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Öğe Accuracy of Proximal Caries Depth Measurements: Comparison of Two Computed Cone Beam Tomography and Storage Phosphor Plate Systems(Galenos Yayincilik, 2017) Sener, Elif; Baksi, B. Guniz; Horasan, Sinan; Grondahl, Hans-Goran; Kose, TimurObjective: The aim of this study was to compare the accuracy of NewTom 9000 [cone beam computerized tomography (CBCT)], Accu-I-Tomo [limited CBTC (LCBCT)] and Digora Optime [storage phosphor plate (SPP)] imaging systems in assessing the depths of defects with different shapes and sizes on the proximal surfaces of teeth. Materials and Methods: Thirty out of 50 incisive teeth with sound proximal surfaces were divided into three equal groups. Mechanical defects of different sizes and depths were created on their proximal surfaces and teeth were placed in acrylic blocks with approximal contacts. Radiographs of the blocks were obtained with CBCT, LCBCT and SPP systems. The depth measurements of 60 artificial defects were performed by 3 radiologists in the digital radiographs. The gold standard (true measure) was defined as the mean of the 2 observers' measurements on the microscopic sections. Results from imaging systems and true depths were compared using Bland-Altman plots. The agreement was determined with intra-class correlation coefficient. Results: Maximum deviation from the true length in axial and sagittal slices of CBCT system was 2 mm [95% confidence interval (CI) 2.60-0.60] and 1.5 mm (95% CI 0.30-2.30) respectively while the deviation of LCBCT was 0.66 mm (95% CI 0.53-2.22) and 0.37 mm (95% CI 0.50-2.25). The deviation from truth for SPP was 0.66 mm (95% CI 0.33-2.25). Correlation among observers was 0.487 and 0.700 respectively, for CBCT axial and sagittal slices; while it was 0.979 and 0.985 for LCBCT and 0.979 for SPP. Conclusion: Images obtained with the Accu-I-Tomo LCBCT system were more accurate than Newtom CBCT and Digora SPP system for measurement of caries lesion depth. Correlation among observers was higher for LCBCT and SPP systems compared with CBCT system.Öğe Anatomical landmarks of mandibular interforaminal region related to dental implant placement with 3D CBCT: comparison between edentulous and dental mandibles(Springer France, 2018) Sener, Elif; Onem, Erinc; Akar, Gulcan Coskun; Govsa, Figen; Ozer, Mehmet Asim; Pinar, Yelda; Mert, Ali; Sen, B. Guniz BaksiAnterior mandibular (interforaminal) region is important in implant applications as it serves a basis for neurovascular bedding and holds the prosthesis for patients. Treatment planning for dental implant patients is often complicated by the unknown extent of the anterior loop of the neurovascular bundle. Anatomical structures including mandibular incisive canal (MIC) and lingual foramen (LF) should also be examined as part of the detailed analysis for their neurovascular structures. This study aimed to detect the positions of LF and MIC as well as the prolongation of interforaminal region in Anatolian population to supply the reference data of the surgical safe zone in chin for the clinicians. Mandibles of 70 adult specimens (35 edentulous + 35 dentate) were retrieved from the Department of Anatomy, Ege University. Images of the dry mandibles were obtained using a cone beam computed tomography unit applying a standardized exposure protocol. Afterwards, mandibles were sawn into vertical sections according to the respective tomographic cross-sections. Images were evaluated for the absence/presence of the MIC, its dimensions and antero-posterior length for both edentulous and dentate groups. In addition; the presence, number, location, labial canal and LF diameter and height of the LF were determined for both groups. The MIC was observed in 80 and 68.6% of the dentate and edentulous groups, consecutively (p > 0.05). The MIC continued towards the incisor region in a slightly downward direction. The LF was observed in all dentate mandibles (100%), while it was present in 94.3% of the edentulous mandibles (p > 0.05). For the dentate group, 62.9% of the specimens had two foramens and 20% had three foramens in the mandibular midline. Mean length of the MIC in dentate groups and edentulous groups was measured as 2.55 +/- 0.809 and 3.08 +/- 1.745 mm, respectively. Well-defined MIC mean diameter in dentate groups and edentulous groups were measured as 2.44 +/- 0.702 and 2.35 +/- 0.652 mm, respectively. Significant difference was found between dentate and edentulous group in most of the parameters except for the LF and the diameter of the MIC (p > 0.05). The correlation between observers' measurements ranged between 0.742 and 0.993 for all anatomical landmarks and mandible groups. The MIC and LF are associated with neurovascular bundle variations in number, location and size. Therefore, clinicians should determine each of these anatomical structures on a case-by-case basis to recognize their presence and to take measures for the possible implications of various treatment options. These guidelines included leaving a 2 mm safety zone between an implant and the coronal aspect of the neurovascular bundle. To avoid neurovascular injury during surgery in the interforaminal area, guidelines were developed with respect to validating the presence of an anterior loop of the neurovascular bundle.Öğe Assessment of the canal anatomy of the premolar teeth in a selected Turkish population: a cone-beam computed tomography study(BMC, 2023) Erkan, Erhan; Olcay, Keziban; Eyuboglu, Tan Firat; Sener, Elif; Gundogar, MustafaBackgroundTeeth may have additional roots and a different number of root canals. Overlooked root canals may cause endodontic failure. The aim of this study was to investigate the prevalence of root canals and the number of roots of premolars in a selected Turkish population.Materials and methodsA total of 2,570 teeth from 1,438 patients were evaluated. The cone-beam computed tomography scans of 1,055 maxillary and 1,515 mandibular premolars were examined.ResultsType IV root canal morphology was observed most frequently in maxillary first premolars (77%), and the rates of single and double channel formations were very similar (51% and 49%, respectively). Of the second maxillary premolars, 57.4% had Type I morphology, and 89.9% of the teeth were single-rooted, while 68.6% had a single root canal. The most common formation was Type I (85%) among mandibular first premolars, and a single root was observed in 95.6% of these teeth. In addition, 87% of the mandibular first premolars had a single root canal. The second mandibular premolars mostly had Type I (95.4%) formation, and 99.3% of the teeth were single-rooted, while 96.9% had a single root canal.ConclusionAccording to our findings, 51% of maxillary first premolars had a single root, 79.4% had two root canals, and 77% had Type IV (77%) formation. Maxillary second premolars mostly had Type I formation. In addition, a single root and single root canal formation were most common. Mandibular first premolars generally had a single root and single root canal formation, but 13% had two root canals, and 6.4% had Type V formation. More than 95% of mandibular second premolars had Type I formation.Öğe Deep learning for automated detection and numbering of permanent teeth on panoramic images(British Inst Radiology, 2022) Gurses, Baris Oguz; Sener, Elif; Guneri, Pelin[No Abstract Available]Öğe Effect of Cone beam Computed Tomography on Treatment Decision of Wisdom Tooth(Galenos Yayincilik, 2021) Yuce, Meltem Ozden; Sener, Elif; Isik, Gozde; Adali, Emine; Koyuncu, Banu Ozveri; Baksi, Bedriye Guniz; Gurhan, CeydaObjective: This diagnostic accuracy study aimed to evaluate the relationship between mandibular third molars (M3) and mandibular canal (MC) using panoramic radiographs (PR) and cone-beam computed tomography (CBCT) and to assess the effect of CBCT on treatment decision. Materials and Methods: CBCT scans of 150 patients with close association between MC and M3 on PR were included in the study. The degree of superimposition, Buccolingual position (buccal, central and lingual) and physical relationship (separation, contact and involved) were measured on CBCT images. Fisher's Exact test was used to evaluate differences between PR and CBCT. Results: All M3 were directly superimposed on the MC on PR; however, CBCT showed separation from the canal in 10% of M3 roots. Evaluation of CBCT images revealed that the probability to observe an involvement was significantly higher when the MC was in the lingual position (57.6%) than in other positions. Conclusion: Three-dimensional imaging is very useful to clarify the true relationship between M3 and MC relative to two-dimensional panoramic images, and the clinician may decide to change the treatment plan based on CBCT images in patients with high risk. Nevertheless, PR can be considered an acceptable diagnostic method with low radiation dose compare with CBCT.Öğe Effect of Tube Current on Linear Measurement Accuracy of Cone Beam Computed Tomography Images(Bentham Science Publ Ltd, 2018) Sener, Elif; Onem, Erinc; Mert, Ali; Baksi, B. GunizObjective: To compare the accuracy of linear bone measurements on Cone Beam Computed Tomography (CBCT) images obtained using different tube currents. Methods: Twelve reference points were prepared by using burs and heated gutta-percha on each of the ten dry mandibles for horizontal and vertical measurements on anterior and posterior segments. Images were obtained with Kodak 9000 3D cbct system at 5 different tube currents (2 mA, 3.2 mA, 6.3 mA, 10 mA and 15 mA). Three radiologists did total of 1200 linear measurements. True lengths were determined with a digital caliper. Height and width measurements from each of the mA settings were compared to the gold standard using Bland and Altman plots. Overall comparison of the measurements was done using repeated measures ANOVA. Correlation between individual measurements of each observer was assessed with Pearson's correlation analysis. Results: No differences were found in the height and width measurements for both anterior (p>0.05) and posterior (p>0.05) measurements for different mA settings. Increase in mA caused an increase in the geometric accuracy of cbct images (p>0.05). Mean deviations from the gold standard ranged between -0.7 and +0.12 mm among the lowest and highest tube settings. The correlation between observers' measurements ranged between 0.97 and 0.98 for increasing tube settings. Conclusion: Tube current may be reduced as low as 2mA without jeopardizing linear measurement accuracy.Öğe Farklı Endikasyonlar İçin Hazırlanan Dental Volümetrik Tomografi Raporlarının İçeriğinin Değerlendirilmesi(2022) Baydar, Oguzhan; Önem, Erinç; Sener, Elif; Şen, Bedriye Güniz BaksıGiriş ve Amaç: Farklı diş hekimliği fakültelerinden elde edilen dental volümetrik tomografi (DVT) raporlarının biçimsel formatları ile endikasyona-özgü içeriklerinin değerlendirilmesi. Yöntem ve Gereçler: Sıklıkla DVT reçetelenen endikasyonlardan kemik-içi lezyonlar, gömülü dişler, implant planlaması ve endodontik patolojiler için yazılan DVT raporlarının içeriğinde bulunması gereken parametreler, derleme makaleleri ve birlik raporları rehberliğinde listelenerek özel rapor içerik formları oluşturuldu. Yirmi altı diş hekimliği fakültesinden elde edilen 200 rapor farklı endikasyonlar için gruplandırılarak format ve içerikteki parametrelerin varlığı/yokluğu yönünden değerlendirildi. Bulgular tanımlayıcı istatistiksel yöntemlerle değerlendirildi. Bulgular: Raporların %91’i yapılandırılmış formatta idi. Demografik bilgiler (%91,5) ile cihaz özellikleri (%56,5) en sık raporlanan parametreler iken, klinik bulguların %22,5 oranında raporlandığı bulundu. Kemik-içi patolojilere ait raporlarda, lezyonun biçimsel ve boyutsal özelliklerinin sırasıyla %42 ve %46 oranında raporlandığı görüldü. Gömülü dişlere ait raporlarda diş konumunun %92 oranında yazıldığı gözlendi. İmplant planlaması için hazırlanan raporlarda vital dokularla ilişkilerin %64 oranında yazıldığı saptandı. Endodontik kökenli patolojiler için hazırlanan raporlarda ise kök-kanal morfolojisine ait değerlendirmelerin %20 oranında yazıldığı gözlendi. Tartışma ve Sonuç: DVT raporlarının yazımında yapılandırılmış format tercih edilmektedir. İçerikte bulunması gereken bilgiler yönünden en yetersiz raporların endodontik kökenli patolojiler için hazırlandığı gözlendi. Farklı endikasyonlara ait raporlarda mutlaka bulunması gereken parametrelerin standardize edilmesi ve ortak bir terminoloji geliştirilmesi için eğitim müfredatının revizyonu önerilmektedir.Öğe Is Manual Segmentation the Real Gold Standard for Tooth Segmentation? A Preliminary in vivo Study Using Cone-beam Computed Tomography Images(Galenos Yayincilik, 2021) Sabanci, Sercan; Sener, Elif; Turhal, Rukiye Irmak; Gurses, Baris Oguz; Govsa, Figen; Tekin, Ugur; Baltaci, AysunObjective: This study aimed to assess whether manual segmentation is an accurate method in tooth volume measurement and to compare the outcomes of manual, automatic, and semiautomatic segmentations on cone-beam computed tomography (CBCT) images by comparing each system with the water displacement method, which is the gold standard. Materials and Methods: CBCT images of l0 maxillary impacted teeth were used in this preliminary in vivo study. Following the acquisition of CBCT scans, manual, automatic, and semiautomatic segmentations were completed by the same operator. After surgical removal, the volumes of all impacted teeth were measured with the water displacement method, which was used as the gold standard. The volume of each segmented image was measured in mm(3) using the 3D-Doctor software. The established volumes of each segmented image were compared with those of the gold standard using the 95% confidence interval bootstrap percentiles. Intraobserver reliability was determined using the intraclass correlation coefficient. Results: All segmentation methods revealed significantly different volume values both from the gold standard and from each other (p=0.000). The semiautomatic segmentation demonstrated comparable performance with the manual method, and both systems provided comparable volumes with the gold standard than did the automatic method. Excellent intra-observer intraclass correlations were found for all protocols. Conclusion: The actual volumes of the specimen were not obtained by manual, semiautomatic, and automatic segmentations. Semiautomatic segmentation demonstrated comparable performance to the manual method, whereas automatic segmentation yielded the poorest values. The automatic and semiautomatic segmentations may be improved by the development and utilization of novel or hybrid segmentation algorithms for a faster process and more accurate results.Öğe Postgraduate Dental Students' Knowledge Levels Toward Medication-Related Osteonecrosis of the Jaws(Marmara Univ, Inst Health Sciences, 2023) Aslan, Elif; Sener, Elif; Onem, Erinc; Mert, Ali; Cankaya, HuelyaObjective: Medication-related osteonecrosis of the jaws (MRONJ), is often described as a side-effect of bisphosphonates within the dental school curriculum. However, as highlighted in the current literature, some antiresorptive and antiangiogenic drugs may also cause MRONJ. This study aimed to investigate the awareness and knowledge of post-graduate dental students (PDSs) from different specialty/doctoral programs towards MRONJ.Methods: An electronic questionnaire containing 28 questions in 3 different sections focusing on demographic characteristics, general information, and clinical attitude, was prepared. Two-thousand PDSs from 27 universities were invited to participate in the survey in December 2021. The obtained data were evaluated statistically using descriptive statistics and the Chi-Square test (p=.05).Results: The response rate of the survey was 10%. The number of PDSs showed a homogeneous distribution for each specialty, whereas the number of women participants was higher than that of men (p<.05). In the general information section, the highest correct answer rates belonged to students from Oral and Maxillofacial Surgery and Oral and Maxillofacial Radiology departments. However, there was no statistically significant difference between different dental specialties regarding correct answer rates (p>.05). PDSs had higher rates of correct answers to general information questions about antiresorptive drugs than for antiangiogenic drugs. 92% of participants stated that they obtained their knowledge about MRONJ from their undergraduate education.Conclusion: The findings of this study reveal the necessity of updating the dental school curriculum in line with the current literature on MRONJ, as well as including more postgraduate courses on MRONJ during the specialty/doctoral education period.Öğe The Impact of Transition of Paper-Based Consent Forms to Digital Format on Dental Healthcare Efficiency(Marmara Universitesi, 2024) Aslan, Elif; Komat, Omer Berfu; Karatay, Asena; Kacar, Mehmet Emin; Mutlu, Onur; Sener, ElifObjective: To evaluate the perceptions and attitudes of patients of different ages and education levels regarding the transition of paper- based consent forms to digital format. Methods: Ninety-four patients were divided into three groups according to their age range (18-39, 40-59, over 60) as well as education level (primary/secondary school, high school, university). Participants were administered a digital consent form along with an online questionnaire aimed at determining perceptions and attitudes of patients towards paper-based and digital consent. Demographic data was analyzed using descriptive statistics. Pearson's Chi-Square test was used to compare the answer rates between patient groups categorized according to age ranges and educational levels (p=.05). Results: 79.8% and 90.4% of participants reported that converting paper-based consent forms to digital format would be more advantageous for the workflow of healthcare services and in terms of functionality and usability, respectively. The proportion of participants stating they had sufficient knowledge about informed consent was higher in the university graduate group (p<.05). While 47.8% of the primary and/or secondary school graduates and 48.2% of high school graduates preferred written consent, 34.1% of the university graduate group was in favor of digital consent (p<.05). No other differences were obtained among patient groups regarding answers given to the questionnaire (p>.05). Conclusion: Digital consent may provide advantages for the workflow and efficiency of healthcare services and the quality of consent process. However, using digital forms as a part of in-person dentist-patient communication may be more favorable in obtaining trust-based patient consent.Öğe Treatment decision for impacted mandibular third molars: Effects of cone-beam computed tomography and level of surgeons' experience(Public Library of Science, 2024) Adali, Emine; Ozden Yuce, Meltem; Isik, Gozde; Sener, Elif; Mert, AliThe aim of this study was to analyse the effect of surgeons' experience and the benefit of using cone-beam computed tomography (CBCT) images, compared to the use of panoramic radiography (PAN) images, on their decisions with regard to mandibular third molar treatment modality. Panoramic radiographs and CBCTs from a total of 143 patients who had undergone impacted third molar surgery were randomly evaluated for treatment decision by 10 participants with differing clinical experience (5 novices and 5 experienced surgeons). The degree of agreement between the same type of participants was 'Substantial Agreement' (0.61-0.80) or 'Almost Perfect' (0.81-1.00). When the treatment modality decisions of the experienced and novice surgeons, using PAN and CBCT images, were compared, a statistically significant difference was found (p<0.01) between the variables. In 50 cases, experienced surgeons decided from CBCT images that total extraction was the best treatment method but opted for coronectomy when presented with PAN images of the same cases. In 164 cases novice surgeons decided on total extraction from CBCT images but chose coronectomy when presented with PAN images of the same cases. The results obtained from this study revealed that the degree of professional experience of the surgeon was a significant factor in determining the treatment decision. Moreover, the treatment choice of experienced surgeons was less affected by the change in imaging technique employed, when compared to novice surgeons.Öğe Use of Fractal Analysis for the Discrimination of Trabecular Changes Between Individuals With Healthy Gingiva or Moderate Periodontitis(Wiley, 2015) Sener, Elif; Cinarcik, Serhat; Baksi, B. GunizBackground: The aim of this study is to evaluate the capability of fractal analysis to discriminate the changes in the trabecular structure of interdental bone between individuals with healthy gingiva or moderate periodontitis using digital images. Methods: Two groups of patients were included according to the probing depth, bleeding on probing, and clinical attachment level. The first group (n = 50) consisted of individuals with healthy gingiva, whereas the other group consisted of patients with moderate periodontitis (n = 50). Periapical images obtained with a storage phosphor plate system during clinical examination were used for the fractal dimension (FD) calculations. Two rectangular regions of interest (ROIs) were placed at mandibular posterior interdental bone areas. The mean of the two ROIs was used to calculate mean FD by using the box-counting method. Student t test was used for the comparison of the FDs of the two groups (P = 0.05). Results: The mean FD of patients with periodontitis was 0.83, whereas it was 1.02 for the patients with healthy gingiva. A significant difference was obtained in the mean FD values of healthy individuals and patients with moderate periodontitis (P <0.05). Conclusion: Fractal analysis can quantitatively discriminate the trabecular integrity alterations induced by periodontitis and therefore can be recommended for the diagnosis and monitoring of changes in trabecular architecture associated with periodontitis.
