Alper Saglanmak’s research while affiliated with Istanbul University and other places

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Publications (15)


PREVALENCE OF PERI-IMPLANT DISEASE AROUND SUBCRESTAL PLACED IMPLANTS
  • Article

January 2025

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4 Reads

Sağlık Bilimlerinde İleri Araştırmalar Dergisi / Journal of Advanced Research in Health Sciences

Alper Sağlanmak

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Study flow chart of the study population.
Box-plot graphic of mDASs and NRSs change. ** p < 0.01.
Variable description and their distribution.
Subjective self-assessment of mDASs and NRSs according to study groups.
Predictors in logistic regression model of dental anxiety reduction.

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Changes of Dental Implant Surgery-Related Anxiety and Pain with Respect to ASA-Physical Status
  • Article
  • Full-text available

November 2024

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25 Reads

Background/Objectives: Rehabilitation of missing teeth with dental implants is a strong trigger of dental anxiety. The sympathetic response caused by anxiety can lead to cardiovascular and cerebrovascular incidents, especially in patients at systemic risk (ASA Physical Status-II and ASA Physical Status-III). Dental anxiety can affect physical health by activating the sympathetic response, and the patient’s physical health status may also affect dental anxiety. The aim of this study was to analyze the factors that may reduce anxiety and pain, considering the patient’s physical health status according to American Society of Anesthesiologists (ASA-PS). Methods: A total of 562 implants were placed under local anesthesia in 201 patients with ASA PS-I (healthy) and ASA PS-II and III (comorbid). The effect of patient-, dentist-, and surgery-related variables on dental anxiety and pain perception were evaluated. Modified Corah Dental Anxiety Scale and Numerical Rating Scale for Pain scores were measured and recorded preoperatively (T0) and 1 week postoperatively (T1). The effects of the associated variables were analyzed using binary logistic regression and non-parametric tests (p < 0.05). Results: Age (OR = 1.089), gender (OR = 6.493), ASA-PS (OR = 13.912), and the number of placed implants (OR = 0.807) were significantly associated with reduction in dental anxiety. There were statistically significant differences between the study groups in terms of mDAS score reduction (p = 0.028). Conclusions: ASA-PS, gender and the number of placed implants affected the anxiety of the patients. Age and number of implants seem to be variables with a relative influence that depends on other factors.

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Immediate Implantation with Autologous Mineralized Dentin Graft versus Deproteinized Bovine Bone as Space-Filling Substitute in Maxillary Anterior Zone: Retrospective Radiological and Clinical Study

September 2024

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45 Reads

Background/Objectives: Various bone substitutes have been recommended to augment the horizontal gap following immediate implantation. The purpose of this study was to compare the effectiveness of an autogenous mineralized dentin graft or a deproteinized bovine bone in horizontal gap augmentation following immediate implant placement in the maxillary anterior region. Methods: A total of 110 patients underwent tooth extraction followed by immediate implant placement. The patients were divided into two groups. The first group received an autogenous mineralized dentin graft (the test group) while the second group received a deproteinized bovine bone (the control group) to augment the horizontal gap. Preoperative (T0), immediate postoperative (T1), and 1-year postoperative (T2) cone beam computed tomography scans were taken from all the patients. Linear measurements were recorded 1 mm (R1) and 5 mm (R2) points apical to the implant platform at both T1 and T2 time intervals. Pink Esthetic Scores and prosthetic complications were evaluated as well. Results: There were 57 patients with a mean age of 45.42 ± 9.86 (range 24–63 years) selected as the test group and 53 patients with a mean age of 40.28 ± 11.69 (range 20–63 years) as the control group. The mean reduction in the buccal bone plate at R1 was 6.39 ± 3.78% in the test group and 6.99 ± 5.01% in the control group (p > 0.05). The mean reduction in the buccal bone plate at R2 was 5.46 ± 4.98% in the test group and 6.77 ± 7.60% in the control group (p < 0.05). The PES and prosthetic-related complications were shown to be negligible between the groups (p > 0.05). Conclusions: The efficiency of using an autogenous mineralized dentin graft for horizontal gap augmentation showed similar results in comparison to using a deproteinized bovine bone in relation to buccolingual socket reduction following immediate implantation.


Osseodensification drilling technique in posterior area (a); osseodensified augmentation application (b); endo−sinus bone gain 6 months post op in ODA Group (c); endo−sinus bone gain 6 months post op in OD Group (d).
Endo-sinus bone gain according to study groups at 6 months.
Endo-sinus bone gain according to RBH at 6 months after osseodensification protocol (OD).
Maxillary Sinus Floor Elevation and Simultaneous Implant Installation via Osseodensification Drills: A Retrospective Analysis of Bone Gain in 72 Patients Followed for 6 Months

April 2024

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92 Reads

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6 Citations

Alper Saglanmak

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Ihsan Caglar Cinar

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[...]

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Background/Objectives: The aim of this retrospective study was to radiographically evaluate the endo-sinus bone gain (ESBG) following osseodensification procedures using CBCT and compare the results to more conventional sinus lifting techniques. Methods: A total of 72 patients underwent crestal sinus floor elevation procedures and were provided with 102 implants with a sand-blasted and acid-etched surface with microthreads (Medentika® Microcone Implants, Hugelsheim, Germany). Patients were divided into two groups; the osseodensification group (OD; n = 36) and the osseodensified augmentation group (ODA; n = 36). Results: The mean residual bone height (RBH) was 5.71 (1.77) and 4.30 (0.94) mm in the OD and ODA groups, respectively. An ESBG of 3.45 (1.18) and 5.74 (1.31) mm was observed in the OD and ODA groups, respectively, and as compared to the baseline RBH, the ESBG was statistically significant in both groups after 6 months (p < 0.001). Conclusions: Within the limits of this retrospective study, crestal sinus lifting with the osseodensification technique seems to be a fast, effective, and safe method. Longer follow-up studies with full intrasinus bone topography and structure analyses are needed to prove the success rate of endo-sinus bone gain.


Retrospective analysis of three different xenografts in maxillary sinus augmentation: histologic and three-dimensional radiologic study

June 2023

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23 Reads

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2 Citations

Quintessence international (Berlin, Germany: 1985)

Low bone density and lack of adequate vertical bone dimension as a result of maxillary sinus pneumatization present some of the most problematic cases for endosseous implant applications in posterior maxillary regions that hinder prosthetic rehabilitation; Objectives: The overall objectives of the study were to assess the histologic, histomorphometric and radiological evaluation of biopsies gathered from maxillary sinuses which were grafted with three different bovine bone particles (Bio-Oss®, Cerabone® and Ti-Oss®) and analyze the volume of the bone graft and the quantity of new bone formation; Methods and materials: Thirty-six patients with <4mm of residual ridge height unilaterally in the posterior maxilla, were equally divided into 3 groups, each of which received different bovine bone particles for maxillary sinus augmentation. Six-months later, biopsies were harvested for histological and histomorphometric evaluations. Volumetric changes in maxillary sinus augmentation were analyzed at 1-week (T-I) and 6-months (T-II) time points following maxillary sinus augmentation surgery; Results: Histomorphometric and histological analysis revealed significant difference between Ti-Oss® group compared with Bio-Oss® and Cerabone® groups (P=0.011). In term of residual graft particles and soft tissue, there were no significant differences between groups. 3-D volumetric reductions between 1-week (baseline) and 6-month time points recorded significant graft volume reduction in all groups (P<0.05). Significantly greater bone resorption and lower new-bone formation were manifested in Ti-Oss® group in comparison to the other groups; Conclusions: Within the limits of this study, histological and radiological results indicated that, Bio-Oss® and Cerabone® could be used efficiently in sinus augmentation procedures, while further prospective studies are needed to evaluate the Ti-Oss® material in maxillary sinus augmentation.


Figure 3. Volumetric evaluation of a grafted site.
Relationship between augmentation technique and bone graft resorption variable.
Comparison of Allogeneic Bone Plate and Guided Bone Regeneration Efficiency in Horizontally Deficient Maxillary Alveolar Ridges

October 2022

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180 Reads

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3 Citations

Applied Sciences

(1) Background: Bone Lamina Technique and Guided Bone Regeneration (GBR) are commonly used for horizontally-deficient maxillary ridge reconstruction, although more detailed evaluation to assess the differences between such techniques is necessitated. (2) Methods: In this retrospective study, patients having a horizontal bone width of ≤4 mm in the maxilla, who were treated with Cortical Strut (CS), were collected to represent the “test group”, and those treated with GBR with no CS involvement represented the “control group”. A 1:1 mixture of autogenous bone (AB) and anorganic bovine bone (ABB) with resorbable collagen membrane was applied to both groups. Volumetric changes between groups were measured with cone-beam computed tomography (CBCT). The primary outcome represented volumetric graft resorption rate whilst the secondary outcomes represented any probable complications and implant insertion torque. (3) Results: A total of 36 patients were included in this study (36 grafted sites; 18 for CS group and 18 for GBR group). Mean bone graft volume reduction in the CS and GBR groups was 8.26 ± 1.60% and 14.36 ± 3.55%, respectively. The GBR group showed significantly more bone resorption than the CS group (p < 0.001). Complications and insertion torque were similar between the groups (p > 0.05). (4) Conclusions: Both CS and GBR techniques for hard-tissue augmentation provided sufficient bone graft mass volume for implant insertion, whereas CS demonstrated lower resorption rate at maxillary augmented sites, compared to GBR.


Fig 4 Crestal bone loss at the 5-year control (thick biotype). P1, 0.40 mm; P2, 0.37 mm.
Effect of soft tissue thickness on crestal bone loss of early loaded implants with platform switching: 1- and 5-year data

January 2021

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171 Reads

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6 Citations

Quintessence international (Berlin, Germany: 1985)

Objectives: The aim of this retrospective study was to evaluate the effect of vertical soft tissue thickness (STT) on crestal bone loss (CBL) of early loaded implants after 1 and 5 years. Method and materials: Forty-four tapered implants with platform switching and conical connection were placed in the posterior mandible and maxilla to rehabilitate edentulous sites. STT at implant sites was divided into two groups: thin (n = 21, mean STT = 2.0 ± 0.3 mm) and thick (n = 23, mean STT = 3.0 ± 0.8 mm). The implants were loaded after 6 to 8 weeks. Survival and success rates and CBL were measured after 1 and 5 years. Results: The survival and success rates at 1 and 5 years were 100% and 97.8%, respectively. At the 1-year follow-up, the CBL of the thin and thick gingival groups was 0.96 ± 0.49 and 0.55 ± 0.41 mm, respectively; the difference was statistically significant (P = .004). At 5 years, the CBL of the thin and thick gingiva groups increased to 1.12 ± 0.84 and 0.65 ± 0.69 mm, respectively; the difference was not statistically significant (P = .052). Conclusion: At 1 year, the CBL was more pronounced at sites with a thin gingiva; at 5 years the difference between the groups was not statisically significantly different. Within the limitations of this study, early loading of implants with platform switched and conical connection was safe. .


Dental Implants

November 2020

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1,149 Reads

The goal of modern dentistry is to return patients to oral health in a predictable fashion. The partial and complete edentulous patient may be unable to recover normal function, esthetics, comfort, or speech with a traditional removable prosthesis. The patient’s function when wearing a denture may be reduced to one sixth of the level formerly experienced with natural dentition; however, an implant prosthesis may return the function to near-normal limits. The esthetics of the edentulous patient is affected as a result of muscle and bone atrophy. In order to replace a missing tooth, the development of materials science and technology improved the materials for implant application. Nowadays, titanium has become the most popular implant material due to its advantages. The first submerged implant placed by Strock was still functioning 40 years later. Recently, zirconia implants and innovative surface designs are being researched and practiced. In this chapter, these materials will be comparatively discussed through contemporary literature and research.


Platelet Rich Fibrin (PRF) Application in Oral Surgery

November 2020

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1,609 Reads

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4 Citations

Platelet rich fibrin (PRF) is an autologous biological product which becomes popular day by day and available in a wide variety of fields in medicine. Platelet concentrates which are introduced at the early 90s have evolved over the years. The use such autologous materials have become trendy in recent years to encounter demanding expectations of patients, improve treatment success and maximize patient comfort. Despite its increasing use in dentistry and oral surgery, the most indications and effects are still being discussed. PRF is easily accepted by patients because of its low cost, easy to receive, low donor morbidity, low postoperative complication and infection rate. This biomaterial may be a solution for patients who have strong negative beliefs about the use of allografts and xenografts or who are afraid of complications during the grafting procedure. The objectives of these technologies are to use their synergistic effect to improve the hard and soft tissue regeneration. PRF in oral surgery are used for alveolar bone reconstruction, dental implant surgery, sinus augmentation, socket preservation, osteonecrosis, oroantral fistula closure, struggling with oral ulcers, preventing swelling and edema constitution. This chapter aims to review the clinical applications of platelets in oral surgery and the role of molecular components in tissue healing.



Citations (7)


... Recent technological developments have given rise to a range of new techniques for performing sinus augmentation less invasively through the crestal route. In a previous study [48], the osseodensification technique was employed for crestal sinus augmentation, and it was found that there was promising endo-sinus bone gain without implant failure, even in cases with a limited residual bone height of 2-4 mm. However, the study is limited by a six-month follow-up period, and further research is required to assess long-term outcomes. ...

Reference:

Dental Implant Rehabilitation of Posterior Maxillary Edentulism via Sinus Augmentation Using the Lateral Window Technique: A Retrospective Analysis of 289 Implants Followed Up for 15 Years
Maxillary Sinus Floor Elevation and Simultaneous Implant Installation via Osseodensification Drills: A Retrospective Analysis of Bone Gain in 72 Patients Followed for 6 Months

... When a dental element is lost in the posterior region of the maxilla, there is natural reabsorption of the alveolar process and at the same time, pneumatization of the maxillary sinus occurs. It will increase its volume towards the location where the roots existed and this will often make it difficult or unfeasible to restore implants in that location [1,2]. ...

Retrospective analysis of three different xenografts in maxillary sinus augmentation: histologic and three-dimensional radiologic study
  • Citing Article
  • June 2023

Quintessence international (Berlin, Germany: 1985)

... Mineralized allografts (MAs) provide good stability and space maintenance because of their physical properties. [4,6,13] Osteoconductive scaff olds of MAs ensure volume preservation and new bone formation [14]. It can be composed of cortical and cancellous particles or both. ...

Comparison of Allogeneic Bone Plate and Guided Bone Regeneration Efficiency in Horizontally Deficient Maxillary Alveolar Ridges

Applied Sciences

... Thin soft tissue phenotype is a risk factor for peri-implant tissue dehiscence (Kan et al. 2018) as pronounced marginal bone loss ensues 12 months after placement (Saglanmak et al. 2021). Hence, there is literature consensus for the superiority of greater tissue thickness over thin biotypes, especially in platformmatched implants (Cochran et al. 1997;Di Gianfilippo et al. 2020). ...

Effect of soft tissue thickness on crestal bone loss of early loaded implants with platform switching: 1- and 5-year data

Quintessence international (Berlin, Germany: 1985)

... PRF serves as a supportive template for tissue regeneration by guiding clot formation through sustaining growth factors and stem cells as a naturally forming fibrin scaffold. There are many applications of PRF in cosmetic medicine and surgery [38][39]. Further research is expected to uncover more benefits to be obtained from PRF's regenerative properties, bioavailability, and autologous nature. ...

Platelet Rich Fibrin (PRF) Application in Oral Surgery

... Sacco developed the third-generation concentrated growth factor (CGF) in 2006, which offers significant advancements in tissue and bone repair (38,(134)(135)(136)(137)(138)(139)(140). CGF is created through centrifugation at varying speeds, resulting in a denser and more robust fibrin matrix than PRP and PRF (1, [141][142][143][144][145][146][147]. This matrix, rich in growth factors, provides improved tissue healing and regeneration (148)(149)(150)(151)(152)(153)(154)(155)(156)(157)(158)support. ...

Histologic, Histomorphometric, and Clinical Analysis of the Effects of Growth Factors in a Fibrin Network Used in Maxillary Sinus Augmentation

... During dental caries, bacteria can erode the dentin layer and penetrate the tooth pulp through dentinal tubules or deep cavities, leading to pulpitis and periapical inflammation, which can eventually result in tooth loss [2]. In pulpitis [3], the significant activation and infiltration of inflammatory cells, such as T-lymphocytes, monocytes, macrophages, and eosinophils, occurs in response to bacterial products, such as lipopolysaccharide (LPS). To prevent pulp necrosis at the early stages of pulpitis, it is therefore crucial to promote tissue repair [4]. ...

Presence of ROS in Inflammatory Environment of Peri-Implantitis Tissue: In Vitro and In Vivo Human Evidence