Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Biomechanical Behaviors of Implant-Supported Zirconia Restorations Cemented to Novel Screw-Retained Abutment Systems: A Three-Dimensional Finite Element Analysis Study
Yeni Vida Tutuculu Abutment Sistemlerine Simante Edilen İmplant Destekli Zirkonya Restorasyonların Biyomekanik Davranışları: Üç Boyutlu Sonlu Elemanlar Analiz Çalışması
Necati KALELİa, Çağrı URALb
aİstanbul Medeniyet University Faculty of Dentistry, Department of Dentistry, İstanbul, TURKEY
bOndokuz Mayıs University Faculty of Dentistry, Department of Prosthodontics, Samsun, TURKEY
Turkiye Klinikleri J Dental Sci. 2020;26(2):219-30
doi: 10.5336/dentalsci.2019-66364
Article Language: EN
Full Text
ABSTRACT
 Objective: The purpose of this study was to evaluate the biomechanical behaviors of non-engaging titanium base abutments (NTiBA) bonded to three-unit zirconia restorations in terms of stress distribution in implants and prosthetic components. Material and Methods: Three-dimensional (3D) models of a tissue-level and bonelevel implant systems and their screw-retained abutments (SRA) and NTiBA were created. A bone block representing the maxillary right posterior region was created, and the implants were placed in the first premolar and first molar areas. Six different three-unit implant-supported fixed dental prostheses (I-FDPs) models were created: tissuelevel implant, N-TiBA, 6 mm crown height (TL6); tissue-level implant, N-TiBA, 10 mm crown height (TL10); bone-level implant, SRA, 6 mm crown height (SR6); bone-level implant, SRA, 10 mm crown height (SR10); bone-level implant, N-TiBA, 6 mm crown height (BL6); bonelevel implant, N-TiBA, 10 mm crown height (BL10). The restoration material was determined as monolithic zirconia. In each model, equal vertical (200 N) and oblique (100 N) loads were applied to each tooth simultaneously. The stress distribution in the restoration, implant, abutments, and basal screws was evaluated through the von Mises stres analysis. Results: The TL6 and TL10 exhibited higher von Mises stres values in the implants and lower von Mises stress values in the abutments than in the other FEA models. The increase in the crown height resulted in higher stress values under oblique loading compared to vertical loading. Conclusion: The non-engaging connection type and crown height affected the stress distribution in the implant and prosthetic components.

Keywords: Non-engaging connection; screw-retained restoration; titanium base abutment
ÖZET
 Amaç: Bu çalışmanın amacı, üç üyeli zirkonya restorasyonlara simante edilen non-engaging titanyum baz abutmentların (N-TiBA) biyomekanik davranışlarını, implant ve protez bileşenlerinde stres dağılımı açısından değerlendirmektir. Gereç ve Yöntemler: Doku seviyesi ve kemik seviyesi implant sistemlerine ait vida tutuculu abutmentlar (SRA) ve N-TiBA'ların üç boyutlu modellemeleri yapıldı. Sağ maksiler posterior bölgeyi temsil eden bir kemik bloğu oluşturuldu ve implantlar birinci premolar ve birinci molar bölgelerine yerleştirildi. Altı farklı üç üyeli implant üstü sabit parsiyel protez (I-FDP) modeli oluşturuldu: doku seviyesi implant, N-TiBA, 6 mm kron yüksekliği (TL6); doku seviyesi implant, N-TiBA, 10 mm kron yüksekliği (TL10); kemik seviyesi implant, SRA, 6 mm kron yüksekliği (SR6); kemik seviyesi implant, SRA, 10 mm kron yüksekliği (SR10); kemik seviyesi implant, N-TiBA, 6 mm kron yüksekliği (BL6); kemik seviyesi implant, NTiBA, 10 mm kron yüksekliği (BL10). Restorasyon malzemesi monolitik zirkonya olarak belirlenmiştir. Her modelde, her dişe aynı anda eşit dikey (200 N) ve oblik (100 N) yük uygulandı. Restorasyon, implant, abutmentlar ve bazal vidalardaki stres dağılımı von Mises stres analizi ile değerlendirildi. Bulgular: TL6 ve TL10 modellemelerinde, implantlarda daha yüksek von Mises stres değerleri gözlenirken ve abutmentlarda daha düşük von Mises stres değerleri gözlendi. Kron yüksekliğindeki artış, dikey yüklemeye kıyasla eğik yükleme altında daha yüksek stres değerlerine neden oldu. Sonuç: Non-engaging bağlantı tipi ve kron yüksekliği, implant ve protetik bileşenlerde stres dağılımını etkiledi.

Anahtar Kelimeler: Non-engaging bağlantı; vida tutuculu restorasyon; titanium baz abutment
REFERENCES:
  1. Silva GC, Cornacchia TM, de Magalhães CS, Bueno AC, Moreira AN. Biomechanical evaluation of screw-and cement-retained implant-supported prostheses: a nonlinear finite element analysis. J Prosthet Dent. 2014;112(6):1479-88. [Crossref]  [PubMed] 
  2. Wittneben JG, Millen C, Brägger U. Clinical performance of screw-versus cement-retained fixed implant-supported reconstructions-a systematic review. Int J Oral Maxillofac Implants. 2014;29 Suppl:84-98. [Crossref]  [PubMed] 
  3. Sailer I, Muhlemann S, Zwahlen M, Hämmerle CH, Schneider D. Cemented and screw-retained implant reconstructions: a systematic review of the survival and complication rates. Clin Oral Implants Res. 2012;23 Suppl 6:163-201. [Crossref]  [PubMed] 
  4. Lemos CA, de Souza Batista VE, Almeida DA, Santiago Júnior JF, Verri FR, Pellizzer EP. Evaluation of cement-retained versus screw-retained implant-supported restorations for marginal bone loss: a systematic review and meta-analysis. J Prosthet Dent. 2016;115(4):419-27. [Crossref]  [PubMed] 
  5. Wilson TG Jr. The positive relationship between excess cement and peri-implant disease: a prospective clinical endoscopic study. J Periodontol. 2009;80(9):1388-92. [Crossref]  [PubMed] 
  6. Korsch M, Obst U, Walther W. Cement-associated peri-implantitis: a retrospective clinical observational study of fixed implant-supported restorations using a methacrylate cement. Clin Oral Implants Res. 2014;25(7):797-802. [Crossref]  [PubMed] 
  7. Venezia P, Torsello F, Cavalcanti R, D'Amato S. Retrospective analysis of 26 complete-arch implant-supported monolithic zirconia prostheses with feldspathic porcelain veneering limited to the facial surface. J Prosthet Dent. 2015;114(4):506-12. [Crossref]  [PubMed] 
  8. Worni A, Kolgeci L, Rentsch-Kollar A, Katsoulis J, Mericske-Stern R. Zirconia-based screw-retained prostheses supported by implants: a retrospective study on technical complications and failures. Clin Implant Dent Relat Res. 2015;17(6):1073-81. [Crossref]  [PubMed] 
  9. Mehra M, Vahidi F. Complete mouth implant rehabilitation with a zirconia ceramic system: a clinical report. J Prosthet Dent. 2014;112(1):1-4. [Crossref]  [PubMed] 
  10. Konstantinidis IK, Jacoby S, Rädel M, Böning K. Prospective evaluation of zirconia based tooth-and implant-supported fixed dental prostheses: 3-year results. J Dent. 2015;43(1):87-93. [Crossref]  [PubMed] 
  11. Guess PC, Att W, Strub JR. Zirconia in fixed implant prosthodontics. Clin Implant Dent Relat Res. 2012;14(5):633-45. [Crossref]  [PubMed] 
  12. de Kok P, Kleverlaan CJ, de Jager N, Kuijs R, Feilzer AJ. Mechanical performance of implant-supported posterior crowns. J Prosthet Dent. 2015;114(1):59-66. [Crossref]  [PubMed] 
  13. Kaleli N, Sarac D, Külünk S, Öztürk Ö. Effect of different restorative crown and customized abutment materials on stress distribution in single implants and peripheral bone: a three-dimensional finite element analysis study. J Prosthet Dent. 2018;119(3):437-45. [Crossref]  [PubMed] 
  14. Elshiyab SH, Nawafleh N, Walsh L, George R. Fracture resistance and survival of implant-supported, zirconia-based hybrid-abutment crowns: influence of aging and crown structure. J Investig Clin Dent. 2018;9(4):e12355. [Crossref]  [PubMed] 
  15. Morneburg TR, Pröschel PA. Measurement of masticatory forces and implant loads: a methodologic clinical study. Int J Prosthodont. 2002;15(1):20-7.
  16. Guess PC, Schultheis S, Bonfante EA, Coelho PG, Ferencz JL, Silva NR. All-ceramic systems: laboratory and clinical performance. Dent Clin North Am. 2011;55(2):333-52. [Crossref]  [PubMed] 
  17. Chang JS, Ji W, Choi CH, Kim S. Catastrophic failure of a monolithic zirconia prosthesis. J Prosthet Dent. 2015;113(2):86-90. [Crossref]  [PubMed] 
  18. Rojas-Vizcaya F. Full zirconia fixed detachable implant-retained restorations manufactured from monolithic zirconia: clinical report after two years in service. J Prosthodont. 2011;20(7):570-6. [Crossref]  [PubMed] 
  19. Abdulmajeed AA, Lim KG, Närhi TO, Cooper LF. Complete-arch implant-supported monolithic zirconia fixed dental prostheses: a systematic review. J Prosthet Dent. 2016;115(6):672-7.e1. [Crossref]  [PubMed] 
  20. Cheng CW, Chien CH, Chen CJ, Papaspyridakos P. Complete-mouth implant rehabilitation with modified monolithic zirconia implant-supported fixed dental prostheses and an immediate-loading protocol: a clinical report. J Prosthet Dent. 2013;109(6):347-52. [Crossref] 
  21. Cardelli P, Manobianco FP, Serafini N, Murmura G, Beuer F. Full-arch, implant-supported monolithic zirconia rehabilitations: pilot clinical evaluation of wear against natural or composite teeth. J Prosthodont. 2016;25(8):629-33. [Crossref]  [PubMed] 
  22. Altarawneh S, Limmer B, Reside GJ, Cooper L. Dual jaw treatment of edentulism using implant-supported monolithic zirconia fixed prostheses. J Esthet Restor Dent. 2015;27(2):63-70. [Crossref]  [PubMed] 
  23. Brodbeck U. The ZiReal post: a new ceramic implant abutment. J Esthet Restor Dent. 2003;15(1):10-24. [Crossref]  [PubMed] 
  24. Stimmelmayr M, Edelhoff D, Güth JF, Erdelt K, Happe A, Beuer F. Wear at the titanium-titanium and the titanium-zirconia implant-abutment interface: a comparative in vitro study. Dent Mater. 2012;28(12):1215-20. [Crossref]  [PubMed] 
  25. Klotz MW, Taylor TD, Goldberg AJ. Wear at the titanium-zirconia implant-abutment interface: a pilot study. Int J Oral Maxillofac Implants. 2011;26(5):970-5.
  26. Taylor TD, Klotz MW, Lawton RA. Titanium tattooing associated with zirconia implant abutments: a clinical report of two cases. Int J Oral Maxillofac Implants. 2014;29(4):958-60. [Crossref]  [PubMed] 
  27. Rojas Vizcaya F. Retrospective 2-to 7-year follow-up study of 20 double full-arch implant-supported monolithic zirconia fixed prostheses: measurements and recommendations for optimal design. J Prosthodont. 2018;27(6):501-8. [Crossref]  [PubMed] 
  28. Kurbad A, Kurbad S. CAD/CAM-based implant abutments. Int J Comput Dent. 2013;16(2):125-41.
  29. Kim JS, Raigrodski AJ, Flinn BD, Rubenstein JE, Chung KH, Mancl LA. In vitro assessment of three types of zirconia implant abutments under static load. J Prosthet Dent. 2013;109(4):255-63. [Crossref] 
  30. Elshiyab SH, Nawafleh N, Öchsner A, George R. Fracture resistance of implant-supported monolithic crowns cemented to zirconia hybrid-abutments: zirconia-based crowns vs. lithium disilicate crowns. J Adv Prosthodont. 2018;10(1):65-72. [Crossref]  [PubMed]  [PMC] 
  31. Zeller S, Guichet D, Kontogiorgos E, Nagy WW. Accuracy of three digital workflows for implant abutment and crown fabrication using a digital measuring technique. J Prosthet Dent. 2019;121(2):276-84. [Crossref]  [PubMed] 
  32. Kelly JR, Rungruanganunt P. Fatigue behavior of computer-aided design/computer-assisted manufacture ceramic abutments as a function of design and ceramics processing. Int J Oral Maxillofac Implants. 2016;31(3):601-9. [Crossref]  [PubMed] 
  33. Selz CF, Vuck A, Guess PC. Full-mouth rehabilitation with monolithic CAD/CAM-fabricated hybrid and all-ceramic materials: a case report and 3-year follow up. Quintessence Int. 2016;47(2):115-21.
  34. Elsayed A, Wille S, Al-Akhali M, Kern M. Effect of fatigue loading on the fracture strength and failure mode of lithium disilicate and zirconia implant abutments. Clin Oral Implants Res. 2018;29(1):20-7. [Crossref]  [PubMed] 
  35. Worni A, Katsoulis J, Kolgeci L, Worni M, Mericske-Stern R. Monolithic zirconia reconstructions supported by teeth and implants: 1-to 3-year results of a case series. Quintessence Int. 2017;48(6):459-67.
  36. Epprecht A, Zeltner M, Benic G, Özcan M. A strain gauge analysis comparing 4-unit veneered zirconium dioxide implant-borne fixed dental prosthesis on engaging and non-engaging abutments before and after torque application. Clin Exp Dent Res. 2018;4(1):13-8. [Crossref]  [PubMed]  [PMC] 
  37. Schoenbaum TR, Stevenson RG, Balinghasay E. The hemi-engaging fixed dental implant prosthesis: a technique for improved stability and handling. J Prosthet Dent. 2018,120(1):17-9. [Crossref]  [PubMed] 
  38. Saidin S, Abdul Kadir MR, Sulaiman E, Ebu Kasim NH. Effects of different implant-abutment connections on micromotion and stress distribution: prediction of microgap formation. J Dent. 2012;40(6):467-74. [Crossref]  [PubMed] 
  39. Takahashi JM, Dayrell AC, Consani RL, de Arruda Nóbilo MA, Henriques GE, Mesquita MF. Stress evaluation of implant-abutment connections under different loading conditions: a 3D finite element study. J Oral Implantol. 2015;41(2):133-7. [Crossref]  [PubMed] 
  40. Eskitascioglu G, Usumez A, Sevimay M, Soykan E, Unsal E. The influence of occlusal loading location on stresses transferred to implant-supported prostheses and supporting bone: a three-dimensional finite element study. J Prosthet Dent. 2004;91(2):144-50. [Crossref]  [PubMed] 
  41. Cinel S, Celik E, Sagirkaya E, Sahin O. Experimental evaluation of stress distribution with narrow diameter implants: a finite element analysis. J Prosthet Dent. 2018;119(3):417-25. [Crossref]  [PubMed] 
  42. Franco-Tabares S, Stenport VF, Hjalmarsson L, Johansson CB. Limited effect of cement material on stress distribution of a monolithic translucent zirconia crown: a three-dimensional dinite element analysis. Int J Prosthodont. 2018;31(1):67-70. [Crossref]  [PubMed] 
  43. Lanza A, Aversa R, Rengo S, Apicella D, Apicella A. 3D FEA of cemented steel, glass and carbon posts in a maxillary incisor. Dent Mater. 2005;21(8):709-15. [Crossref]  [PubMed] 
  44. Soares PV, Santos-Filho PCF, Queiroz EC, Araújo TC, Campos RE, Araújo CA, et al. Fracture resistance and stress distribution in endodontically treated maxillary premolars restored with composite resin. J Prosthodont. 2008;17(2):114-9. [Crossref]  [PubMed] 
  45. Katranji A, Misch K, Wang HL. Cortical bone thickness in dentate and edentulous human cadavers. J Periodontol. 2007;78(5):874-8. [Crossref]  [PubMed] 
  46. Wu JC, Wilson PR. Optimal cement space for resin luting cements. Int J Prosthodont. 1994;7(3):209-15.
  47. Kious AR, Roberts HW, Brackett WW. Film thicknesses of recently introduced luting cements. J Prosthet Dent. 2009;101(3):189-92. [Crossref] 
  48. de Faria Almeida DA, Pellizzer EP, Verri FR, Santiago Jr JF, de Carvalho PSP. Influence of tapered and external hexagon connections on bone stresses around tilted dental implants: three-dimensional finite element method with statistical analysis. J Periodontol. 2014;85(2):261-9. [Crossref]  [PubMed] 
  49. Lin CL, Wang JC, Chang SH, Chen ST. Evaluation of stress induced by implant type, number of splinted teeth, and variations in periodontal support in tooth-implant-supported fixed partial dentures: a non-linear finite element analysis. J Periodontol. 2010;81(1):121-30. [Crossref]  [PubMed] 
  50. Iplikçioğlu H, Akça K. Comparative evaluation of the effect of diameter, length and number of implants supporting three-unit fixed partial prostheses on stress distribution in the bone. J Dent. 2002;30(1):41-6. [Crossref] 
  51. Nissan J, Ghelfan O, Gross O, Priel I, Gross M, Chaushu G. The effect of crown/implant ratio and crown height space on stress distribution in unsplinted implant supporting restorations. J Oral Maxillofac Surg. 2011;69(7):1934-9. [Crossref]  [PubMed] 
  52. de Moraes SL, Verri FR, Junior JF Jr, Almeida DA, de Mello CC, Pellizzer EP. A 3-D finite element study of the influence of crown-implant ratio on stress distribution. Braz Dent J. 2013;24(6):635-41. [Crossref]  [PubMed] 
  53. Nishioka RS, de Vasconcellos LG, Jóias RP, Rode Sde M. Load-application devices: a comparative strain gauge analysis. Braz Dent J. 2015;26(3):258-62. [Crossref]  [PubMed] 
  54. Alkan I, Sertgöz A, Ekici B. Influence of occlusal forces on stress distribution in preloaded dental implant screws. J Prosthet Dent. 2004;91(4):319-25. [Crossref]  [PubMed] 

.: Up To Date

.: Process List

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