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    The effect of repeated bonding on the shear bond strength of different resin cements to enamel and dentin
    (Korean Acad Prosthodontics, 2017) Bulut, Ali Can; Atsu, Saadet Saglam
    PURPOSE. Cementation failures of restorations are frequently observed in clinical practice. The purpose of this study is to compare the effect of initial and repeated bonding on the bond strengths of different resin cements to enamel and dentin. MATERIALS AND METHODS. Ninety human maxillary central incisors were bisected longitudinally. The 180 tooth halves were divided into 2 groups (n = 90) for enamel and dentin bonding. The enamel and dentin groups were further divided into 3 groups (n = 30) for different resin cement types. Composite resin (Filtek Ultimate) cylinders (3 x 3 mm) were prepared and luted to enamel and dentin using Variolink II (Group V), RelyX ARC (Group R), or Panavia F 2.0 (Group P) resin cement. After 24 hours, initial shear bond strengths of the resin cements to,enamel and dentin were measured. Using new cylinders, the specimens were de-bonded and re-bonded twice to measure the first and the second bond strengths to enamel and dentin. Failure modes and bonding interfaces were examined. Data were statistically analyzed. RESULTS. Initial and repeated bond strengths to enamel were similar for all the groups. The first (15.3 +/- 2.2 MPa) and second (10.4 +/- 2.2 MPa) bond strengths to dentin were significantly higher in Group V (P<.0001). Second bond strengths of dentin groups were significantly lower than initial and first bond strengths to dentin (P<.0001). CONCLUSION. All resin cements have similar initial and repeated bond strengths to enamel. Variolink II has the highest first and second bond strength to dentin. Bond strength to dentin decreases after the first re-bonding for all resin cements.
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    Evaluation of the Effect of Different Abutment Materials on the Final Color of the Restoration After Aging: An In Vitro Study
    (Quintessence Publishing Co Inc, 2022) Tuerksayar, Almira Ada Diken; Bulut, Ali Can; Atsu, Saadet Saglam
    To compare the effect of thermomechanical aging on implant abutment color change when using different abutment backgrounds. Materials and Methods: In this study, three separate experimental groups (n = 10) with different implant abutment materials were used: zirconia, modified polyether ether ketone (MPEEK), and polyether ketone ketone (PEKK). Equal-sized glass-ceramic incisor crowns were cemented to the abutments using transparent dual-curing resin cement. The specimens were then subjected to the thermomechanical aging process for the clinical equivalent of 5 years of use. The color values of each specimen in the middle third and the incisal third were recorded by a digital spectrophotometer in the CIE L*a*b* color coordinates both before and after the aging process. Color differences between groups were compared using one-way analysis of variance (ANOVA), while Tukey test was used to compare differences within the groups (P = .05). Results: In terms of color change (Delta E00) values, the zirconia group was found to show statistically more color changes only in the middle third (P < .000), but there was no significant difference between the the MPEEK and PEKK groups. In all groups, the Delta E00 value was clinically acceptable (Delta E00 < 1.8). Conclusion: After the aging process, high-performance polymer abutments caused less color change than zirconia. Therefore, esthetically satisfying results can be obtained in the anterior region, especially when highly translucent crown materials are used.
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    Fracture Resistance of Titanium, Zirconia, and Ceramic-Reinforced Polyetheretherketone Implant Abutments Supporting CAD/CAM Monolithic Lithium Disilicate Ceramic Crowns After Aging
    (Quintessence Publishing Co Inc, 2019) Atsu, Saadet Saglam; Aksan, M. Emin; Bulut, Ali Can
    Purpose: The purpose of this study was to compare the fracture resistances and the fracture types of titanium, zirconia, and ceramic-reinforced polyetheretherketone (PEEK) implant abutments supporting computer-aided design/computer-aided manufacturing (CAD/CAM) monolithic lithium disilicate ceramic crowns after in vitro dynamic loading and thermocycling aging. Materials and Methods: Three implant abutment (SKY Implant) groups-titanium (group Ti, control); zirconia with titanium base (group Zr); and ceramic-reinforced PEEK (BioHPP) with titanium base (group RPEEK); n = 12 each-were used. Thirty-six CAD/CAM monolithic lithium disilicate crowns (IPS e. max CAD) in the form of a maxillary central incisor were cemented with Panavia V5 on the abutments. The specimens were subjected to dynamic loading and thermocycling. Fracture resistances of the restorations were tested with a universal testing machine (0.5 mm/min), and their fracture patterns were analyzed. One-way analysis of variance (ANOVA) and Tukey post hoc test were used for statistical analyses (alpha = .05). Results: All samples survived after aging. The fracture strength values (mean +/- standard deviation) of the groups were as follows: group Ti, 787.8 +/- 120.9 N; group Zr, 623.9 +/- 97.4 N; and group RPEEK, 602.9 +/- 121 N. The fracture strengths were significantly higher in group Ti compared to groups Zr and RPEEK (P =.001). No significant difference was observed between groups Zr and RPEEK. Failures generally occurred due to fracture of the screw in group Ti, abutment and crown in group Zr, and crown in group RPEEK. Conclusion: Ceramic-reinforced PEEK abutments may be an alternative to zirconia abutments with a titanium base for single-implant restorations in the anterior region. However, there is need for further in vitro and clinical studies to evaluate the long-term performance of ceramic-reinforced PEEK abutments.
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    Fracture Resistance of Zirconia, Polyetheretherketone, and Polyetherketoneketone Implant Abutments After Aging
    (Quintessence Publishing Co Inc, 2021) Turksayar, Almira Ada Diken; Atsu, Saadet Saglam
    Purpose: This study aimed to assess the fracture resistance of zirconia (Zr), reinforced polyetheretherketone (PEEK), and polyetherketoneketone (PEKK) implant abutments restored with glass-ceramic crowns after thermomechanical aging. Materials and Methods: Zr, reinforced PEEK, and PEKK titanium base abutments were divided into three groups (n = 10). CAD/CAM maxillary central incisor crowns were fabricated using monolithic lithium disilicate and luted to the abutments using resin cement. The specimens were thermomechanically aged (1.2 x 10(6) cycles, 49 N, 5 degrees C to 55 degrees C). After testing fracture strength and determining fracture patterns, statistical analyses were made using the one-way analysis of variance (ANOVA) and Tukey post hoc tests (alpha=.05). Results: Fracture resistance of the PEKK abutments (541.90 +/- 68.49 N) was significantly lower than the Zr (780.65 +/- 105.77 N) and reinforced PEEK (741.09 +/- 99.84 N) abutments (P=.000). A significant discrepancy was not detected between the reinforced PEEK and Zr abutments. Failures usually formed due to crown or abutment fracture, plastic deformation of the titanium base or screw fracture in the Zr group, crown fracture or separation of the abutment-crown complex from the titanium base in the reinforced PEEK group, and abutment fracture without crown deformation in the PEKK group. Conclusion: After thermomechanical aging, the reinforced PEEK abutments exhibited similar fracture resistance to the Zr abutments. All abutment types withstood the physiologic occlusal forces typical for the oral anterior region. Before considering them as alternative esthetic implant abutment materials, further in vitro and clinical studies are needed to determine their long-term performance.
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    Neonatal line on fetus and infant teeth An indicator of live birth and mode of delivery
    (Elsevier Ireland Ltd, 2014) Canturk, Nergis; Atsu, Saadet Saglam; Aka, P. Sema; Dagalp, Rukiye
    Background: The neonatal line (NL) is an important issue in forensic odontology. It is the sign of a developmental birth defect, which is caused by the effect of metabolic stress on tooth structures when the fetus passes to extrauterine life. Aims: The aim of this research is to determine the existence and thickness of NL in teeth, as it is a legal necessity to indicate the signs of viability at birth in a forensic examination of a fetus or infant case. Study design and subjects: This research was conducted on 48 lower left and right lateral teeth, which were taken from 24 autopsy cases (46% female and 54% male). Left lateral teeth were sectioned in a vertical plane and right lateral teeth were sectioned in a horizontal plane. The NL thickness was measured with a scanning electron microscope (SEM). These cases comprised three conditions as: 70.3% normal birth, 16.7% caesarean sections, and 12.5% still birth cases under the legal and ethical permission. Outcome measures: The mean NL thickness of normal birth cases was higher than caesarean cases as 7.7 mu m and 2.5 mu m, respectively. Results and conclusions: The results showed a statistical significance between all birth conditions. NL does not exist in still birth cases (p < 0.001). Not only is the presence of NL a sign of live birth, but also its thickness is an indicator of the delivery mode where NL thickness of normal birth was found thicker than the caesarean cases. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
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    Occlusal Thickness and Cement-Type Effects on Fracture Resistance of Implant-Supported Posterior Monolithic Zirconia Crowns
    (Quintessence Publishing Co Inc, 2021) Bulut, Ali Can; Atsu, Saadet Saglam
    Purpose: To evaluate the factors that could influence the fracture resistance of implant-supported posterior monolithic zirconia crowns. Materials and Methods: Sixty zirconia molar crowns with three different occlusal thicknesses of 0.5, 1.0, and 1.5 mm (20 samples per group) were prepared for implant abutments using a CAD/CAM system. In each group, 10 crowns were luted on the abutment with resin cement (Panavia F), and the other 10 crowns were luted with resin-modified glass-ionomer cement (Ketac Cem Plus). Dynamic loading (1.2 x 10(6) cycles; 70 N) and thermal cycling were applied to the samples using a chewing simulator before evaluating their fracture resistance with a universal testing machine and examining their fracture type using a stereomicroscope. One-way analysis of variance (ANOVA), the Duncan test, and two-way ANOVA were used for data evaluation (alpha = .05). Results: The occlusal thickness (P < .001) and cement type (P < .01) affected the fracture load of the monolithic zirconia crowns. The highest fracture resistance was found in 1.5-mm-thick crowns luted with resin cement (4,212 +/- 501 N), and the lowest fracture resistance was found in 0.5-mm and 1-mm-thick crowns luted with resin-modified glass-ionomer cement (1,198 +/- 116 N and 1,197 +/- 66 N). A significant difference was not found in the mean maximum fracture load between the 1.5-mm-thick crowns cemented with resin cement and glass-ionomer resin cement. Conclusion: Both the occlusal thickness and cement type remarkably affected the fracture resistance of the crowns, but occlusal thickness was more significant. Implant-supported posterior zirconia crowns can withstand physiologic occlusal forces even with a thickness as low as 0.5 mm. Resin luting cement is recommended for implant-supported posterior zirconia crowns with reduced occlusal thickness.
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    Oral parafunctions, personality traits, anxiety and their association with signs and symptoms of temporomandibular disorders in the adolescents
    (Makerere Univ, Fac Med, 2019) Atsu, Saadet Saglam; Guner, Sibel; Palulu, Nilgun; Bulut, Ali Can; Kurkcuoglu, Isin
    Objectives: To investigate the association between oral parafunctions, personality traits, anxiety and signs and symptoms of temporomandibular disorders in the adolescents. Methods: Two hundred and seventy adolescents were examined clinically for the signs and symptoms of temporomandibular disorders. Participants completed questionnaires about demographic variables, medical history, symptoms of temporomandibular disorders, parafunctional oral habits, Minnesota Multibasic Personality Inventory, and Spielberger State-Trait Anxiety Inventory. Results: Logistic regression analyses revealed that bruxism was associated with joint tenderness (Odds ratio (OR)=6.38, p < 0.01), joint noises (OR=6.02, p < 0.01) and masticatory muscle tenderness (OR=4.19, p < 0.05) to palpation. State anxiety showed increased risk of joint tenderness (OR=2.47, p < 0.05) and muscle tenderness (OR=3.25, p < 0.05) to palpation. Conclusion: Within the limitations of this study, it was concluded that oral parafunctions, especially bruxism, state anxiety, depression and hysteria were associated with signs and symptoms of temporomandibular disorders in adolescents.
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    The effect of nanocoatings of SiO2, TiO2, and ZrO2 on titanium- porcelain bonding
    (Mosby-Elsevier, 2021) Atsu, Saadet Saglam; Aksan, Muhammed Emin; Bulut, Ali Can; Tamimi, Faleh
    Statement of problem. Durable titanium-porcelain bonding is challenging because of the formation of a thick oxide layer on the surface during porcelain firing. Purpose. The purpose of this in vitro study was to evaluate how atomic layer deposition (ALD) of different oxide coatings affected titanium-porcelain bonding and failure types. Materials and methods. Forty-four airborne-particle abraded Type-2 titanium specimens were coated by ALD with either SiO2, TiO2, or ZrO2 (n=11) at a thickness of 30 nm, whereas control specimens were left uncoated (n=11) (airborne-particle abraded only). The surface roughness of the specimens was analyzed with a profilometer before applying porcelain (Vita Titankeramic). Titanium-porcelain bonding was analyzed by using a 3-point bend test. Surface properties and titanium-porcelain interfaces were examined under scanning electron microscopy combined with energy-dispersive spectroscopy, and failure types were evaluated by using a stereomicroscope. Surface roughness and bond strength data were analyzed by 1-way ANOVA and Tukey HSD tests. Failure type data were analyzed by the Fisher-Freeman-Halton exact test (alpha=.05). Results. All nanocoatings increased surface roughness values, but only TiO2 and ZrO2 coatings showed statistically significant higher roughness than the control surfaces (P<.001). Specimens coated with SiO2 (28.59 +/- 4.37 MPa) and TiO2 (26.86 +/- 3.66 MPa) presented significantly higher bonding strength than control (22.04 +/- 4.59 MPa) specimens (P<.01). Fracture types of different groups were not statistically different (P>.05). Conclusions. Nanocoating titanium surfaces with SiO2 and TiO2 by using the ALD technique significantly improved titanium-porcelain bonding.
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    The effect of nanocoatings of SiO2, TiO2, and ZrO2 on titanium-porcelain bonding
    (Mosby Inc., 2021) Atsu, Saadet Saglam; Aksan, Muhammed Emin; Bulut, Ali Can; Tamimi, Faleh
    Statement of problem: Durable titanium-porcelain bonding is challenging because of the formation of a thick oxide layer on the surface during porcelain firing. Purpose: The purpose of this in vitro study was to evaluate how atomic layer deposition (ALD) of different oxide coatings affected titanium-porcelain bonding and failure types. Material and methods: Forty-four airborne-particle abraded Type-2 titanium specimens were coated by ALD with either SiO2, TiO2, or ZrO2 (n=11) at a thickness of 30 nm, whereas control specimens were left uncoated (n=11) (airborne-particle abraded only). The surface roughness of the specimens was analyzed with a profilometer before applying porcelain (Vita Titankeramic). Titanium-porcelain bonding was analyzed by using a 3-point bend test. Surface properties and titanium-porcelain interfaces were examined under scanning electron microscopy combined with energy-dispersive spectroscopy, and failure types were evaluated by using a stereomicroscope. Surface roughness and bond strength data were analyzed by 1-way ANOVA and Tukey HSD tests. Failure type data were analyzed by the Fisher-Freeman-Halton exact test (?=.05). Results: All nanocoatings increased surface roughness values, but only TiO2 and ZrO2 coatings showed statistically significant higher roughness than the control surfaces (P<.001). Specimens coated with SiO2 (28.59 ±4.37 MPa) and TiO2 (26.86 ±3.66 MPa) presented significantly higher bonding strength than control (22.04 ±4.59 MPa) specimens (P<.01). Fracture types of different groups were not statistically different (P>.05). Conclusions: Nanocoating titanium surfaces with SiO2 and TiO2 by using the ALD technique significantly improved titanium-porcelain bonding. © 2021 Editorial Council for the Journal of Prosthetic Dentistry