Publications by authors named "Gülce Çakmak"

7 Publications

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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.

J Prosthet Dent 2021 Apr 5. Epub 2021 Apr 5.

Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio.

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.

Material And Methods: Three tooth-supported surgical guides with sleeve holes positioned in the first premolar and second molar sites were prepared. Guide sleeves (Ø 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 (Ø 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 (α=.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).

Conclusions: 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.
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http://dx.doi.org/10.1016/j.prosdent.2020.12.036DOI Listing
April 2021

Effect of thermocycling on the surface properties of resin-matrix CAD-CAM ceramics after different surface treatments.

J Mech Behav Biomed Mater 2021 05 18;117:104401. Epub 2021 Feb 18.

Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University, Ohio, USA.

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 mm-thick) 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 (α=.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.
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http://dx.doi.org/10.1016/j.jmbbm.2021.104401DOI Listing
May 2021

Load to failure of high-density polymers for implant-supported fixed, cantilevered prostheses with titanium bases.

Int J Prosthodont 2021 Feb 19. Epub 2021 Feb 19.

Purpose: To analyze the load to failure of different CAD/CAM high-density polymers (HDPs) and zirconia when titanium (Ti) bases were included in a cantilevered situation.

Materials And Methods: Five specimens were fabricated from five different CAD/CAM polymethyl methacrylate (PMMA) HDPs (Copratemp [CT]; Tempo-CAD [TC]; TD Dental [TD]; M-PM Disc-Pink [MPM]; M-PM Disc-White [MPMW]), and five specimens were prepared from a 3Y-TZP zirconia (FireZr [FZR]) (control). Ti bases (D Master Dental Implants) were cemented onto the specimens (8 mm [thickness] × 7 mm [width] × 30 mm [length]). Each specimen was fixated using a clamp for a cantilever loading distance of 10 mm. The load was applied on the cantilever until failure, and the maximum load to failure values (N) were analyzed by using analysis of variance (GLIMMIX procedure) with a lognormal error distribution in addition to the restricted maximum likelihood estimation method to eliminate the need for equality of variances and Tukey Honest Significant Difference (α = .05).

Results: Differences among load-to-failure values of HDPs were not significant (P > .05). However, zirconia had significantly higher load-to-failure values than HDPs (P < .001). The behavior of HDPs and zirconia under loading was different in terms of displacement. HDPs showed weaker but more ductile behavior than zirconia, which is stronger, but more brittle.

Conclusion: Tested brands of HDPs performed similarly under loading. Zirconia with a Ti base showed higher strength compared to all tested HDPs with a Ti base. The loads that fractured the specimens with Ti bases were close to the maximum occlusal bite forces recorded in previous clinical studies.
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http://dx.doi.org/10.11607/ijp.7036DOI Listing
February 2021

Surface roughness of high-performance polymers used for fixed implant-supported prostheses.

J Prosthet Dent 2021 Feb 11. Epub 2021 Feb 11.

Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio. Electronic address:

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 7×8×30-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 (α=.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 μm.
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http://dx.doi.org/10.1016/j.prosdent.2020.11.029DOI Listing
February 2021

Effect of Impression Technique and Operator Experience on Impression Time and Operator-Reported Outcomes.

J Prosthodont 2021 Feb 2. Epub 2021 Feb 2.

Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.

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 (α = 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.
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http://dx.doi.org/10.1111/jopr.13340DOI Listing
February 2021

Flexural strength of CAD-CAM and conventional interim resin materials with a surface sealant.

J Prosthet Dent 2020 Dec 3;124(6):800.e1-800.e7. Epub 2020 Oct 3.

Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Ohio.

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 (25×2×2 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 °C and 55 °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 (σ) were calculated in megapascals (MPa) and analyzed by using a 2-way ANOVA. Post hoc pairwise comparisons and independent t test analysis were done (α=.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.
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http://dx.doi.org/10.1016/j.prosdent.2020.09.004DOI Listing
December 2020

The effect of scanner type and scan body position on the accuracy of complete-arch digital implant scans.

Clin Implant Dent Relat Res 2020 Aug 8;22(4):533-541. Epub 2020 Jul 8.

Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA.

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).
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http://dx.doi.org/10.1111/cid.12919DOI Listing
August 2020