Ocular prostheses play a crucial role in restoring both functional and esthetic outcomes for patients with anophthalmia. However, long-term complications such as iris discoloration are frequently encountered and often require clinical intervention. This case report describes the esthetic rehabilitation of a discolored ocular prosthesis in a 50-year-old male who had been wearing the prosthesis for three years. The discoloration, which compromised facial symmetry and patient confidence, was managed through a conservative and cost-effective approach. The procedure involved removal of the discolored iris, digital imaging of the contralateral eye, and fabrication of a new iris using high-resolution digital photography, followed by repolishing and reinsertion without altering the original scleral structure. The outcome demonstrated excellent esthetic integration and high patient satisfaction, eliminating the need for complete prosthesis replacement. This report highlights the clinical value of digital iris reproduction as a minimally invasive, time-efficient, and cost-effective technique for ocular prosthesis modification.
Objectives: The purpose of this study was to examine the mechanical and structural characteristics of titanium-reinforced platelet-rich fibrin (T-PRF) in individuals with and without periodontitis. Methods: Twenty-one healthy individuals and twenty-one patients with periodontitis had their T-PRF samples taken. Haematological study of the entire blood picture, mechanical qualities (tensile strength), and structural characteristics (predominant cell types and fibrin network) were assessed.Results: T-PRF's mechanical and structural properties differed between patients with and without periodontitis. Individuals with periodontitis had lower fibrin networks and T-PRF tensile strengths than those who were healthy.Conclusions: This study shows whether periodontitis influences the mechanical and structural properties of T-PRF, which could affect its efficacy in clinical applications. Understanding these differences is critical for maximising T-PRF's regenerative capabilities in periodontal treatment.
Objective: The aim of this study was to evaluate the diagnostic performance of ChatGPT-5.1 in determining the presence or absence of apical lesions on panoramic radiographs based on visual input and to analyze the obtained results on a jaw-specific basis. Materials and Methods: A total of 207 anonymized panoramic radiographs were retrospectively analyzed. In each radiograph, the region in which an apical lesion was present was recorded as “lesion-present,” whereas the contralateral jaw region without an apical lesion on the same radiograph was considered “lesion-absent.” In this context, each lesion-present and lesion-absent region was treated as an independent unit of analysis. All evaluations were independently performed by ChatGPT-5.1 using standardized and anatomically restricted prompts that clearly defined the jaw (maxilla/mandible), side (right/left), and anatomical region. Model outputs were classified as true positive, true negative, false positive, or false negative. Sensitivity, specificity, accuracy, and F1 score were calculated for overall performance and on a jaw-specific basis. Results: Overall sensitivity, specificity, accuracy, and F1 score of ChatGPT-5.1 were 67.15%, 60.87%, 64.01%, and 65.11%, respectively. Tooth-level detection sensitivity was 67.6%. Mandibular performance was higher than maxillary performance (accuracy: 67.52% vs. 57.14%; tooth-level sensitivity: 69.89% vs. 63.04%). Concusion: ChatGPT-5.1 demonstrated a moderate level of diagnostic performance in detecting apical lesions on panoramic radiographs. The findings indicate that the model is not suitable for use as a standalone reliable diagnostic tool.
Objectives: Silver diamine fluoride (SDF) is widely recognized as an effective, minimally invasive agent for caries management. Despite its cariostatic and preventive benefits, the main drawback is the dark discoloration of dental hard tissues. This in vitro study aimed to evaluate the discoloration potential of 38% SDF on sound enamel surfaces of primary and permanent teeth, and to assess the mitigating effects of potassium iodide (KI) and post-treatment rinsing.Materials and Methods: A total of 120 extracted molars (primary and permanent, n = 60 each) with intact enamel were randomly allocated into eight groups (n = 15) according to treatment protocol: SDF without rinsing, SDF with rinsing, SDF + KI without rinsing, and SDF + KI with rinsing. Color measurements (CIE Lab* system) were recorded using a spectrophotometer at baseline, immediately after application, 24 hours, 72 hours, and 1 week. Color change (ΔE) values were calculated, with ΔE ≥ 3.7 considered clinically perceptible. Statistical analysis was performed with significance set at p < 0.05.Results: SDF without rinsing produced the greatest discoloration in both dentition types (p < 0.001), with ΔE values exceeding the perceptibility threshold at all time points. The combination of SDF + KI followed by rinsing resulted in the lowest ΔE values, remaining below clinical significance during early intervals. Groups treated with KI alone or rinsing alone exhibited intermediate levels of staining, without significant differences between them (p > 0.05). Permanent teeth generally showed more pronounced darkening than primary teeth.Conclusions: Within the limitations of this in vitro study, 38% SDF caused clinically perceptible discoloration on sound enamel of both primary and permanent teeth, especially without rinsing. The adjunctive use of KI with immediate rinsing effectively minimized staining. Clinicians should exercise caution when applying SDF to esthetically sensitive areas, and inform patients or caregivers of potential discoloration risks.
Objective: This study aimed to investigate the relationship between the presence of nutrient canals and potential trabecular bone changes in jaws with or without cysts, using two different classification methods. Materials and Methods: CBCT images from 60 patients with unilateral jaw cysts located in either the maxilla or mandible were reviewed retrospectively. Cyst-affected sides with or without nutrient canals were grouped and compared to all unaffected sides combined. Trabecular bone quality was assessed both qualitatively (visual trabecular pattern classification) and quantitatively (modified Lekholm and Zarb classification based on HU ranges). Fisher’s Exact and Fisher-Freeman-Halton tests were used to compare frequencies between groups. Intra-observer reliability was assessed using Kappa statistics. Significance was set at p < 0.05.Results: Nutrient canals were significantly associated with sclerotic trabecular bone patterns in cyst-affected regions (p = 0.001), with nutrient canals more frequent in areas of “average” or “above-average” trabecular density. Nutrient canals also showed a significant association with the highest bone density category (Q1) in both cystic (p < 0.001) and non-cystic regions (p = 0.003). A significant association was observed between qualitative and quantitative classifications (p < 0.001). Intra-observer reliability was moderate for visual trabecular assessments and high for the quantitative classification.Conclusion: Sclerotic changes in the trabecular bone around jaw cysts are closely associated with occurrence of nutrient canals, potentially reflecting compensatory vascular adaptation. Nutrient canals should be clearly documented in CBCT reports. The modified Lekholm and Zarb classification may serve as a reliable alternative to visual methods for assessing bone quality on CBCT images.
A 56-year-old female on long-term methotrexate presented with painful oral ulcerations diagnosed as erythema multiforme. Despite continued methotrexate use, lesions resolved with acyclovir and corticosteroids, confirming herpes simplex virus-associated erythema multiforme. This case highlights the importance of therapeutic response in distinguishing viral triggers from drug-induced causes for accurate management.
Applications of artificial intelligence (AI) are increasingly becoming an indispensable component of orthodontic practices. The number of AI studies focused on orthodontics is growing rapidly. The fundamental operations of the AI algorithms utilized in these studies typically rely on binary logic (black or white, or 0 or 1). However, binary logic does not fully reflect the complexities of real life. Reality is more nuanced, with shades of gray and irregularities. Therefore, fuzzy logic-based AI systems, which mimic human-like reasoning, may facilitate more optimal and realistic decision-making in the healthcare and orthodontics fields. This article aims to introduce the concept of fuzzy logic to orthodontists, demonstrate its application through clinical case examples, emphasize the importance of adopting a fuzzy logic approach in treatment planning, and raise awareness among orthodontists about the potential for fuzzy logic AI to play a more prominent role in orthodontic practice in the future.
Objective: Periodontology postgraduate education in Turkiye is provided through doctoral (Ph.D.) and specialty programs, both requiring the completion of a thesis. Publication and citation of thesis-derived research are recognized indicators of academic quality, yet limited data compare these programs within the same timeframe. This study aimed to evaluate and compare the quality of Ph.D. and specialty theses completed between 2015 and 2019, based on publication rates and citation performances.Materials and Methods: A total of 299 theses (119 Ph.D., 180 specialty) archived in the National Thesis Center were examined. Thesis characteristics (year, author gender, supervisor’s academic title, study design, topic, follow-up period, and evaluated parameters) were recorded. Publication status, indexing category, journal quartile, and citation counts were determined. Results: The overall publication rate was 50.8%, with no significant difference between Ph.D. (54.6%) and specialty theses (48.3%) (p=0.287). Among published theses, 70.8% of Ph.D. and 62.1% of specialty theses appeared in Science Citation Index (SCI)/SCI-Expanded journals. Citation performance, including cited publications, total citations, and mean citation rates, was also similar (p>0.05 for all). Demographic and descriptive parameters, such as supervisor’s academic title, study design, topic, and follow-up period did not influence publication and citation status.Conclusion: Ph.D. and specialty theses in periodontology completed between 2015 and 2019 demonstrated comparable publication rates and citation performances, suggesting that specialty theses are non-inferiority to Ph.D. theses. Strengthening the dissemination of thesis-derived publications will enhance scientific visibility and support the dual mission of postgraduate periodontology training by advancing clinical expertise and fostering academic scholarship.
Background and Objectives: The pursuit of enhanced bond strength between ceramic restorations and dentin has led to the development of immediate dentin sealing (IDS) as a promising technique. However, it is crucial to assess the effect of IDS on microleakage to ensure the long-term success and durability of these restorations. This study aimed to compare the microleakage of ceramic onlays bonded using IDS and delayed dentin sealing (DDS) protocols.Materials and Methods: Twenty recently extracted human maxillary premolars were randomly allocated into two groups (n = 10 each) based on the dentin sealing technique employed. The first group received immediate dentin sealing (IDS), whereas the second group underwent delayed dentin sealing (DDS). Standardized cavities were prepared, and the dentin surfaces were sealed or left unsealed accordingly. Impressions were taken, and temporary restorations were fabricated. The wax patterns were milled, and the onlays were fabricated by heat-pressing technique using lithium disilicate glass-ceramic. The restorations were bonded, thermocycled, and immersed in methylene blue solution. Microleakage was evaluated by examining the degree of dye penetration using a stereomicroscope.Results: The Mann-Whitney U test revealed no significant differences in microleakage between the two groups at the occlusal, palatal, and proximal margins.Conclusions: Within the limitations of this in vitro study, the findings suggest that the IDS technique does not significantly influence the microleakage of ceramic onlays compared to the DDS protocol.
Objectives: To establish cephalometric norms for various nasal parameters in skeletal normodivergent Malaysian Malay adult females, and to compare nasal parameter differences across normo-, hypo-, and hyperdivergent vertical skeletal dimensions. Materials and Methods: This retrospective study analysed 156 pre-orthodontic lateral cephalometric radiographs of skeletal Class I Malay females aged 18 to 30 years (mean age= 24.12 ± 3.38). Cephalograms were categorised into normodivergent (MMPA: 24.8° ± 6.7°), hypodivergent (<18.1°), and hyperdivergent (>31.5°). Sixteen nasal parameters were manually traced, comprising nine linear (nasal depth 1, nasal depth 2, nasal bone length, nasal length, columella convexity, nasal dorsum axis, nasal tip protrusion, nasal height, and hump) and seven angular (nasomental, nasofrontal, nasofacial, nasolabial, nasal tip, soft tissue facial convexity, and nasal bone angles) parameters. One-way ANOVA with Bonferroni post-hoc test (p< 0.05) was used to compare mean nasal parameters across the three vertical skeletal groups. Intra- and inter-examiner reproducibility was assessed using the Intraclass Correlation Coefficient (ICC) with remeasurements made after one week. Results: ICC analysis demonstrated excellent intra- and inter-examiner reliability (0.93 and 0.91, respectively). No significant differences were observed in linear nasal parameters across all groups except nasal depth 2 (p = 0.02) which was significantly greater in normodivergent than hyperdivergent group. No significant differences were found in angular nasal parameters. Conclusions: Nasal cephalometric norms in normodivergent Malaysian Malay female were established, providing an essential reference data for nasal assessment. Nasal depth 2 varied significantly across groups, suggesting that vertical skeletal pattern can influence this specific nasal variable, which is crucial for improving orthodontic and surgical treatment planning in the Malay population.
Objective: Oral contraceptives (OCs) are widely prescribed hormonal agents that may influence bone homeostasis due to their estrogen content. Estrogen is essential for maintaining skeletal integrity, primarily by modulating osteoblast and osteoclast activity. This study aimed to evaluate whether combined oral contraceptive (COC) use affects mandibular bone microarchitecture using fractal dimension (FD) analysis and panoramic mandibular index (PMI) assessments. Methods: A case-control design was employed, analyzing digital panoramic radiographs from 290 women aged 18–50, including 145 COC users and 145 age-matched controls. FD values were determined from three mandibular sites: the condyle, angle, and interdental region. PMI values were also computed. Data were analyzed using SPSS software version 21.0 (IBM Corp., Armonk, NY, USA), p<0.05 was considered significant. Results: There were no statistically significant variations in FD values observed between the COC user group and the control group in the condylar (p=0.183), angular (p=0.603), or interdental (p=0.159) areas. Likewise, there was no significant difference in PMI values between the two groups (p=0.183). Additionally, neither FD nor PMI values were significantly associated with estimated duration of contraceptive use. Conclusion: Based on FD and PMI measurements, the study found no evidence that COC use leads to notable alterations in mandibular bone structure. These results suggest that estrogen-containing contraceptives may not adversely affect jawbone health in premenopausal women.
Objectives: This study aimed to assess the knowledge and awareness of family medicine resident in Turkey regarding avulsion injuries, a severe form of dental trauma. Materials and Methods: A cross-sectional, survey-based study was conducted in November 2023, involving 138 family medicine resident physicians from various universities and training hospitals across Turkey. Data were collected via an online questionnaire designed to evaluate participants' demographic information, educational background, and knowledge of dental avulsion management. Results: Of the 138 participants, 68.8% were female and 31.2% were male, with an average age of 30 years and an average professional experience of 5 years. A significant portion (91.3%) had not received any training related to dental trauma, and 64.5% expressed a desire for such training. Only 7.2% of the resident physicians knew that an avulsed permanent tooth should be immediately reimplanted, while 85.5% preferred to refer the patient to a dentist without reimplanting the tooth due to infection risks. Furthermore, 73.9% of participants indicated insufficient knowledge about dental avulsion, and 54.3% acknowledged the importance of cleaning the avulsed tooth, with 31.2% preferring saline solution. Conclusions: Family medicine resident physicians demonstrated inadequate knowledge about avulsion injuries and their management. It is recommended that emergency dental treatment and management courses, provided by dentists, be incorporated into the training programs for medical branches frequently encountering dental trauma patients. Enhancing resident physician awareness and knowledge is crucial for improving the prognosis of dental trauma patients through proper initial intervention.
Objectives: Chlorhexidine, a key component of periodontal treatments and preventive dentistry, can occasionally cause various side effects. This study aims to compare the adverse effects of chlorhexidine used in dental applications, analyzing them by demographic factors and severity, as reported in the Food and Drug Administration Adverse Event Reporting System. Materials and Methods: Dental adverse event reports related to the use of chlorhexidine for dental and/or oral reasons, from the Food and Drug Administration Adverse Event Reporting System database, were retrospectively analyzed from the reporting start date to December 2025. Adverse effects were categorized based on the patients' demographic and clinical characteristics and compared according to their severity. Results: A search of the database using the keywords "chlorhexidine" and "chlorhexidine gluconate" related to dental and oral indications between 1977 and 2025 identified a total of 651 cases. Of these, 407 cases (62.5%) were classified as serious, and 18 deaths have been reported. Among the cases, 66.4% involved females, 26.3% involved males, and gender information was not reported for 7.4%. Regarding age distribution, most cases (46.4%) occurred in individuals aged 18–64 years. Of these cases, 37.6% reported only systemic adverse effects, 45.9% reported only dental/oral adverse effects, and 16.4% reported both systemic and oral adverse effects. Among dental/oral adverse events, tooth discoloration, dry mouth, and gingival pain were the most frequently reported, while the highest Reporting Odds Ratio (ROR) value was observed in taste disorder (ROR: 378.7). Conclusions: The data reveal that a significant proportion of adverse events reported from chlorhexidine use for dental and/or oral purposes involved mucosal, periodontal and inflammatory reactions. While serious consequences were linked to the use of additional medications, it is important to emphasize that 18 fatalities were reported. Integrating clinical evidence with pharmacovigilance data has the potential to influence clinicians’ prescribing preferences for chlorhexidine in dental practice, facilitating more informed and evidence-based decision-making. Keywords: Chlorhexidine, chlorhexidine gluconate, pharmacovigilance, tooth discoloration, United States Food and Drug Administration
Objective: This study aimed to investigate the presence, number, and bilateral distribution of the zygomaticofacial foramen (ZFF) in a Central Anatolian population using cone-beam computed tomography (CBCT), and to evaluate potential sex-related differences in its anatomical characteristics.Materials and Methods: A total of 550 CBCT images from patients aged 16–85 years (273 males, 277 females) were analyzed. High-quality CBCT images were included, while patients with craniofacial anomalies, trauma, or orthodontic treatments were excluded. Image evaluation was performed using OnDemand 3D Imaging Software, and statistical analyses were conducted using SPSS (version 22.0). Chi-square analysis was used to compare ZFF presence and distribution between sexes and sides.Results: At least one ZFF was present in 211 patients, while 339 patients had no foramen. On the right side, one foramen was observed in 117 patients, two in 40, and three in six. On the left side, 1 foramen was detected in 136 patients, 2 in 20, and 3 in 3. A statistically significant difference was found with respect to foramen presence between the right and left sides (p0.05).Conclusions: CBCT imaging effectively identifies anatomical variations of ZFF, assisting in preoperative planning for maxillofacial surgeries. The findings highlight the importance of considering individual anatomical differences during surgical interventions. Further large-scale, multi-center CBCT studies are needed to explore ethnic variations in ZFF anatomy.Keywords: anatomical variation, cone-beam computed tomography, maxillofacial radiology, maxillofacial surgery, zygomaticofacial foramen
Objectives: This in vitro study aims to evaluate the accuracy of root canal working length measurements made by the Raypex 6 electronic apex locator in the presence of QMix, 40% citric acid, 5.25% NaOCl, 17% EDTA, and 2% CHX irrigation solutions, in comparison to the actual working length (AWL).Materials and Methods: Eighty caries-free mandibular premolars were used in the study. The AWL for each tooth was determined under a microscope with a size 10/.02 K-type file. The teeth were placed in a simulated oral environment apparatus, and measurements were taken with the Raypex 6 using five different irrigation solutions. After the application of each solution, the canal was irrigated with 0.9% saline and dried with paper points. The measurements were compared using repeated measures ANOVA and the Bonferroni post-hoc test (p
Objectives: Dental implantology has become a contemporary and important component of dentistry practice, the importance of which is increasing. The fact that dental implantology has become an important treatment option in dentistry practice reveals the importance of implantology education. The aim of this survey study is to evaluate undergraduate and postgraduate dental implantology education in Turkey by undergraduate dentistry students.Materials and Methods: A total of 233 5th year undergraduate dentistry students who completed dental implantology theoretical training from three different dentistry faculties were included in the study. Participants were asked to fill out a printed survey consisting of a total of 20 questions with different answer options. The survey aimed to obtain the participants' opinions on various topics such as implantology education, educational qualifications, practice authorizations, postgraduate dental implantology education, adequacy of courses, and standardization of education levels. Results: A total of 233 participants (110 male, 123 female) were included in the study. The distribution of the answers to the survey questions according to the faculties was tabulated. The answers to the open-ended questions were categorized and classified. According to the results of the study, the participants think that dental implantology education provided until graduation in Turkey is inadequate. It is thought that the lack of education is especially in clinical practice and according to the study results, the practical aspect of dental implantology education should be strengthened. The study results indicate that dental implantology education in Turkey should be standardized at an international level and indicate that universities have an importance in this standardization. Conclusions: Intern dentists do not consider themselves competent in performing dental implantology treatments after graduation, and the majority of participants find dental implantology courses useful. In addition, participants state that the courses should be provided by universities.
Objectives: This study aimed to determine the correlation between gloss and roughness in low-viscosity bulk fill composite resins. Materials and methods: The study had an experimental, analytical, prospective, and cross-sectional design, with a sample of 60 blocks of low-viscosity resins distributed into three groups of 20 units each: Group 1—3M Filtek Bulk Fill Flow (FBF), Group 2—Opus Bulk Fill Flow APS (OBF), Group 3—Opalis Flow (OF) (Control). Gloss and roughness were measured using a gloss meter and a contact roughness meter. In the descriptive analysis, measures of central tendency and dispersion were calculated. The normality of the data was evaluated using the Shapiro-Wilk test. For the comparison of roughness between resins, the ANOVA test was applied, and for gloss, the Kruskal-Wallis test was applied, both with Tukey and Dwass-Steel-Critchlow-Figner post-hoc tests, respectively. The relationship between variables was measured using Pearson and Spearman correlations. The data were processed using the SPSS statistical package, considering a significance level of 0.05. Results: The FBF resin had the highest average roughness, while OF had the lowest value; in addition, OF had the highest gloss values. On the other hand, there was a statistically significant high negative correlation between roughness and gloss (p<0.01). Conclusions: There was an inverse relationship between roughness and gloss regardless of the type of resin evaluated.
Aim:Dentin hypersensitivity (DH) is a common dental complaint, and many patients now seek information from AI chatbots. Yet, the accuracy, reliability, and readability of chatbot-generated DH content remain uncertain.Materials and Methods:A consensus-based DH question set was presented to three AI chatbots (ChatGPT-4o, DeepSeek, Copilot) in independent, standardized sessions. Three blinded periodontologists evaluated the responses using CLEAR, mGQS, accuracy scores, DISCERN, and readability metrics (FRE, FKGL). Non-parametric tests compared inter-model differences.Results:Significant differences were found in FKGL (p=0.025), DISCERN (p=0.004), and response length (p
Intentional replantation is a procedure based on the principle of extracting the tooth in cases where endodontic treatment has failed through conventional or surgical approaches, evaluating and treating the root end extraorally, and then replanting the tooth into its socket. This case report presents the treatment of two cases using the intentional replantation method: one in which healing was not observed after retreatment, and another with external root resorption. In both cases, clinical and radiographic evaluations performed 12 months after replantation revealed continued healing and function.
Objectives: Wound dressings protect the wound and accelerate the healing of ulcers. This study was designed to assess the impact of distinct the impact of oral dressings for the wound healing phase of experimentally produced traumatic oral ulcers.Materials and Methods: The study included 45 male Sprague-Dawley rats, which were randomly allocated into three groups: Group 1, Group 2 and Control Group.Two different wound dressings were applied: hyaluronic acid (Group 1) and a wound dressing composed of a combination of bioactive materials (Group 2). Tissue samples were taken in the 3rd, 7th,14th days and evaluated histopathologically. The Kruskal–Wallis test was applied to compare numerical data across groups, followed by post-hoc testing to identify intergroup differences. Categorical variables were compared using the Chi-square test.Results: Group 1 exhibited enhanced overall efficacy, with a notable decrease in ulceration recorded on days 3, 7, and 14 in Group 2. Edema was more noticeable in Group 2 than in Group 1. Group 2 revealed superior efficacy in facilitating granulation tissue production in early phase. Both groups demonstrated enhanced migration of polymorphonuclear leukocytes and mononuclear cells to the ulcer location. Conclusions: Both wound coverings positively affected the wound healing process by regulating distinct phases of healing.
