Turkiye Klinikleri Journal of Dental Sciences

.: REVIEW
Avulse Dişleri Taşıma Ortamları: Bir Güncelleme
Transport Media for Avulsed Teeth: an Update
Elif BALLIKAYAa, Şeyma ÖZTÜRKa, Zafer C.ÇEHRELİa
aHacettepe Üniversitesi Diş Hekimliği Fakültesi, Çocuk Diş Hekimliği ABD, Ankara, TÜRKİYE
Turkiye Klinikleri J Dental Sci. 2020;26(3):487-95
doi: 10.5336/dentalsci.2019-71742
Article Language: TR
Full Text
ÖZET
 Avulsiyon, bir dişin alveol soketten tamamen ayrılmasıyla sonuçlanan ve acil tedavi gerektiren, en ciddi diş yaralanmasıdır. Avulse dişlerde, ideal tedavi immediat replantasyon olmakla birlikte bu her olguda mümkün olmayabilir. Diş replantasyonu sonrası daha olumlu bir prognoz elde etmek için, avulse dişin ağız dışında geçirdiği sürenin kısa olması ve replante edilene kadar uygun bir taşıma ortamının kullanılması gerekmektedir. Avulse dişlerde taşıma ortamı, periodontal ligament (PDL) hücrelerinin canlılığını ve mitojenik yeteneklerini koruyabilecek biyolojik özelliklerin yanı sıra uygun pH ve ozmolaliteye sahip olmalıdır. Fizyolojik yapıda olmayan taşıma ortamları, PDL hücrelerinde canlılığı olumsuz yönde etkileyerek diş kökünde replasman rezorpsiyonuna ve ankiloza yol açabilir. Literatürde taşıma ortamı olarak tükürük, süt ve Hank'in dengeli tuz çözeltisi (HDTÇ) gibi birçok sıvı ve vasatın etkinliği araştırılmıştır. Musluk suyu, ani hücre lizisine yol açarak kuru ortama benzer sonuçlar veren en kötü taşıma ortamları arasındadır. Her ne kadar HDTÇ, ViaSpan ve Eagle'nın minimum esansiyel vasatı (EM) avulsiyondan sonra bir süreliğine PDL hücrelerini canlı tutma potansiyeline sahip olsa da bu taşıma ortamlarının kullanılabilirliği, maliyetleri ve halkın kaza anında erişebilme yetersizliği bu ortamları daha az ideal kılmaktadır. Süt, çoğu durumda en uygun, en ucuz ve en erişilebilir taşıma ortamıdır ve ayrıca PDL hücrelerini canlı tutabilme özelliğine sahiptir. Bu literatür derlemesinde, avulse dişlerin taşınmasında kullanılan doğal ve yapay taşıma ortamları ve bu alandaki güncel gelişmeler değerlendirilecektir.

Anahtar Kelimeler: Dental travma; avulsiyon; taşıma ortamı
ABSTRACT
 Dental avulsion is the most severe type of dental injury that requires emergency treatment and results in the complete displacement of a tooth from the alveolar socket. Although the ideal treatment for an avulsed tooth is immediate replantation, this may not be possible in every case. To achieve a more favorable prognosis following tooth replantation, short extra-alveolar time and use of an appropriate transport media until replantation of avulsed teeth are essential The transport media for avulsed teeth should possess favorable pH, osmolality and biological properties that help preserve the vitality and mitogenic properties of the periodontal ligament (PDL) cells. The non-physiological storage media could result in replacement resorption of root and ankylosis by affecting periodontal ligament cells negatively. Numerous studies have studied the efficacy of a variety of transport media comprising saliva, milk and Hank's Balanced Salt. Tap water which has similar results to the dry environment is one of the worst transport media leading to sudden cell lysis. Although HBSS, ViaSpan and Eagle's medium have great potential to maintain the PDL cells alive for a while after an avulsion, the practicalities of using these solutions, the costs and the lack of ready availability to the public make them less than ideal. Milk is the most convenient, cheapest and readily available solution in most situations and also being capable of keeping PDL cells alive. This article will review natural and artificial storage mediums for the transport of avulsed teeth and the recent updates in this field.

Keywords: Dental trauma; avulsion; storage media
REFERENCES:
  1. Longo DL, Fumes AC, Küchler EC, Paula-Silva FWG, Nelson-Filho P, Silva LAB, et al. Efficiency of different storage media for avulsed teeth in animal models: a systematic review. Dent Traumatol. 2018;34(1):12-9. [Crossref]  [PubMed] 
  2. Abdul M, Date R, Yussuf C, Khandwawala N, Hegde V. Avulsed tooth-a storage medium dilemma an update. J Trauma Treat. 2015;4(245):2167-1222.1000245.
  3. Ahangari Z, Alborzi S, Yadegari Z, Dehghani F, Ahangari L, Naseri M, et al. The effect of propolis as a biological storage media on periodontal ligament cell survival in an avulsed tooth: an in vitro study. Cell J. 2013;15(3):244-9. [PubMed] 
  4. Babaji P, Melkundi M, Devanna R, Suresh BS, Chaurasia VR, Gopinath PV, et al. In vitro comparative evaluation of different storage media (hank's balanced salt solution, propolis, aloe vera, and pomegranate juice) for preservation of avulsed tooth. Eur J Dent. 2017;11(1):71-5. [Crossref]  [PubMed]  [PMC] 
  5. Mesquita GC, Soares PBF, Moura CCG, Roscoe MG, Paiva SM, Soares CJ, et al. A 12-year retrospective study of avulsion cases in a public Brazilian dental trauma service. Braz Dent J. 2017;28(6):749-56. [Crossref]  [PubMed] 
  6. Khinda VI, Kaur G, Brar GS, Kallar S, Khurana H. Clinical and practical implications of storage media used for tooth avulsion. Int J Clin Pediatr Dent. 2017;10(2):158-65. [Crossref]  [PubMed]  [PMC] 
  7. Gomes MCB, Westphalen VPD, Westphalen FH, Silva Neto UX, Fariniuk LF, Carneiro E, et al. Study of storage media for avulsed teeth. Brazil J Dent Traumatol. 2009;1(2):69-76.
  8. Waymouth C. Osmolality of mammalian blood and of media for culture of mammalian cells. In Vitro. 1970;6(2):109-27. [Crossref]  [PubMed] 
  9. Andreasen JO, Kristerson L. The effect of limited drying or removal of the periodontal ligament. Periodontal healing after replantation of mature permanent incisors in monkeys. Acta Odontol Scand. 1981;39(1):1-13. [Crossref]  [PubMed] 
  10. Blomlöf L, Lindskog S, Andersson L, Hedström KG, Hammarström L. Storage of experimentally avulsed teeth in milk prior to replantation. J Dent Res. 1983;62(8):912-6. [Crossref]  [PubMed] 
  11. Ashkenazi M, Marouni M, Sarnat H. In vitro viability, mitogenicity and clonogenic capacities of periodontal ligament fibroblasts after storage in four media supplemented with growth factors. Dent Traumatol. 2001;17(1):27-35. [Crossref]  [PubMed] 
  12. Poi WR, Sonoda CK, Martins CM, Melo ME, Pellizzer EP, de Mendonça MR, et al. Storage media for avulsed teeth: a literature review. Braz Dent J. 2013;24(5):437-45. [Crossref]  [PubMed] 
  13. Badakhsh S, Eskandarian T, Esmaeilpour T. The use of aloe vera extract as a novel storage media for the avulsed tooth. Iran J Med Sci. 2014;39(4):327-32. [PubMed] 
  14. Al-Nazhan S, Al-Nasser A. Viability of human periodontal ligament fibroblasts in tissue culture after exposure to different contact lens solutions. J Contemp Dent Pract. 2006;1;7(4):37-44. [Crossref]  [PubMed] 
  15. Lee W, Stover S, Rasoulianboroujeni M, Sherman K, Fahimipour F, Dashtimoghadam E, et al. The efficacy of commercial tooth storage media for maintaining the viability of human periodontal ligament fibroblasts. Int Endod J. 2018;51(1):58-68. [Crossref]  [PubMed] 
  16. Blomlöf L, Otteskog P, Hammarström L. Effect of storage in media with different ion strengths and osmolalities on human periodontal ligament cells. Scand J Dent Res. 1981;89(2):180-7. [Crossref]  [PubMed] 
  17. Marino TG, West LA, Liewehr FR, Mailhot JM, Buxton TB, Runner RR, et al. Determination of periodontal ligament cell viability in long shelf-life milk. J Endod. 2000;26(12):699-702. [Crossref]  [PubMed] 
  18. Trope M. Clinical management of the avulsed tooth: present strategies and future directions. Dent Traumatol. 2002;18(1):1-11. [Crossref]  [PubMed] 
  19. Andersson L, Andreasen JO, Day P, Heithersay G, Trope M, Diangelis AJ, et al. International association of dental traumatology guidelines for the management of traumatic dental injuries: 2. avulsion of permanent teeth. Dent Traumatol. 2012;28(2):88-96. [Crossref]  [PubMed] 
  20. Malhotra N. Current developments in interim transport (storage) media in dentistry: an update. Br Dent J. 2011;8;211(1):29-33. [Crossref]  [PubMed] 
  21. Ashkenazi M, Sarnat H, Keila S. In vitro viability, mitogenicity and clonogenic capacity of periodontal ligament cells after storage in six different media. Endod Dent Traumatol. 1999;15(4):149-56. [Crossref]  [PubMed] 
  22. Trope M, Friedman S. Periodontal healing of replanted dog teeth stored in Viaspan, milk and Hank's balanced salt solution. Endod Dent Traumatol. 1992;8(5):183-8. [Crossref]  [PubMed] 
  23. Ulusoy AT, Kalyoncuoglu E, Kaya S, Cehreli ZC. Evaluation of goat milk as storage media to preserve viability of human periodontal ligament cells in vitro. Dent Traumatol. 2016;32(4):264-8. [Crossref]  [PubMed] 
  24. de Souza BDM, Bortoluzzi EA, Reyes-Carmona J, Dos Santos LGP, de Oliveira Simões CM, Felippe WT, et al. Effect of temperature and seven storage media on human periodontal ligament fibroblast viability. Dent Traumatol. 2017;33(2):100-05. [Crossref]  [PubMed] 
  25. Sinpreechanon P, Boonzong U, Sricholpech M. Comparative evaluation of periodontal ligament fibroblasts stored in different types of milk: effects on viability and biosynthesis of collagen. Eur J Oral Sci. 2019;127(4):323-32. [Crossref]  [PubMed] 
  26. Martin MP, Pileggi R. A quantitative analysis of propolis: a promising new storage media following avulsion. Dent Traumatol. 2004;20(2):85-9. [Crossref]  [PubMed] 
  27. Pileggi R, Antony K, Johnson K, Zuo J, Holliday LS. Propolis inhibits osteoclast maturation. Dent Traumatol. 2009;25(6):584-8. [Crossref]  [PubMed] 
  28. Campbell-Falck D, Thomas T, Falck TM, Tutuo N, Clem K. The intravenous use of coconut water. Am J Emerg Med. 2000;18(1):108-11. [Crossref]  [PubMed] 
  29. Moreira‐Neto JJS, Gondim JO, Raddi MSG, Pansani CA. Viability of human fibroblasts in coconut water as a storage medium. Int Endod J. 2009;42(9):827-30. [Crossref]  [PubMed] 
  30. Tripathi S, Bruch D, Gatto LA, Kittur DS. Green tea extract prolongs allograft survival as an adjunctive therapy along with low dose cyclosporine a. J Surg Res. 2009;1;154(1):85-90. [Crossref]  [PubMed] 
  31. Hwang JY, Choi SC, Park JH, Kang SW. The use of green tea extract as a storage medium for the avulsed tooth. J Endod. 2011;37(7):962-7. [Crossref]  [PubMed] 
  32. Khademi AA, Saei S, Mohajeri MR, Mirkheshti N, Ghassami F, Torabi nia N, et al. A new storage medium for an avulsed tooth. J Contemp Dent Pract. 2008;1;9(6):25-32. [Crossref]  [PubMed] 
  33. Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F, et al. Guidelines for the management of traumatic dental injuries. II. Avulsion of permanent teeth. Dent Traumatol. 2007;23(3):130-6. [Crossref]  [PubMed] 
  34. Andersson L, Andreasen JO, Day P, Heithersay G, Trope M, DiAngelis AJ, et al. Guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Pediatr Dent. 2016;38(6):369-76. [PubMed] 
  35. Ozan F, Tepe B, Polat ZA, Er K. Evaluation of in vitro effect of morus rubra (red mulberry) on survival of periodontal ligament cells. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(2):e66-9. [Crossref]  [PubMed] 
  36. Joseph B, Raj SJ. Pharmacognostic and phytochemical properties of aloe vera linn- an overview. Int J Pharm Sci Rev Res. 2010;4(2):106-10.
  37. Davis RH, Leitner MG, Russo JM, Byrne ME. Wound healing. Oral and topical activity of aloe vera. J Am Podiatr Med Assoc. 1989;79(11):559-62. [Crossref]  [PubMed] 
  38. Pileggi R, Dumsha TC, Nor JE. Assessment of post-traumatic PDL cells viability by a novel collagenase assay. Dent Traumatol. 2002;18(4):186-9. [Crossref]  [PubMed] 
  39. Rajendran P, Varghese NO, Varughese JM, Murugaian E. Evaluation, using extracted human teeth, of Ricetral as a storage medium for avulsions - an in vitro study. Dent Traumatol. 2011;27(3):217-20. [Crossref]  [PubMed] 
  40. Harkacz Sr OM, Carnes Jr DL, Walker 3rd WA. Determination of periodontal ligament cell viability in the oral rehydration fluid gatorade and milks of varying fat content. J Endod. 1997;23(11):687-90. [Crossref]  [PubMed] 
  41. Sigalas E, Regan JD, Kramer PR, Witherspoon DE, Opperman LA. Survival of human periodontal ligament cells in media proposed for transport of avulsed teeth. Dent Traumatol. 2004;20(1):21-8. [Crossref]  [PubMed] 
  42. Gopikrishna V, Thomas T, Kandaswamy D. A quantitative analysis of coconut water: a new storage media for avulsed teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(2):e61-5. [Crossref]  [PubMed] 
  43. Casaroto AR, Hidalgo MM, Seil AM, Franco SL, Cuman RKN, Moreschi E, et al. Study of the effectiveness of propolis extract as a storage medium for avulsed teeth. Dent Traumatol. 2010;26(4):323-31. [Crossref]  [PubMed] 
  44. Thomas T, Gopikrishna V, Kandaswamy D. Comparative evaluation of maintenance of cell viability of an experimental transport media "coconut water" with Hank's balanced salt solution and milk, for transportation of an avulsed tooth: an in vitro cell culture study. J Conserv Dent. 2008;11(1):22-9. [Crossref]  [PubMed]  [PMC] 
  45. de Souza BDM, Bortoluzzi EA, da Silveira Teixeira C, Felippe WT, Simões CMO, Felippe MCS, et al. Effect of HBSS storage time on human periodontal ligament fibroblast viability. Dent Traumatol. 2010;26(6):481-3. [Crossref]  [PubMed] 
  46. Souza BDM, Lückemeyer DD, Felippe WT, Simões CMO, Felippe MCS. Effect of temperature and storage media on human periodontal ligament fibroblast viability. Dent Traumatol. 2010;26(3):271-5. [Crossref]  [PubMed] 
  47. Koçaklı ZG, Akıllıoğlu K, Doğan A. [Isolation and culture of vascular smooth muscle cells]. Archives Medical Review Journal. 2015;24(3):390-401. [Crossref] 
  48. Saxena P, Pant VA, Wadhwani KK, Kashyap MP, Gupta SK, Pant AB, et al. Potential of the propolis as storage medium to preserve the viability of cultured human periodontal ligament cells: an in vitro study. Dent Traumatol. 2011;27(2):102-8. [Crossref]  [PubMed] 
  49. Osmanovic A, Halilovic S, Kurtovic‐Kozaric A, Hadziabdic N. Evaluation of periodontal ligament cell viability in different storage media based on human PDL cell culture experiments-a systematic review. Dent Traumatol. 2018;34(6):384-93. [Crossref]  [PubMed] 
  50. Sottovia AD, Sottovia Filho D, Poi WR, Panzarini SR, Luize DS, Sonoda CK, et al. Tooth replantation after use of Euro-Collins solution or bovine milk as storage medium: a histomorphometric analysis in dogs. J Oral Maxillofac Surg. 2010;68(1):111-9. [Crossref]  [PubMed] 
  51. Alaçam T, Görgül G, Omürlü H, Can M. Lactate dehydrogenase activity in periodontal ligament cells stored in different transport media. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82(3):321-3. [Crossref]  [PubMed] 
  52. Ishikawa S, Iwasaki K, Komaki M, Ishikawa I. Role of ascorbic acid in periodontal ligament cell differentiation. J Periodontol. 2004;75(5):709-16. [Crossref]  [PubMed] 
  53. Sculean A, Schwarz F, Becker J, Brecx M. The application of an enamel matrix protein derivative (Emdogain) in regenerative periodontal therapy: a review. Med Princ Pract. 2007;16(3):167-80. [Crossref]  [PubMed] 

.: Up To Date

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com