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    Comparative Ex Vivo Evaluation of Two Electronic Percussive Testing Devices Measuring the Stability of Dental Implants
    (Amer Acad Periodontology, 2014) Geckili, Onur; Bilhan, Hakan; Cilingir, Altug; Bilmenoglu, Caglar; Ates, Gokcen; Urgun, Aliye Ceren; Bural, Canan
    Background: A comparative ex vivo study was performed to determine electronic percussive test values (PTVs) measured by cabled and wireless electronic percussive testing (EPT) devices and to evaluate the intra-and interobserver reliability of the wireless EPT device. Methods: Forty implants were inserted into the vertebrae and forty into the pelvis of a steer, a safe distance apart. The implants were all 4.3 mm wide and 13 mm long, from the same manufacturer. PTV of each implant was measured by four different examiners, using both EPT devices, and compared. Additionally, the intra-and interobserver reliability of the wireless EPT device was evaluated. Results: Statistically significant differences (P < 0.05) were observed between PTVs made by the two EPT devices. PTVs measured by the wireless EPT device were significantly higher than the cabled EPT device (P < 0.05), indicating lower implant stability. The intraobserver reliability of the wireless EPT device was evaluated as excellent for the measurements in type II bone and good-to-excellent in type IV bone; interobserver reliability was evaluated as fair-to-good in both bone types. Conclusion: The wireless EPT device gives PTVs higher than the cabled EPT device, indicating lower implant stability, and its inter-and intraobserver reliability is good and acceptable.
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    Comparison of the Primary Stability of Two Implant Designs in Two Different Bone Types: An In Vitro Study
    (Quintessence Publishing Co Inc, 2015) Bilhan, Hakan; Bilmenoglu, Caglar; Urgun, Aliye Ceren; Ates, Gokcen; Bural, Canan; Cilingir, Altug; Geckili, Onur
    Purpose: Achievement of primary stability upon surgical placement of dental implants is a key factor for successful osseointegration and depends mainly on implant-related factors. The aim of this study was to compare and assess the primary stability of implants with active and regular threads in type 2 as well as type 4 bone. Materials and Methods: Fresh cow vertebrae and a pelvis were used as models of type 4 bone and type 2 bone, respectively. Implants with two different designs-regular-threaded and active-threaded-both 4.3 mm wide and 13 mm long, were placed in both types of bone (n = 80). Stability measurements were completed by four prosthodontists using two different Periotest devices and resonance frequency analysis. Statistical analyses were performed with the Mann-Whitney U test. Results: No statistically significant differences were found between the implant types in either type of bone in the stability measured with different methods. For both implant types, the mean resonance frequency values in type 2 bone were statistically significantly higher than in type 4 bone, whereas the mean Periotest values in type 2 bone were statistically significantly lower than in type 4 bone. Conclusion: Within the limitations of this in vitro study in bone types 2 and 4, the active-threaded implant, which was invented to increase primary stability, did not show higher primary stability compared to a regular-threaded implant.
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    Determination of the Optimum Torque to Tighten the Smartpegs of Magnetic Resonance Frequency Analyses Devices: An Ex Vivo Study
    (Allen Press Inc, 2015) Geckili, Onur; Cilingir, Altug; Bural, Canan; Bilmenoglu, Caglar; Bilhan, Hakan
    The aim of this study was to find an optimal value for tightening the Smartpegs for magnetic radiofrequency analysis devices (RFAs) devices. Thirty implants were placed in 3 cow ribs. The RFA value of each implant was measured in buccal and mesial directions after tightening the Smartpegs with 1, 3, 4, 8, 9, 10, and 11 Ncm. Additionally, 4 different examiners measured the RFA after hand tightening the Smartpegs, and the results were compared. The buccal implant stability quotient (ISQ) values when the Smartpegs were tightened to 1Ncm were significantly lower than the ISQ values when the Smartpegs were tightened to 3, 4, 8, 9, 10, and 11 Ncm (P<.05). The mesial ISQ values when the Smartpegs were tightened to 1, 3, and 4 Ncm were significantly lower than the ISQ values when the Smartpegs were tightened with higher torque values (P<.05). The buccal measurements made by 1 examiner was significantly lower than 3 Ncm (P<.05), and the buccal measurements made by 1 examiner was significantly lower than 4 Ncm (P<.05). The mesial ISQ values measured by 2 examiners were significantly lower than 3 Ncm (P<.05), and the mesial ISQ values measured by the other 2 examiners were significantly lower than 8 Ncm (P<.05). The tightening of the Smartpegs should be standardized by the manufacturer to a range of 5-8 Ncm in order to gain reliable objective RFA values, instead of leaving it to subjective finger pressure.
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    The Evaluation of the Reliability of Periotest for Implant Stability Measurements: An In Vitro Study
    (Allen Press Inc, 2015) Bilhan, Hakan; Cilingir, Altug; Bural, Canan; Bilmenoglu, Caglar; Sakar, Olcay; Geckili, Onur
    Periotest (Medizintechnik Gulden, Modautal, Germany) is a widely accepted implant stability measurement method, although the reliability is not well known. The aim of this in vitro study was to investigate the reliability of the Periotest in implant stability measurements. Thirty implants were placed in 3 cow ribs. The stability of each implant was measured by insertion torque, resonance frequency analyses, and Periotest and then compared. The Periotest values (PTVs) were measured by 4 different examiners. The measurements were repeated twice in both the buccal and mesial directions, for each implant at 2-hour intervals and the intra-and interobserver reliability of Periotest was measured. Results showed that the intraobserver reliability of the Periotest was excellent for the buccal PTVs but fair to poor for the mesial PTVs. The interobserver reliability of the Periotest was excellent for the buccal PTVs but poor for the mesial PTVs. No significance was found between the PTVs and IT values (P =.803) and PTVs and ISQ values, whereas a 47.1% significant correlation was detected between the IT values and ISQ values (P =.009). The present study indicates that only Periotest measurements from buccal result in excellent intra-and interobserver reliability for the quantification of the implant stability.
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    Evaluation of two interforaminal implants and implant-assisted removable dentures on stress distribution: an in vitro study
    (Korean Acad Oral & Maxillofacial Surgery, 2019) Bilhan, Selda Arat; Geckili, Onur; Cilingir, Altug; Bozdag, Ergun; Bilhan, Hakan
    Objectives: In mandibular edentulism, the treatment option with a two-interforaminal implant-retained bridge and a removable partial denture is rarely evaluated in literature. The aim of this in vitro study was to evaluate the stress distribution of this treatment option by comparing it with traditional treatment options with interforaminal implants in the edentulous mandible. Materials and Methods: Two interforaminal implants were placed in a formalin-fixed cadaver mandible, and overdentures with three different types of attachments were fabricated: (1) two ball attachments and an overdenture, (2) a Dolder bar and an overdenture, and (3) screw-retained two-implant inter-canine porcelain fused to a metal bridge and an implant-assisted removable denture (IARD) with precision attachments. Three biting conditions were generated for each denture type, and the strains were documented under vertical loading of 100 N. Results: The calculated strain values from measured strains in all measurement sites and loading conditions for the screw-retained two-implant inter-canine porcelain fused to a metal bridge and a cast framework partial denture with precision attachments situation were lower than in the other scenarios (P<0.05). Conclusion: Within the limitations of the present study, it can be concluded that an IARD may be a reasonable and valuable alternative to ball attachments or a bar in two interforaminal implants, especially when the patients prefer to be able to show their teeth even when they take out their removable dentures.
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    In vitro comparison of trueness of 10 intraoral scanners for implant-supported complete-arch fixed dental prostheses
    (Mosby-Elsevier, 2020) Bilmenoglu, Caglar; Cilingir, Altug; Geckili, Onur; Bilhan, Hakan; Bilgin, Tayfun
    Statement of problem. Digital scanning systems have become popular, but whether these systems are adequate for complete-arch implant-supported fixed dental prostheses is unclear. Purpose. The purpose of this in vitro study was to evaluate the trueness of 10 different dental intraoral scanners. Material and methods. Six implant analogs were installed, and an edentulous mandibular model composed of scannable Type 4 gypsum was scanned with 10 different intraoral scanners (3D Progress, Omnicam, Bluecam, Apollo DI, Planscan, E4D Tech, TRIOS MonoColor Cart, TRIOS Color Cart, TRIOS Color Pod, Lythos), 10 times each after the scan body was placed on the implant abutments. The data obtained were then converted into standard tessellation language format. For the control group, the gypsum model was scanned with an industrial scanner (ATOS Core 80). For trueness, the dental and industrial scanning data packs were analyzed with 3D comparison software. Statistical analyses were performed by using the Kruskal-Wallis and Mann-Whitney U tests. Results. When ranked according to their surface superimposition values, the Color POD, Omnicam, Apollo DI, Color Cart, MonoColor Cart, and Bluecam scanners were found within the range of 31 to 45 mm. This group was followed by E4D, 3D Progress, Lythos, and Planscan, which were found within the range of 82 to 344 mm according to the same criteria. Conclusions. Some of the digital scanners had the necessary performance for the fabrication of complete-arch implant-supported fixed dental prostheses. However, the possibility of data loss producing artifacts should be considered.
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    The Influence of Interimplant Distance in Mandibular Overdentures Supported by Two Implants on Patient Satisfaction and Quality of Life
    (Quintessence Publishing Co Inc, 2015) Geckili, Onur; Cilingir, Altug; Erdogan, Ozge; Kesoglu, Aysun Coskun; Bilmenoglu, Caglar; Ozdiler, Arda; Bilhan, Hakan
    This study evaluates the influence of interimplant distance (ID) on patient satisfaction and quality of life (QOL) of 55 patients who received mandibular overdentures supported by two implants. IDs were measured over the residual ridge crest and linearly on all of the patients' mandibular casts. The crestal detours of all patients were determined by subtracting these two values from each other. Higher IDs were associated with better QOL scores (P < .05), whereas higher crestal detour values were associated with better general comfort, chewing, ease of hygiene maintenance, esthetics, pain, and QOL scores (P < .05).