Person: AĞRALI, ÖMER BİRKAN
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AĞRALI
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ÖMER BİRKAN
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Publication Open Access Periodontal treatment in a generalized severe chronic periodontitis patient: A case report with 7-year follow-up(2015-04) AĞRALI, ÖMER BİRKAN; Agrali, Omer Birkan; Kuru, Bahar ErenThe aim of the periodontal treatment is to provide healthy and functional dentition all through a lifetime. In this report, periodontal treatment of a 42‑year‑old male patient with generalized severe chronic periodontitis is presented. He received initial periodontal treatment together with adjunctive antimicrobials. The devital teeth were endodontically treated, and free gingival grafts were placed at the inadequate keratinized tissue zones before regenerative surgery. Following the surgical treatment using enamel matrix derivatives and xenogenic bone graft combination, the patient was put on a strict recall program. After 12 months, favorable clinical and radiographical improvements were obtained. The 7‑year maintenance of the present case with several initially hopeless teeth has been shown and discussed in this report. It can be concluded that optimum oral hygiene level as well as the positive cooperation of the patient enhanced the success of periodontal treatment results even in extremely severe periodontal destruction.Publication Metadata only Evaluation of gingival crevicular fluid transforming growth factor-1 level after treatment of intrabony periodontal defects with enamel matrix derivatives and autogenous bone graft: A randomized controlled clinical trial(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2016) YARAT, AYŞEN; Agrali, O. B.; Kuru, B. E.; Yarat, A.; Kuru, L.Aim: The present study aimed to evaluate the effects of enamel matrix derivatives (EMD) either alone or combined with autogenous bone graft (ABG) applied to intrabony defects in chronic periodontitis patients on clinical/radiographic parameters and gingival crevicular fluid (GCF) transforming growth factor-1 (TGF-1) level and to compare with open flap debridement (OFD). Materials and Methods: A total of 30 deep intrabony defects in 12 patients were randomly treated with EMD + ABG (combination group), EMD alone (EMD group), or OFD (control group). Clinical parameters, including plaque index, gingival index, bleeding on probing, probing depth, relative attachment level, and recession were recorded at baseline and 6 months postsurgery. Intrabony defect fill percentage was calculated on the standardized radiographs. TGF-1 level was evaluated in GCF just before surgery and 7, 14, 30, 90, 180 days after surgery using enzyme-linked immunosorbent assay. Results: All treatment procedures led to significant improvements at 6 months (P 0.01). Gain in attachment level (P 0.01) and radiographic defect fill (P 0.05) of the combination and EMD groups were found to be significantly higher than those of the control group, while the use of EMD either with ABG or alone was observed to produce significantly less recession than the OFD (P 0.05). Conclusion: The findings suggest no clinical and radiographic differences between the combination and EMD groups whereas GCF TGF-1 level demonstrates an increase during the healing phase and is positively affected from EMD.Publication Open Access Multidisciplinary Treatment Approach in a Patient with History of Nasopharyngeal Carcinoma(2014) DOĞAN, BAŞAK; Yavuz, Atacan; Ağralı, Omer Birkan; Calışkan, Zeynep Lale; Türkaydın, Dilek; Sertgöz, Atilla; Kuru, Bahar; Doğan, BaşakRadiotherapy in NPC patients has side effects on the dentition, which affects quality of life dramatically. This case report presents multidisciplinary dental treatment approach in a 17-year-old male patient with a history of nasopharyngeal carcinoma (NPC), which was treated with chemotherapy and radiotherapy. The adolescent patient applied to dental hospital 4 years after the radiotherapy with aesthetic and functional problems on dentition affecting psychological, social, and physical aspects of his life. The dentition of the patient demonstrated the severe destruction as a devastating side effect of radiotherapy. With a successful multidisciplinary approach, our patient's aesthetics, function, and self-confidence were obtained. Well-established procedures, which include preventative care and maintenance, can reduce the duration and expenses of the treatment and help in challenging the life-long complications of radiotherapy.Publication Open Access Evaluation of the Effectiveness of Esterified Hyaluronic Acid Fibers on Bone Regeneration in Rat Calvarial Defects(HINDAWI LTD, 2018-06-28) ÖZBEYLİ, DİLEK; Agrali, Omer B.; Yildirim, Selin; Ozener, Hafize O.; Kose, Kemal N.; Ozbeyli, Dilek; Soluk-Tekkesin, Merva; Kuru, LeylaHyaluronic acid (HA) constitutes one of the major components of the extracellular matrix domain in almost all mammals. The aim of this study was to evaluate the regenerative capacity of HA matrix in rat calvarial bone defects and compare with those of different combinations of resorbable collagen membrane (M) and bovine-derived xenograft (G). Twenty-four 3-month-old male Sprague-Dawley rats weighing 200-250 g were included. Control group was created by leaving one defect empty from 2 critical size defects with 5 mm diameter formed in the calvarial bones of 8 rats. In the same rats, the other defect was treated with HA matrix alone. One of the 2 defects formed in other 8 rats was treated with HA + G and the other with HA + M. One of the 2 defects formed in the remaining 8 rats was treated wilh G+M and the other with HA+G+M. The animals were sacrificed at 4 weeks. Histologic, histomorphometric, and immunohistochemical analyses were performed. Both HA matrix alone and its combinalions with G and M supported new bone formation (NBF). However, NBF was significantly greater in G+M and HA+G+M groups compared to control and HA alone (P < 0.00l). Bone morphogenetic protein-2 was expressed with varying degrees in all groups, without any difference among them. Within the limitations of the present study, HA matrix, used alone or in combination with G and M, did not contribute significantly to bone regeneration in rat calvarial bone defects.Publication Metadata only Do Platform Switching Together with Subcrestal Placement have a Benefit on Marginal Bone Levels Around Dental Implants?(AVES PRESS LTD, 2018) KURU, LEYLA; Agrali, Omer Birkan; Elemek, Eser; Dincer, Janberd; Kigili, Ahmet; Cilingir, Altug; Kuru, Leyla; Almas, KhalidObjective: The aim of this retrospective study was to assess the marginal bone levels around platform-switched dental implants placed subcrestally in partially or totally edentulous patients who had been treated in a private practice. Methods: A total of 200 implants placed in 64 patients, with a mean follow-up time of 5.3 +/- 1.7 years, were included in the study. Implants were placed 0.5 mm subcrestally via one-or two-stage surgical approach. Data regarding the distribution and diameter of the implants, the type of the prosthetic restoration, and marginal bone levels were assessed by one calibrated examiner. Results: Overall, the mean marginal bone loss was found to be 0.82 +/- 1.6 mm, and 66% of the implants (n=81) showed no bone loss, whereas 28% (n=35) showed bone loss >1mm, and 20% (n=25) showed bone loss >2mm. Out of 18 implants in use for 1-3 years, 14 of them showed no bone loss. Among implants that were in function for 3-5 years, 25% (n=15) showed bone loss >1mm, and 12% (n=7) showed bone loss >2mm. In this study, the majority of the implants were in use for more than 5 years (n=122). Out of them, 66% (n=81) showed no bone loss, whereas 28% (n=35) showed bone loss >1 mm, and 20% (n=25) showed bone loss >2mm. Conclusion: Within the limits of this retrospective study, one can say that slight amount of marginal bone loss is observed around the platform-switched implants placed subcrestally in a long-term follow-up. However, further studies are needed to confirm this finding.Publication Metadata only Does Obstructive Sleep Apnea Affect Oral and Periodontal Health in Children with Down Syndrome? A Preliminary Study(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2019) AĞRALI, ÖMER BİRKAN; Durhan, M. A.; Agrali, O. B.; Kiyan, E.; Ikizoglu, N. Bas; Ersu, R.; Tanboga, I.Objective: Children with Down syndrome (DS) are at increased risk for obstructive sleep apnea (OSA) compared with children without DS, with reported prevalence of 31 +/- 75% among clinical-based samples. We aimed to find out whether there is any effect of OSA on periodontal and dental health in children with DS. Material and Methods: Overnight polysomnography (PSG) was performed. OSA was defined as Apnea-Hypopnea Index (AHI) >= 1/h. Children received a full mouth periodontal and dental examination that included probing depths (PD), plaque index (PI), gingival index (GI), and bleeding on probing (BOP) on six sites per tooth. Decay, decay - Missing, missing - Filling, filling - Tooth, tooth (DMFT-for permanent tooth/dmft-for primary tooth) scores were calculated. Results: Children were divided into two groups depending on whether they were diagnosed with OSA or no OSA. Group 1 (DS with OSA) and Group 2 (DS without OSA) included 11 children (age = 11.5 +/- 2.2) and 7 children (mean age = 9.7 +/- 2.3), respectively. Subjects in Group 1 displayed statistically significantly higher levels of GI (P = 0.020) and BOP (P = 0.006) than Group 2. Conclusion: OSA is an important problem for DS and may affect oral health negatively. Based on our findings, OSA can be associated with impaired gingival health in DS children and close follow-up may be necessary for this group.Publication Open Access Treatment of lateral periodontal cyst with guided tissue regeneration(2014-07) KURU, LEYLA; Meseli, Suleyman Emre; Agrali, Omer Birkan; Peker, Onder; Kuru, LeylaABSTRACT Lateral periodontal cyst (LPC), originated from epithelial rests in the periodontal ligament, is a noninflammatory cyst on the lateral surface of the root of a vital tooth. LPC is generally asymptomatic and presents a round or oval uniform lucency with well-defined borders radiographically. In this case report, clinical, histological and radiographical findings and periodontal treatment of 32-year-old female patient, who was referred to Department of Periodontology Clinic of Faculty of Dentistry, Marmara University with a painless hyperplastic lesion on the distobuccal site of the tooth number 12, were presented. The tooth number 12 was vital and a well-defined round radiolucent area with corticated borders was determined radiographically. Preliminary diagnosis was LPC based on clinical and radiographical findings. Mechanical periodontal treatment consisted of oral hygiene instructions, scaling and root planing was applied and flap operation was performed to gain access to the lesion. Following enucleation of the lesion, alveolar bone destruction shaped as a tunnel from labial to palatinal site was observed. The bone cavity was grafted with bovine-derived xenograft, followed by placement of a resorbable collagen membrane. Tissues removed from of the lesion were examined histologically. Hematoxylen-eosin stained sections showed vasculature granulomatous structure underlying squamous epithelium, and destructed bone spaces, all of which were consisted with LPC. Acceptable clinical healing was achieved at 6 months follow-up period. Satisfactory clinical and radiographical outcome can be achieved in the treatment of LPC using regenerative periodontal approach.Publication Metadata only Peri-implant Tissues and Diseases(MARMARA UNIV, INST HEALTH SCIENCES, 2017) YILDIRIM, HATİCE SELİN; Elemek, Eser; Agrali, Omer Birkan; Yildirim, Hatice Selin; Kuru, LeylaPeri-implant diseases occur due to imbalance between host response and biofilm after successful osseointegration of an implant with the bone. Among peri-implant diseases, peri-implant mucositis is used to describe the presence of inflammation only within the mucosa, whereas peri-implantitis is characterized by loss of supporting bone in addition to the inflammation within the mucosa. For the diagnosis of peri-implant diseases, probing depth, bleeding on probing, and suppuration are clinically assessed. Additionally, supporting bone levels are radiographically evaluated. Smoking, lack of oral hygiene, history of periodontal disease, diabetes mellitus, cardiovascular diseases, and implant surface characteristics are the known risk factors for the development of peri-implant diseases. For the treatment of peri-implant mucositis, antimicrobial treatment is performed together with mechanical debridement. However, these treatment approaches are not sufficient for peri-implantitis cases. For the treatment of peri-implantitis, resective and/or regenerative surgical interventions are used in addition to mechanical debridement. It is crucial to improve the knowledge among dentists about the prevention and progression of peri-implant diseases. On the other hand, patients should be advised regular dental visits and to maintain the highest level of oral hygiene.Publication Metadata only Extra- and Intraoral Clinical Findings of Recessive Dystrophic Epidermolysis Bullosa: A Case Report(AVES PRESS LTD, 2016) NAMDAR PEKİNER, FİLİZ MEDİHA; Meseli, Suleyman Emre; Agrali, Omer Birkan; Pekiner, Filiz Namdar; Kuru, LeylaEpidermolysis bullosa (EB) is a heterogeneous group of inherited blistering mucocutaneous disorders that have a specific defect in the attachment mechanisms of the epithelial cells, either to each other or to the underlying connective tissue. Recessive dystrophic type EB (Hallopeau-Siemens syndrome) represents repeated episodes of cutaneous breakdown, which heal with scarring, resulting in the fusion of the fingers into a mitten-like deformity. The vesicle/bulla can be intraorally observed and the depth of the buccal vestibule may decrease because of scarring. In this case report, the intra-/extraoral findings of a 25-year-old male patient, who was diagnosed with recessive dystrophic type EB immediately after birth, are presented. Extraoral examination revealed mitten-like hands and feet because of scar tissue formations on the hands and feet. Similarly, during intraoral examination, scar tissue formations were observed that had caused denuded mouth opening and limited tongue functions. In addition, periodontal problems and dental caries were observed because of limited plaque control. This case report emphasizes the importance of knowledge regarding patients with EB and presents some intraoral findings.Publication Metadata only Drug Delivery Systems for Dental Applications(BENTHAM SCIENCE PUBL LTD, 2017) OKTAR, FAİK NÜZHET; Ficai, Denisa; Sandulescu, Mihai; Ficai, Anton; Andronescu, Ecaterina; Yetmez, Mehmet; Agrali, Omer B.; Elemek, Eser; Gunduz, Oguzhan; Sahin, Yesim M.; Oktar, Faik N.Inevitable caries formation and other tooth related diseases are one of the most common factors affecting human quality of life, as they are often followed by loss of teeth. Significant research efforts have been devoted to establishing control and preventive solutions. It is clearly known that fluoride is one of the promising chemical substances with anti-carious activity. The elimination of the microbial infection, especially the multispecies infections induced by aerobic and anaerobic bacteria, is a current challenge of the endodontic therapy. Using antibiotics or other active agents (from ions, nanoparticles to natural products) loaded in specific drug carrier systems seems to be ideal approach in treating and controlling dental diseases, even if, the drug delivery systems used in dental applications are less established comparing with other tissues/organs. Based on the importance of biomedical drug delivery systems the present study aims to give a brief review on the improvements of drug delivery systems for dental applications.