD patients are needed to get more information on the oral health status of this patient group.

Effect of leaching residual methyl methacrylate concentrations on in vitro cytotoxicity of heat polymerized denture base acrylic resin processed with different polymerization cycles

Objectives Residual methyl methacrylate (MMA) may leach from the acrylic resin denture bases and have adverse effects on the oral mucosa. This in vitro study evaluated and correlated the effect of the leaching residual MMA concentrations ([MMA]r) on in vitro cytotoxicity of L-929 fibroblasts. Material and Methods A total of 144 heat-polymerized acrylic resin specimens were fabricated using 4 different polymerization cycles: (1) at 74ºC for 9 h, (2) at 74ºC for 9 h and terminal boiling (at 100ºC) for 30 min, (3) at 74ºC for 9 h and terminal boiling for 3 h, (4) at 74ºC for 30 min and terminal boiling for 30 min. Specimens were eluted in a complete cell culture medium at 37ºC for 1, 2, 5 and 7 days. [MMA]r in eluates was measured using high-performance liquid chromatography. In vitro cytotoxicity of eluates on L-929 fibroblasts was evaluated by means of cell proliferation using a tetrazolium salt XTT (sodium 3´-[1-phenyl-aminocarbonyl)-3,4-tetrazolium]bis(4-methoxy-6-nitro)benzenesulphonic acid) assay. Differences in [MMA]r of eluates and cell proliferation values between polymerization cycles were statistically analyzed by Kruskal-Wallis, Friedman and Dunns multiple comparison tests. The correlation between [MMA]r of eluates and cell proliferation was analyzed by Pearsons correlation test (p<0.05). Results [MMA]r was significantly (p≤0.001) higher in eluates of specimens polymerized with cycle without terminal boiling after elution of 1 and 2 days. Cell proliferation values for all cycles were significantly (p<0.01) lower in eluates of 1 day than those of 2 days. The correlation between [MMA]r and cell proliferation values was negative after all elution periods, showing significance (p<0.05) for elution of 1 and 2 days. MMA continued to leach from acrylic resin throughout 7 days and leaching concentrations markedly reduced after elution of 1 and 2 days. Conclusion Due to reduction of leaching residual MMA concentrations, use of terminal boiling in the polymerization process for at least 30 min and water storage of the heat-polymerized denture bases for at least 1 to 2 days before denture delivery is clinically recommended for minimizing the residual MMA and possible cytotoxic effects.

Effect of post-polymerization heat-treatments on degree of conversion, leaching residual MMA and in vitro cytotoxicity of autopolymerizing acrylic repair resin

OBJECTIVES This study evaluated the effect of post-polymerization heat-treatments on degree of conversion (DC), residual methyl methacrylate concentration (MMA(r)) and in vitro cytotoxicity of autopolymerizing acrylic repair resin. METHODS A total of 336 specimens were prepared by bench- and hydroflask-curing and subjected to post-polymerization heat-treatments: a) water immersion at 60°C for 30 min, b) microwaving at 500 W for 3 min, c) combined use of water immersion and microwaving d) no treatment (as control). Specimens were eluted in cell culture medium for 1, 2, 5 and 7 days. DC and MMA(r) in eluates were measured by FTIR spectrometry and HPLC, respectively. In vitro cytotoxicity of eluates on L-929 fibroblasts was determined by XTT assay. Data were statistically analyzed with Dunns multiple comparison and Pearson correlation tests (p≤0.05). RESULTS DC was highest (99.9%) in bench- and hydroflask-cured groups which were subjected to water immersion. At all elution periods, MMA(r) was detected in eluates of all treatment groups and were higher in bench-cured groups than hydro-flask cured groups. Cell proliferation values indicated slightly cytotoxic effect throughout 7 days; regardless of the curing method or post-polymerization treatment. The correlation between MMA(r) and cell proliferation was negative after elution of 1, 2, 5 days and was only statistically significant (p<0.05) at 5 days. At elution of 7 days, the correlation was positive with no significance. SIGNIFICANCE Post-polymerization heat-treatment of autopolymerizing acrylic repair resin by immersion in water at 60°C for 30 min is clinically recommended to improve the DC while reducing the leaching residual MMA.

Effect of glass fibre reinforcement on residual methyl methacrylate content of denture base polymers

OBJECTIVES Residual methyl methacrylate (MMA) content in unreinforced and in glass fibre reinforced, heat-polymerized (long- and short-term terminal boiled and conventionally) autopolymerized (at room temperature and in water at 60 degrees C) and microwave-polymerized (3min at 500W) denture base polymers after processing were compared. METHODS Ten specimens were prepared for each curing cycle (five unreinforced and five reinforced) adding up to a total of 60. Residual MMA content was determined using high-performance liquid chromatography. Data were analysed with one-way ANOVA followed by Tukey HSD and Paired Samples tests. RESULTS For unreinforced and reinforced groups; residual MMA content succesively ranked from lowest to highest in; long- and short-term terminal boiled heat-polymerized, microwave-polymerized, autopolymerized specimens processed in water at 60 degrees C and conventionally heat- and autopolymerized specimens processed at room temperature. Generally residual MMA was found more in glass fibre reinforced test groups than unreinforced groups. However, when reinforced residual MMA increased significantly in long- and short-term terminal boiled heat- (P<0.05) and microwave-polymerized test groups (P<0.01). CONCLUSIONS Although this increase was significant, lowest residual MMA content was found succesively in reinforced long- and short-term terminal boiled heat-polymerized and microwave-polymerized like in unreinforced groups.

Flexural properties of repaired heat-polymerising acrylic resin after wetting with monomer and acetone.

OBJECTIVES Repair strength can be improved by treating fractured surfaces of a denture. BACKGROUND This study investigated flexural properties of heat-polymerised acrylic resin specimens repaired with auto-polymerising and visible light curing (VLC) resins after the repair surfaces were wetted with monomers or acetone. MATERIALS AND METHODS Fifty-four specimens (65 x 10 x 2.5 mm) were prepared and 48 of them were sectioned to simulate denture fracture. Butt-joint designed repair surfaces were wetted with heat-, auto-polymerising monomers and acetone for 180 s and repaired with auto-polymerising and VLC resins. After repairs, specimens were subjected to three-point bending test and flexural strength, strain, fracture load, modulus of elasticity and deflection values were recorded. Data were analysed with Student t and LSD tests (p < or = 0.05). RESULTS Overall flexural strength, strain, fracture load and deflection values of specimens repaired with VLC resin were significantly higher than the specimens repaired with auto-polymerising resin for all types of wetting agent (p < 0.05). Within the wetting agents, heat- and auto-polymerising monomers produced the best mechanical properties, while wetting with acetone did not provide superior effect over both monomers. CONCLUSION In clinical use, wetting the repair surfaces may result in stronger repairs. The use of bonding agent in VLC resin repairs in combination with wetting agent results in improved flexural properties.

Effect of Educational Level on Oral Health in Peritoneal and Hemodialysis Patients

Background. In previous studies, the oral and dental health statuses were compared in hemodialysis (HD) and peritoneal dialysis (PD) patients without taking into account the effect of educational levels on oral health. Hence we aimed to make a comparison of these parameters based upon the subjects educational levels. Patients and Methods. 76 PD (33 males, 43 females-mean age: 44 ± 12 years) and 100 HD (56 males, 44 females-mean age: 46 ± 14 years) patients were included. The number of decayed, missing and filled teeth were detected, DMFT index was calculated and plaque index (PI) values were assessed. Results. Significantly higher numbers of filled teeth (P < .001) and lower PI values (P < .01) in the PD group were detected with higher educational levels, whereas no significance was detected in the HD group. Higher DMFT index values were assessed in the lower educated and high school levels in PD than HD patients (P < .05). Higher numbers of filled teeth (P < .05) were detected in the secondary school level in PD patients. This difference was even more significant in the high school level (P < .001). Conclusion. We assume that PD patients, who were found to be in a higher educational level, are more caring for their oral health as compared to HD patients.

Distal extension mandibular removable partial denture with implant support.

This case report describes the fabrication of a distal extension removable partial denture (RPD) of a 65-year-old man with implant support. Loss of fibroelasticity of the peripheral tissues and reduced mandibular vestibular sulcular depth due to a previous surgical resection and radiotherapy at the right side were the main clinical factors that created difficulty for denture retention and stability. The fabrication of a mandibular RPD supported by anterior teeth and two bilaterally placed implants in the molar area to convert from Kennedy Class 1 design to Kennedy Class 3 implant-bounded RPD is reported. Retention and stability of the denture were improved with implant support on the distal extension site of the RPD. The common clinical problems about distally extended RPDs are lack of retention and stability due to the movement around the rotational axis. Dental implant placement to the distal edentulous site minimizes the potential dislodgement of the RPD is popular. Implant-supported RPD can be suggested as an advantageous and cost-effective treatment option for the partially edentulous patients.

ÇEŞİTLİ KİMYASAL TEMİZLİK SOLÜSYONLARININ AKRİLİK KAİDE MATERYALİNİN YÜZEY SERTLİĞİNE ETKİSİ-THE EFFECT OF VARIOUS CHEMICAL CLEANING SOLUTIONS ON THE SURFACE HARDNESS OF AN ACRYLIC RESIN DENTURE BASE MATERIAL

Ozet Son yillarda, Hepatit B ve kazanilmis immun sistem eksikligi sendromu (AIDS) gibi hastaliklarin gorulme sikliginin ve bu hastaliklarla ilgili bilinclenmenin artmasi capraz enfeksiyon kontrolunun onemini arttirmistir. Ayrica, dis hekimi hastalarina kullanimi kolay, protez kaide maddesine de zarar vermeyen bir temizleyici ajan onermelidir. Ancak, protez temizlik solusyonlarinin protez kaide maddelerinin fiziksel ve mekanik ozelliklerinde bazi degisimlere neden oldugu bildirilmektedir. Bu calismada bes kimyasal temizlik solusyonunun akrilik kaide materyalinin yuzey sertligine etkisi degerlendirilmistir. 1 gun ve 7 gun kimyasal temizlik solusyonlarina daldirma islemleri sonunda, temizlik solusyonunun yapisina bagli olarak yuzey sertlik degerlerinde farkli degisimler belirlenmistir. Ancak, 365 gun gibi uzun sureli daldirma islemi sonunda, bes kimyasal temizlik solusyonunun da deney orneklerinin yuzey sertlik degerlerinde istatistiksel olarak ileri derecede anlamli (p<0.001) azalmaya neden oldugu saptanmistir. Anahtar kelimeler: Kimyasal temizlik solusyonlari, protez kaide maddeleri, yuzey sertligi Abstract The importance of cross-infection control has received an increasing attention in recent years because of the greater incidence and awareness of communicable diseases such as Hepatitis B and acquired immune deficiency syndrome (AIDS). Dentist should advise a cleaning solution which is used esaily and is not harmful to denture base material. However it has been reported that denture cleaning solutions may cause some changes in physical and mechanical properties of denture base materials. In this study, the effects of five chemical cleaning solutions on tJte surface hardness of an acrylic denture base resin material are evaluated. After one day, seven days of immersion periods, due to the composition of the cleaning solution the surface hardness varied. However, after 365 days of immersion the decrease in the surface hardness values with each solution is found to be statistically significant (p<0.001). Key words: Chemical cleaning solutions, denture base nuite-rials, surface hardness

İSKELETSEL ve DİŞSELIII. SINIF BİR OLGUNUN PROTETİK REHABİLİTASYONU-PROSTHETIC REHABILITATION IN TAL AND DENTAL CLASS IU MAL OCCLUSION (A case report)

Ozet Prognatizm ciddi sosyal ve fonksiyonel bir engeldir. Prognatik bir hastanin III. sinif anomaliler hacimsal veya konumsal kaynakli olabilmektedir. Hacimsal anomalilerde mandibulada yapisal bir buyukluk soz konusudur ve bu olgular gercek III. sinif olgulardir. Bu makalede, III. sinif malokluzyonlu yetiskin bir bireyde estetik ve fonksiyonu saglamak amaciyla perio-dontolojik, ortodontik ve protetik kombine bir tedavi yaklasimi anlatilmaktadir. Anahtar sozcukler: III. sinif malokluzyon, ortodontik ve Abstract Prognatiiism The class III anomalies may be in volume or in position. In volumetric anomalies In this article, periodontal, orthodontic and prosthodontic treatment approach as a combined treatment were described to esthetic andfunction of an adult patient with class Hi malocclusion. Key words: Class III malocclusion, orthodontic and periodontal treatment, dentures with precision attachments. is a serious social and functional impediment. Its correction is esential to restore function and esthetics in the oral and behavioral rehabilitation of a prognathous patient. mandibula is bigger than its normal volume and this is the real class III case. oral ve davranissal rehabilitasyonu icin fonksiyon ve estetigini restore etmek gerekir. periodontal tedavi, hassas baglantili protezler.