Browsing by Author "Cakmak, Gulce"

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Citation Count: 21
Accuracy of single implant scans with a combined healing abutment-scan body system and different intraoral scanners: An in vitro study
(Elsevier Sci Ltd, 2021) Cakmak, Gulce; Donmez, Mustafa Borga; Atalay, Sevda; Yilmaz, Hakan; Kokat, Ali Murat; Yilmaz, Burak
Objective: The aim of the present study was to evaluate the accuracy of single implant scans with a combined healing abutment-scan body (CHA-SB) system using different intraoral scanners. Methods: A partially edentulous model with an implant was fabricated, and a CHA-SB system was secured on the implant. The model was scanned using an industrial-grade blue light scanner (ATOS Core 80) and a master reference model was generated (MRM). The model was also scanned with 4 different intraoral scanners (IOSs) [(Virtuo Vivo (VV), TRIOS 3 (T3), Omnicam (CO), and Primescan (PS)]. Test scans (n = 8) were superimposed over the MRM using the best fit algorithm (GOM Inspect 2018; GOM GmbH). After superimpositions, distance and angular deviations at selected areas on CHA-SB system were calculated. The data were analyzed with a 1way ANOVA and Tukey HSD tests for trueness and precision (alpha=0.05). Results: The differences in trueness (distance deviations) among tested IOSs were nonsignificant (P=.652). VV presented the highest angular deviations (P <=.031), and the angular deviations in other IOS scans were not found different (P >=.378). The precision of distance deviation data was not significantly different among scanners (P=.052). For the precision of angular deviation data, significant differences were found among IOSs (P=.002). Compared with PS (P=.007) and T3 (P=.014), VV had significantly lower precision, which was not significantly different than that of CO (P=.815). Conclusions: The accuracy (angular deviation) of scans of a combined healing abutment-scan body system on a single implant varied depending on the IOS. VirtuoVivo scans had the lowest accuracy in terms of angular deviations. When the distance deviation data were considered, scan accuracy of scanners was similar. Clinical Significance: A recently introduced combined healing abutment-scan body system combines the acquisition of both the implant and the soft tissue. When different intraoral scanners scan the combined healing abutment-scan body system, the scan accuracy may vary.
Citation Count: 6
Effect of different disinfection protocols on the surface properties of CAD-CAM denture base materials
(Mosby-elsevier, 2023) Atalay, Sevda; Cakmak, Gulce; Fonseca, Manrique; Schimmel, Martin; Yilmaz, Burak
Statement of problem. Which disinfection protocol provides optimal water contact angle and microhardness for computer-aided design and computer-aided manufacturing (CAD-CAM) polymethyl methacrylate (PMMA) materials is unclear.Purpose. The purpose of this in vitro study was to evaluate the effect of different disinfection protocols (1% sodium hypochlorite, denture cleanser gel, and effervescent tablet) on the water contact angle and microhardness of different CAD-CAM PMMA denture base materials by comparing them with a heat-polymerized PMMA.Material and methods. Disk-shaped specimens (o10x2 mm) were fabricated from 3 different CAD -CAM PMMAs-AvaDent (AV), Merz M-PM (M-PM), and Polident (Poli) -and a heat-polymerized PMMA (Vynacron) (CV) (n=21). Three disinfection protocols (1% sodium hypochlorite [HC], denture cleanser gel [GEL], an effervescent tablet [TAB]) were applied to simulate 180 days of cleansing. The water contact angle and microhardness of specimens were measured before and after disinfection and compared by using a 2-way ANOVA (a=.05).Results. For water contact angle, material (P=.010) and disinfection protocol (P=.002) had a significant effect. The material (P<.001), disinfection protocol (P=.001), and their interaction (P<.001) significantly affected the microhardness after disinfection. When the condition after disinfection was compared with that before disinfection, the water contact angle increased significantly in all material-disinfection protocol pairs (P<.025), and microhardness increased significantly in all material-disinfection protocol pairs (P<.040), except for GEL-(P=.689) or TAB-applied (P=.307) AV, HC-applied M-PM (P=.219), and TAB-applied Poli (P=.159).Conclusions. The material and disinfection protocol affected the water contact angle of all tested PMMAs after disinfection, resulting in more hydrophobic surfaces for heat-polymerized or CAD-CAM PMMAs. The microhardness of heat-polymerized PMMA was less than that of all CAD-CAM PMMAs after disinfection, regardless of the protocol. (J Prosthet Dent 2023;130:787-95)
Citation Count: 5
Effect of guide sleeve material, region, diameter, and number of times drills were used on the material loss from sleeves and drills used for surgical guides: An in vitro study
(Mosby-elsevier, 2022) Ozan, Oguz; Seker, Emre; Cakmak, Gulce; Guo, Xiaohan; Yilmaz, Burak
Statement of problem. How material loss from sleeves and drills is affected when different guide sleeve materials and different sizes of implant drills are used for different regions of surgical guides is unclear. Purpose. The purpose of this in vitro study was to compare the amount of material loss from different guide sleeves (zirconia and cobalt-chromium) and drills of different diameters during osteotomy preparation in different regions. Materials and methods. Three tooth-supported surgical guides with sleeve holes positioned in the first premolar and second molar sites were prepared. Guide sleeves (0 2.20 mm, 3.40 mm, and 4.05 mm) were milled from zirconia (n=60) and cobalt-chromium (n=60) blocks. A total of 12 titanium nitride-coated stainless steel twisted drills (n=6 per sleeve material) of different diameters (0 2.00, 3.20, 3.85 mm) were used with corresponding sleeves during the drilling. The weight loss from the drills and the volume loss from the guide sleeves after drilling were analyzed by using multiple linear mixed effect models (a=.05). Results. According to the 4-way ANOVA for volume loss from sleeves, no significant interaction was found among the 4 main effects (number of times a drill was used, region, diameter, and material), but interactions between the number of times a drill was used and diameter (P=.001) and between the number of times the drill was used and material were significant (P<.001). For weight loss from the drills, a significant interaction was detected between the number of times the drill was used and diameter (P=.024). Conclusion. Less sleeve material was lost when zirconia sleeves were used. All sleeves had more material loss in the molar region than in the premolar region. The diameter had varying effects on the amount of material loss from drills and sleeves. The sleeve material and the region did not affect the material loss from drills.
Citation Count: 9
Effect of Impression Technique and Operator Experience on Impression Time and Operator-Reported Outcomes
(Wiley, 2021) Yilmaz, Hakan; Eglenen, Merve Nur; Cakmak, Gulce; Yilmaz, Burak
Purpose: To investigate the effect of impression technique (conventional preliminary alginate and digital scan) and operator experience in impression making (experienced in digital and conventional, experienced in conventional and inexperienced in digital, and inexperienced in conventional and digital) on impression time, satisfaction and stress levels, and the preference of the operators. Material and Methods: One patient was assigned for each of the 60 operators, who were experienced in impression techniques at different levels (Group 1: experienced in conventional and digital, Group 2: experienced in conventional and inexperienced in digital, Group 3: inexperienced in conventional and digital). They made conventional impressions (irreversible hydrocolloid) and digital scans (Trios 3) from the same patient. The impression times were recorded at each step (patient registration, maxillary arch, mandibular arch, and bite registration) and in total. A visual analog scale (VAS) was used for the operator satisfaction for applicability, comfort, and hygiene; the State-Trait Anxiety Inventory form (STAI-TX1) was used for stress, and a questionnaire was completed to measure the operator's impression preference. The data were analyzed with a 2-way ANOVA and Chi-square test (alpha = 0.05). Results: A significant interaction was found between the operator experience in impression making and the impression technique on time for maxillary and mandibular arch impressions and total time (p <= 0.002). Operator experience and impression technique interaction had a significant effect on comfort and average VAS scores (p <= 0.016). Whereas, no significant effect of this interaction was found on stress (p >= 0.195). Operator experience in impression making had a significant effect on applicability (p < 0.001), and the impression technique had a significant effect on hygiene VAS scores (p < 0.001). Operators in Group 1 and Group 3 preferred the digital scans, however, operators in Group 2 had no preference (p = 0.022). Conclusion: Operator experience in impression making and impression technique had varying effects on clinician's impression time, comfort, applicability, hygiene, and preference. Operators needed less time for the impressions they were experienced with. Operator stress level was not affected by the operator experience in impression making and the impression technique. Dental students and operators experienced in both techniques were satisfied with the digital scans and they preferred digital scans. Operators experienced with conventional impressions were satisfied with conventional impressions but didn't have a preference for the impression type.
Citation Count: 9
Effect of Scanner Type and Scan Body Location on the Accuracy of Mandibular Complete-Arch Digital Implant Scans: An In Vitro Study
(Wiley, 2022) Cakmak, Gulce; Yilmaz, Hakan; Santos, Alejandro Trevino; Kokat, Ali Murat; Yilmaz, Burak
Purpose To compare the accuracy (trueness and precision) of scans of a newly introduced intraoral scanner (IOS) (Virtuo Vivo) and a widely used IOS (Trios 3) to a laboratory scanner (LBS) (Cares 7 SERIES) for 6 implants placed in an edentulous mandible, and to investigate the effect of scan body location on trueness. Material and methods Scanbodies were tightened on 6 implants placed in an edentulous polymethylmethacrylate mandibular model. An industrial scanner was utilized to generate a master reference model STL file. Three different scanners were used to scan the model (2 IOSs and 1 LBS), and the scans (n = 10) were exported into STL files. Best-fitting algorithm was used to superimpose test scans over the MRM-STL (nominal). ANOVA and Tukey HSD tests were performed to analyze the data (alpha = 0.05). Results The distance deviations in Car7-LBS scans were the highest (p < 0.001), whereas those in Tri-IOS scans were the lowest (p < 0.001). Vir-IOS had lower angular deviations than those of Tri-IOS (p = 0.031). In Vir-IOS scans, SB5 had higher distance deviations than SB2 (p = 0.029) and SB3 (p = 0.044). In Car7-LBS scans, SB1 had higher distance deviations than SB3 (p = 0.015) and SB5 (p = 0.005). In Tri-IOS scans, SB1 had higher mean distance deviations than SB2 and SB5 (p = 0.005). Vir-IOS had lower precision than Car7-LBS (distance deviation data) (p = 0.01). No difference was found among scanners for the precision of angular deviation data (p = 0.840). Conclusion When trueness and precision were considered, distance and angular deviations depended on the scanner type. None of the scanners outperformed others in accuracy considering all distance and angular deviations. Scan body location affected only the trueness (distance deviations).
Citation Count: 39
The effect of scanner type and scan body position on the accuracy of complete-arch digital implant scans
(Wiley, 2020) Cakmak, Gulce; Yilmaz, Hakan; Trevino, Alejandro; Kokat, Ali Murat; Yilmaz, Burak
Background How the accuracy of complete-arch implant scans is affected when different intraoral scanners (IOSs) are used and the effect of scan body position on the accuracy are not well-known. Purpose To compare the scan accuracy (trueness and precision) of a recently introduced IOS (Virtuo Vivo) to a commonly used IOS (TRIOS 3) and the scans of a laboratory scanner (LBS; Cares 7 SERIES) in a completely edentulous maxilla with four implants. It was also aimed to evaluate the effect of scan body position on the accuracy. Materials and Methods Multi-unit scan bodies were tightened on a poly(methyl methacrylate) edentulous maxillary model with four implants. A master reference model (MRM) stereolithography (STL) file was generated by scanning the model with a high-precision scanner. The model was scanned with three different scanners (n = 10); two different IOSs and a LBS. STL files were superimposed over the MRM. Results For trueness, scan body position (P= .004) and scanner type (P < .001) had a significant effect on distance deviation and a significant interaction was found (P= .001). For angular deviation, only scanner type had a significant effect (P= .028). For precision, significant difference was found for distance (P= .011) and angular deviations (P= .020) between different scanner types. Conclusions One scanner type was not superior to others when both trueness and precision were considered. Position of the scan body affected the distance deviation (trueness).
Citation Count: 10
Effect of thermocycling on the surface properties of resin-matrix CAD-CAM ceramics after different surface treatments
(Elsevier, 2021) Cakmak, Gulce; Subasi, Meryem Gulce; Yilmaz, Burak
Purpose: To evaluate the effect of thermocycling on the water contact angle (WCA), surface roughness (SR), and microhardness (MH) of resin-matrix computer-assisted design and computer-assisted manufacturing (CAD-CAM) ceramics after different surface treatments (conventional polishing or 2 different surface sealants). Material and methods: Two different types of resin-matrix CAD-CAM ceramics; a nanoparticle-filled resin (CeraSmart; CS) and a resin nanoceramic (Lava Ultimate; LU) were tested. Rectangular-shaped plates (1 mmthick) were divided into 3 groups (n = 8) in terms of surface treatment methods applied: conventional polishing (control) or 2 surface sealants (Optiglaze (OG) and Palaseal (PS)). Scanning electron microscope images ( ? 1000 and ? 700 magnifications) of each material were taken from 2 additional specimens before surface treatments. After surface treatments, WCAs of deionized water, SR, and MH values of specimens were measured. All specimens were subjected to 5000 thermocycling and measurements were repeated. SR, WCA, and MH data before and after thermocycling were compared by using a 2-way ANOVA (?=.05). Results: A significant interaction was found between the surface treatment and the material for WCA after thermocycling (P < .001), for SR before thermocycling (P = .014), and for MH both before and after thermocycling (P .001). SEM images before surface treatments revealed that the surface of CS was mechanically rougher with a more microretentive topography compared with the surface of LU. No significant correlation was found between SR and WCA (P 0.05). Conclusions: Thermocycling affected the SR, MH, and WCA of all resin-matrix CAD-CAM ceramics.
Citation Count: 11
Flexural strength of CAD-CAM and conventional interim resin materials with a surface sealant
(Mosby-elsevier, 2020) Cakmak, Gulce; Yilmaz, Hakan; Aydog, Ozge; Yilmaz, Burak
Statement of problem. The flexural strength of computer-aided design and computer-aided manufacturing (CAD-CAM) and conventional interim resin materials when they are used with a surface sealant is unclear. Purpose. The purpose of this in vitro study was to evaluate the flexural strength of different CAD-CAM polymethyl methacrylate (PMMA)based polymers and conventional interim resin materials, autopolymerized bisacrylate composite resin and polyethyl methacrylate (PEMA) with and without a surface sealant after thermocycling. Material and methods. Fourteen rectangular-shaped specimens (25x2x2 mm) were fabricated from 5 different interim resin materials, 3 different CAD-CAM PMMA-based polymers: Polident-PMMA, Telio CAD, M-PM-Disc; 2 different conventional interim resin materials, and 1 autopolymerized bisacrylate composite resin: Acyrtemp and 1 PEMA resin: Bosworth Trim according to ISO 10477:2018. Two different types of surface treatments (n=7), conventional polishing and surface sealant application, were applied to 1 surface of the specimens. Ten thousand thermocycles were applied in distilled water for all specimens (5 degrees C and 55 degrees C). A 3-point bend test was used to measure the flexural strength of specimens in a universal testing device at a 1 mm/min crosshead speed. The flexural strength data (sigma) were calculated in megapascals (MPa) and analyzed by using a 2-way ANOVA. Post hoc pairwise comparisons and independent t test analysis were done (alpha=.05). Results. According to the 2-way ANOVA, material type (P<.001) significantly affected the flexural strength. Surface treatment type (P=.818) had no significant effect on flexural strength, and no significant interaction was found between material type and surface treatment type (P=.111). CAD-CAM PMMA-based polymers had significantly higher flexural strength than the conventional interim resin materials. However, no significant difference was found within groups of the same type. Also, no significant difference was found in flexural strength values between the conventional polishing and surface sealant groups within each interim resin material (P >=.162). Conclusions. The flexural strength of CAD-CAM PMMA-based polymers was higher than the flexural strength of conventional bisacrylate composite resin and PEMA interim resin materials after thermocycling. The surface treatment type (conventional polishing and surface sealant application) was not found to affect the flexural strength of CAD-CAM PMMA-based polymers, conventional bisacrylate composite resin, or PEMA interim resin materials.
Citation Count: 4
Screw stability of CAD-CAM titanium and zirconia abutments on different implants: An in vitro study
(Wiley, 2021) Yilmaz, Burak; Cakmak, Gulce; Batak, Burcu; Johnston, William M.
Background Limited information is available regarding the removal torque values (RTVs) of screws of different abutment materials when used with different implants. Purpose To evaluate the effect of implant type and abutment material (zirconia; Zir and titanium; Ti) on the RTVs of abutment screws after cyclic loading. Materials and methods Internal conical connection implants (CC, OsseoSpeed TX) and modified internal conical connection implants (MCC, OsseoSpeed EV) (n = 10) were clamped in resin dies. Zir and Ti (N = 20) custom abutments were tightened to implants (20 Ncm for CC and 25 Ncm for MCC) as specified by their manufacturers. The abutments were cyclically loaded by using a sequentially increased loading protocol; 2-million cycles under 100 N, 3-million cycles under 200 N, and 2-million cycles under 300 N loads with 2 Hz. After 7 million cycles, RTVs (Ncm) were measured by using a torque gauge. The data were analyzed with ANOVA by using the restricted maximum likelihood estimation method. Tukey-Kramer adjustment was used for any significant interaction of implant-abutment pairs (alpha = 0.05). Results Two CC implants, 1 with Ti and 1 with Zir abutment, fractured during cyclic loading (under 300 N loads within the 6th and 7th million cycles) and discarded for statistical analysis. Only implant type had a significant effect on RTVs (p <0.001). Screws of Ti abutments on MCC implants had significantly higher RTVs than the screws of Ti (p = 0.003) and Zir (p = 0.005) abutments on CC implants. Conclusions Implant type affected the RTVs, however, the RTVs were higher than the initial torque values for all groups. Screws of Ti abutments on implant, which required greater initial torque values had higher RTVs than the screws of Ti and Zir abutments on the implant that required smaller initial torque values. RTVs were similar for Zir and Ti abutment screws within each implant type.
Citation Count: 12
Surface roughness of high-performance polymers used for fixed implant-supported prostheses
(Mosby-elsevier, 2021) Batak, Burcu; Cakmak, Gulce; Johnston, William M.; Yilmaz, Burak
Statement of problem. High-performance polymers have been recommended by their manufacturers as a framework material for implant-supported fixed prostheses. However, little is known about the surface roughness of high-performance polymers in different compositions and whether they require layering with a composite resin or acrylic resin on the tissue surface. Purpose: The purpose of this in vitro study was to evaluate the surface roughness of different computer-aided design and computer-aided manufacture (CAD-CAM) high-performance polymers and the effect of polishing on their surface roughness. Material and methods: Seventy high-performance polymer specimens (n=10) for 4 different polyetheretherketone (PEEK) brands (BRE, CP, ZZ, J), 1 polyetherketoneketone (PEKK) (PK), and 2 different fiber-reinforced composite resin (FRC) materials (T, TR) were milled from 7x8x30-mm CAD-CAM blocks. The surface roughness (Ra) of each specimen was measured on the same surfaces after milling (baseline) and after polishing by using a contact profilometer. Two-way repeated measures ANOVA (MIXED procedure) and the Bonferroni corrected t test (alpha=.05) were used to analyze the surface roughness data. Results: No significant differences were found among high-performance polymers when the baseline surface roughness measurements of the materials were compared (P>.05). All materials (BRE, PK, CP, T, TR, ZZ), except for a PEEK material (J) (P<.05), had no significant differences in their surface roughness before and after polishing. After polishing, the surface roughness of the J PEEK material was higher than that of CP, PK, T, and ZZ (P<.05). Conclusions: The surface roughness of high-performance polymers in different compositions after milling was similar. Polishing increased the surface roughness of only one PEEK (J) material. All surface roughness values were above the clinical acceptability threshold of 0.2 mu m.