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    Diagnosis and Treatment of Endodontically Treated Teeth with Vertical Root Fracture: Three Case Reports with Two-year Follow-up
    (Elsevier Science Inc, 2011) Ozer, Senem Yigit; Unlu, Gulten; Deger, Yalcin
    Introduction: Vertical root fracture (VRF) is an important threat to the tooth's prognosis during and after root canal treatment. Often the detection of these fractures occurs years later by using conventional periapical radiographs. However, recent studies have addressed the benefits of computed tomography to diagnose these problems earlier. Accurately diagnosed VRFs have been treated by extraction of teeth, with minimal damage to the periodontal ligament, extraoral bonding of fractured segments with an adhesive resin cement, and intentional replantation of teeth after reconstruction. Methods: The 3 case reports presented here describe the diagnosis and treatment of vertically fractured teeth that had been previously treated endodontically. Cone-beam computed tomography (CBCT) was used for diagnostic imaging to detect VRFs. Vertically fractured roots were carefully extracted and extraorally treated by using a self-etching dual-cure adhesive resin cement, and intentional replantations were performed after reconstruction. Results: After a mean follow-up period of 2 years, the teeth were asymptomatic. There was no clinical ankylosis, and diagnosis by using CBCT scans showed reduced periapical radiolucency. Conclusions: Extraoral bonding of fractured segments and intentional replantation of teeth after reconstruction provide an alternative treatment to extraction, especially for anterior teeth. Computed tomography assisted VRF diagnosis is helpful in detecting fractures; however, higher-resolution tomography units providing better image quality would be a better choice for improved visualization of these fractures. (J Endod 2011;37:97-102)
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    Evaluation of chronic hepatitis B patients who voluntarily discontinued oral antiviral therapy: is there an answer to the controversial topic?
    (Lippincott Williams & Wilkins, 2024) Arslan, Eyup; Yildiz, Yesim; Karasahin, Omer; Demir, Yakup; Mermutluoglu, Cigdem Tumbul; Unlu, Gulten; Kuscu, Ferit
    ObjectiveThe uncertain treatment duration for nucleos(t)ide analogues (NA) used in the treatment of chronic hepatitis B (CHB) is an important problem for both patients and physicians. The aim of this study was to evaluate the determinants of virologic relapse (VR) and the optimum time of treatment discontinuation in the follow-up of CHB patients who voluntarily discontinued treatment after virological suppression was achieved under NA use.MethodsData from 138 patients from 11 centers were included in this registry-based study. Factors associated with VR were investigated using multivariate Cox regression analysis.ResultsNinety-nine (71.7%) of the patients were HBeAg (Hepatitis B e antigen) negative. During the 24-month follow-up period after treatment discontinuation, VR occurred in 58.7% (n = 81) of all patients and 57.6% (n = 57) of HBeAg-negative patients. The duration of NA treatment was significantly shorter (cutoff 60 months) in HBeAg-negative patients who later developed VR. In addition, the duration of virologic remission achieved under NA treatment was significantly shorter (cutoff 52 months) in those who later developed VR. In the Cox multivariate regression model of HBeAg-negative patients, having less than 60 months of NA treatment (HR = 2.568; CI:1.280-5.148; P = 0.008) and the levels of alanine aminotransferase being equal to or higher than twice the upper level of normal at the beginning of treatment (HR = 3.753; CI:1.551-9.081; P = 0.003) were found to be statistically significant and independently associated with VR.ConclusionThe findings of this study may provide clinical guidance in terms of determining the most appropriate discontinuation time for NA.
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    The Impact of Vaccination Among Hospitalized Patients with the Diagnosis of COVID-19
    (Doc Design Informatics Co Ltd, 2023) Yildiz, Yesim; Ozger, Hasan Selcuk; Acar, Ali; Seremet-Keskin, Aysegul; Binay, Umut Devrim; Unlu, Gulten; Bayram, Halim
    Objective: We aimed to investigate the vaccination status and the risk factors for the intensive care unit (ICU) support need of the laboratory-confirmed breakthrough COVID-19 infection inpatients. Materials and Methods: This multi-center point-prevalence study was conducted on inpatients, divided into two groups as 'fully' and 'partially' vaccinated according to COVID-19 vaccination status. Results: Totally 516 patients were included in the study. The median age was 65 (55-77), and 53.5% (n=276) of the patients were male. Hypertension (41.9%, n=216), diabetes mellitus (DM) (31.8%, n=164), and coronary artery disease (CAD) (16.3%, n=84) were the predominant comorbidities. Patients were divided into two groups ICU (n=196) and non-ICU (n=301). Hypertension (p=0.026), DM (p=0.048), and congestive heart failure (CHF) (p=0.005) were significantly higher in ICU patients and the median age was younger among non-ICU patients (p=0.033). Of patients, 16.9% (n=87) were fully vaccinated, and this group's need for ICU support was statistically significantly lower (p=0.021). Conclusion: We conclude that older age, hypertension, DM, CHF, and being partially vaccinated were associated with the need for ICU support. Therefore, all countries should continuously monitor post-vaccination breakthrough COVID-19 infections to determine the national booster vaccine administration approach that will provide vulnerable individuals the highest protection.