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    Decision making for optimal treatment for patients with periodontitis based on recent classification criteria
    (Aydin Adnan Menderes University, 2025) Kütük, Ceren; Parlak, Hanife Merva; Parmaksız, Ayhan; Tarhan, Nermin; Keçeli, Hüseyin Gencay
    Objective: The study aimed to evaluate the accuracy and agreement of clinicians with different education levels and clinical experience in periodontitis diagnosis and treatment planning. Materials and Methods: Depending on the stage, grade, and extent components of periodontitis, a consensus diagnosis and treatment plan document prepared by two experienced periodontists was used as a gold-standard. An anonymous survey including 10 periodontitis cases was given to 15 participants (5 periodontal experts (PE), 5 postgraduate periodontology students (PS), and 5 undergraduate dental students (DS)) and asked them to classify each case depending on the components of the disease and select their treatment plan from a multiple-choice questionnaire including 11 dental treatment options. The accuracy of the responses was detected by referring to the gold-standard and inter-examiner agreement levels were also assessed. Results: Except grade, no significant inter-group difference was found in the periodontitis components and this difference only existed in the PE group (p=0.012). PE group gave more accurate treatment planning responses compared to others. The agreement levels of all examiners for stage, grade, and extent were fair (κ=0.366, 0.222, and 0.287, respectively). Treatment planning showed low agreement (κ<0.31) except tooth extraction option (κ=0.554). Both diagnosis and treatment planning responses showed significant variations amongst groups. Conclusion: Although education level and experience showed superiority in terms of periodontitis diagnosis and treatment planning, the results with low accuracy indicate the need for calibration to reduce the variations and enhance the accuracy.
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    Does platelet-rich fibrin improve the clinical outcomes of intentional replantation in the treatment of periodontally hopeless teeth?
    (İstanbul University Press, 2025) Parlak, Hanife Merva; Parmaksız, Ayhan; Uyanık, Mehmet Özgür; Duruel, Onurcem; Keçeli, Hüseyin Gencay
    Purpose The purpose of this study was to evaluate the impact of using platelet-rich fibrin (PRF) on clinical parameters in intentional replantation (IR) treatment. Materials and Methods Data were obtained from 32 mandibular anterior teeth with a 15-month follow up, treated with either IR (n=17) or IR+PRF (n=15). Periodontal parameters included probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and keratinized tissue height (KTH), all of which were assessed retrospectively. Results PD reduction at mesial and midlingual sites was greater in the IR+PRF group at the 15-month follow-up (p=0.043 and p=0.017, respectively), whereas CAL gain in the IR+PRF group was significantly higher at 3, 6, and 15 months (p<0.05). GI scores were similar in both groups, while PI scores were higher in the IR group at 6 and 15 months (p<0.05). Changes in KTH were similar in both groups at all follow-up periods. Conclusion IR can be considered for the treatment of periodontally hopeless mandibular anterior teeth, and combining IR with PRF may improve clinical outcomes. However, its clinical use should be recommended cautiously due to the lack of histological data regarding the effects of PRF on IR healing.
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    Palatal donor site management using tissue adhesives with adjunctive coconut oil in a randomized clinical trial
    (Springer Nature, 2025) Yılmaz, Melis; Balcı, Nur; Günay, Bestegül; Parlak, Hanife Merva; Parmaksız, Ayhan; Toygar, Hilal; Keçeli, Hüseyin Gencay
    Management of the complications occurring in the donor area after epithelialized gingival graft (EGG) harvesting still poses a challenge for clinicians. This study aimed to evaluate the influence of gelatin sponge (GS), cyanoacrylate (CY), and coconut oil (CO) combination in comparison with GS+CY in donor site management. Fifty EGG were harvested from the lateral palate in 50 patients, who were subsequently randomized to receive the GS+CY (control) or GS+CY+CO combination (test). Postoperative pain perception (PP), quantity of analgesics (QA), epithelization level (EL), color match (CM), sensation loss (SL), postoperative discomfort (PD), and delayed bleeding (DB) were evaluated. The GS+CY+CO group showed lower PP scores compared to the GS+CY (p<0.05). The QA intake was similar in both groups. On day 14, the GS+CY+CO group achieved 80% full EL rate, which was higher than the GS+CY group (32%) (p=0.002). CM scores were higher in the GS+CY+CO group at all follow up periods (p<0.001). Both groups reported similar SL, PD, and DB values (p>0.05). GS+CY+CO combination is more effective in reducing pain compared to GS+CO in donor site management after EGG harvesting. Additionally, GS+CY+CO combination may accelerate epithelialization and improve color match compared to GS+CY alone.