Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
MTA Fillapex'in İn Vitro Genotoksisitesinin Değerlendirilmesinin Sistematik İncelemesi
MTA Fillapex In Vitro Genotoxicity Assessment: A Systematic Review
Soley ARSLANa, Yakup ÜSTÜNb, Nazife TAŞÇIOĞLUc, Sebahat Melike DURUKANa, Burak SAĞSENb, Müge Gülcihan ÖNALc, Munis DÜNDARc
aErciyes Üniversitesi Diş Hekimliği Fakültesi, Restoratif Diş Tedavisi ABD, Kayseri, Türkiye
bErciyes Üniversitesi Diş Hekimliği Fakültesi, Endodonti ABD, Kayseri, Türkiye
cErciyes Üniversitesi Tıp Fakültesi, Tıbbi Genetik ABD, Kayseri, Türkiye
Turkiye Klinikleri J Dental Sci. 2022;28(2):372-80
doi: 10.5336/dentalsci.2021-83767
Article Language: TR
Full Text
ÖZET
 Amaç: MTA Fillapex ve AH Plus kanal dolum patlarının, insan hücrelerindeki genotoksik ve sitotoksik etkileri ve insan kan lenfositlerindeki potansiyel genotoksik etkileri ve genotoksisite mekanizmasının işleyişi hakkında yeterli bilgi bulunmamaktadır. Bu sebepler göz önünde bulundurularak, çalışmamızda mevcut materyallerin genotoksisite ve sitotoksisite etkinliği araştırmak amacıyla Sitokinez-Bloke Mikronükleus Sitom yönteminin kullanımı ile ulaşılması hedeflenen etkilerin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Yaşları 20- 35 arasında değişen sağlıklı, herhangi bir rutin ilaç kullanımı ve bağımlılığı bulunmayan 10 bireyden 10 mL kan alındı. Bu örneklerle elde edilen lenfosit kültürlerine değişik konsantrasyonlarda MTA Fillapex ve AH Plus kanal dolgu patları eklendi. Bulunan mikronükleuslu binükleer hücreler, gözlenen metafaz sayıları, nükleoplazmik köprülü [nucleoplasmic bridged (NPB)] ve nükleer tomurcuklu hücreler sayıldı. Preparatlarda 1.000 adet hücre sayıldıktan sonra apoptotik ve nekrotik hücrelerin mevcudiyeti de kayıt altına alındı. Bulgular: Veriler, parametrik olmayan Wilcoxon T-testi ile değerlendirildi. MTA Fillapex patı doz artışıyla beraber toksisitesinde de artış gözlenmiştir. Fakat NPB hücrelerin parametresi hariç tüm parametrelerde, pozitif kontrole göre anlamlı seviyede daha az seviyelerde toksisite saptanmıştır. NPB hücrelere ait bulgular incelendiğinde, MTA Fillapex grubu ile pozitif kontrol arasında istatistiksel açıdan anlamlı bir farka rastlanmamıştır. AH Plus polimerizasyon süresi boyunca toksisite göstermiştir. Sonuç: MTA Fillapex patı, insan kan hücreleri üzerinde AH Plus macununa göre daha az sitotoksik ve genotoksik etki göstermiştir.

Anahtar Kelimeler: MTA Fillapex; AH Plus; genotoksisite; Sitokinez-Bloke Mikronükleus Sitom analizi
ABSTRACT
 Objective: There is a few information about the genotoxic and cytotoxic effects of MTA Fillapex and AH Plus canal filling pastes in human pulp and pulp blood cells. And even that we know the there are some cytotoxic effects on the blood cells there is not enough data about the mechanism of these effects. Considering these reasons, in our study, it was aimed to investigate genotoxic and cytotoxic efficiency of the available materials by using the Cytokinesis-Blocked Micronucleus Cytome method. Material and Methods: 10 mL blood was obtained from ten healthy persons aged 20-35 years who did not use pharmaceuticals or were addicted to them on a regular basis. To the lymphocyte cultures derived from these samples, various quantities of MTA Fillapex and AH Plus channel fillers were applied. Micronucleus binuclear cells found, observed metaphase numbers, nucleoplasmic bridged (NPB) and nuclear bud cells were counted. After counting 1,000 cells in the samples, the presence of apoptotic and necrotic cells was also recorded for the statistical data. Results: Data were evaluated with nonparametric the Wilcoxon T-test. When the findings were evaluated, it was observed that the toxicity of MTA Fillapex increased with the dose. However, in all parameters except the NPB cells parameter, significantly less toxicity was detected compared to the positive control. After we observe data about NPB cells we found that there is no statistically significant difference between the MTA Fillapex group and positive control group also AH Plus study group showed toxicity during the polymerization period. Conclusion: MTA Fillapex paste showed less cytotoxic and genotoxic effect than AH Plus paste on the human blood cells.

Keywords: MTA Fillapex; AH Plus; genotoxicity; Cytokinesis-Block Micronucleus Cytome assay
REFERENCES:
  1. Jafari F, Jafari S, Etesamnia P. Genotoxicity, bioactivity and clinical properties of calcium silicate based sealers: a literature review. Iran Endod J. 2017;12(4):407-13. [PubMed]  [PMC] 
  2. Al-Haddad A, Abu Kasim NH, Che Ab Aziz ZA. Interfacial adaptation and thickness of bioceramic-based root canal sealers. Dent Mater J. 2015;34(4):516-21. [Crossref]  [PubMed] 
  3. Al-Haddad A, Che Ab Aziz ZA. Bioceramic-based root canal sealers: a review. Int J Biomater. 2016;2016:9753210. [Crossref]  [PubMed]  [PMC] 
  4. Leonardo MR, Bezerra da Silva LA, Filho MT, Santana da Silva R. Release of formaldehyde by 4 endodontic sealers. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999; 88(2):221-5. [Crossref]  [PubMed] 
  5. Torabinejad M, Watson TF, Pitt Ford TR. Sealing ability of a mineral trioxide aggregate when used as a root end filling material. J Endod. 1993;19(12):591-5. [Crossref]  [PubMed] 
  6. Roberts HW, Toth JM, Berzins DW, Charlton DG. Mineral trioxide aggregate material use in endodontic treatment: a review of the literature. Dent Mater. 2008;24(2):149-64. [Crossref]  [PubMed] 
  7. Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part I: chemical, physical, and antibacterial properties. J Endod. 2010;36(1):16-27. [Crossref]  [PubMed] 
  8. Holland R, de Souza V, Nery MJ, Otoboni Filho JA, Bernabé PF, Dezan Júnior E. Reaction of rat connective tissue to implanted dentin tubes filled with mineral trioxide aggregate or calcium hydroxide. J Endod. 1999;25(3):161-6. [Crossref]  [PubMed] 
  9. Hauman CH, Love RM. Biocompatibility of dental materials used in contemporary endodontic therapy: a review. Part 1. Intracanal drugs and substances. Int Endod J. 2003; 36(2):75-85. [Crossref]  [PubMed] 
  10. Jaberiansari Z, Naderi S, Tabatabaei FS. Cytotoxic effects of various mineral trioxide aggregate formulations, calcium-enriched mix ture and a new cement on human pulp stem cells. Iran Endod J. 2014;9(4):271-6. [PubMed]  [PMC] 
  11. Saygili G, Saygili S, Tuglu I, Davut Capar I. In vitro cytotoxicity of GuttaFlow Bioseal, GuttaFlow 2, AH-Plus and MTA Fillapex. Iran Endod J. 2017;12(3):354-9. [PubMed]  [PMC] 
  12. Braz MG, Camargo EA, Salvadori DM, Marques ME, Ribeiro DA. Evaluation of genetic damage in human peripheral lymphocytes exposed to mineral trioxide aggregate and Portland cements. J Oral Rehabil. 2006;33(3): 234-9. [Crossref]  [PubMed] 
  13. Accorinte Mde L, Holland R, Reis A, Bortoluzzi MC, Murata SS, Dezan E Jr, et al. Evaluation of mineral trioxide aggregate and calcium hydroxide cement as pulp-capping agents in human teeth. J Endod. 2008;34(1):1-6. [Crossref]  [PubMed] 
  14. Mantellini MG, Botero TM, Yaman P, Dennison JB, Hanks CT, Nör JE. Adhesive resin induces apoptosis and cell-cycle arrest of pulp cells. J Dent Res. 2003;82(8):592-6. [Crossref]  [PubMed] 
  15. Zeferino EG, Bueno CE, Oyama LM, Ribeiro DA. Ex vivo assessment of genotoxicity and cytotoxicity in murine fibroblasts exposed to white MTA or white Portland cement with 15% bismuth oxide. Int Endod J. 2010;43(10):843-8. [Crossref]  [PubMed] 
  16. Ding SJ, Kao CT, Chen CL, Shie MY, Huang TH. Evaluation of human osteosarcoma cell line genotoxicity effects of mineral trixoide aggregate and calcium silicate cements. J Endod. 2010;36(7):1158-62. [Crossref]  [PubMed] 
  17. Ribeiro DA, Sugui MM, Matsumoto MA, Duarte MA, Marques ME, Salvadori DM. Genotoxicity and cytotoxicity of mineral trioxide aggregate and regular and white Portland cements on Chinese hamster ovary (CHO) cells in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(2):258-61. [Crossref]  [PubMed] 
  18. Widel M, Kolosza Z, Jedruś S, Lukaszczyk B, Raczek-Zwierzycka K, Swierniak A. Micronucleus assay in vivo provides significant prognostic information in human cervical carci noma; the updated analysis. Int J Radiat Biol. 2001;77(5):631-6. [Crossref]  [PubMed] 
  19. Fenech M, Morley A. Solutions to the kinetic problem in the micronucleus assay. Cytobios. 1985;43(172-173):233-46. [PubMed] 
  20. Olsson B, Sliwkowski A, Langeland K. Intraosseous implantation for biological evaluation of endodontic materials. J Endod. 1981; 7(6):253-65. [Crossref]  [PubMed] 
  21. Stanley HR. Local and systemic responses to dental composites and glass ionomers. Adv Dent Res. 1992;6:55-64. [Crossref]  [PubMed] 
  22. Torabinejad M, Hong CU, Pitt Ford TR, Kettering JD. Cytotoxicity of four root end filling materials. J Endod. 1995;21(10):489-92. [Crossref]  [PubMed] 
  23. Bin CV, Valera MC, Camargo SE, Rabelo SB, Silva GO, Balducci I, et al. Cytotoxicity and genotoxicity of root canal sealers based on mineral trioxide aggregate. J Endod. 2012;38(4):495-500. [Crossref]  [PubMed] 
  24. Camargo SE, Camargo CH, Hiller KA, Rode SM, Schweikl H, Schmalz G. Cytotoxicity and genotoxicity of pulp capping materials in two cell lines. Int Endod J. 2009;42(3):227-37. [Crossref]  [PubMed] 
  25. Chen CL, Kao CT, Ding SJ, Shie MY, Huang TH. Expression of the inflammatory marker cyclooxygenase-2 in dental pulp cells cultured with mineral trioxide aggregate or calcium silicate cements. J Endod. 2010;36(3):465-8. [Crossref]  [PubMed] 
  26. da Silva GN, Braz MG, de Camargo EA, Salvadori DM, Ribeiro DA. Genotoxicity in primary human peripheral lymphocytes after exposure to regular and white mineral trioxide aggregate. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(5):e50-4. [Crossref]  [PubMed] 
  27. Menezes R, Bramante CM, Letra A, Carvalho VG, Garcia RB. Histologic evaluation of pulpotomies in dog using two types of mineral trioxide aggregate and regular and white Portland cements as wound dressings. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98(3):376-9. [Crossref]  [PubMed] 
  28. Jafari F, Aghazadeh M, Jafari S, Khaki F, Kabiri F. In vitro cytotoxicity comparison of MTA Fillapex, AH-26 and apatite root canal sealer at different setting times. Iran Endod J. 2017;12(2):162-7. [PubMed]  [PMC] 
  29. Collado-González M, Tomás-Catalá CJ, O-ate-Sánchez RE, Moraleda JM, Rodríguez-Lozano FJ. Cytotoxicity of GuttaFlow Bioseal, GuttaFlow2, MTA Fillapex, and AH Plus on human periodontal ligament stem cells. J Endod. 2017;43(5):816-22. [Crossref]  [PubMed] 
  30. Spahl W, Budzikiewicz H. Qualitative analysis of dental resin composites by gas and liquid chromatography/mass spectrometry. Fresen J Anal Chem. 1994;350:684-91. [Crossref] 
  31. Gulati N, Chandra S, Aggarwal PK, Jaiswal JN, Singh M. Cytotoxicity of eugenol in sealer containing zinc-oxide. Endod Dent Traumatol. 1991;7(4):181-5. [Crossref]  [PubMed] 
  32. Kolokouris I, Kotsaki-Kovatsi VP, Economides N, Poulopoulos A, Rozos G, Vlemmas I. Influence of zinc oxide and eugenol sealer on concentration of zinc, calcium and copper in rat tissues. Endod Dent Traumatol. 1998;14(5): 210-3. [Crossref]  [PubMed] 
  33. Nencka D, Walia HD, Austin BP. Histologic evaluation of the biocompatibility of Diaket. J Dent Res. 1995;74:101.
  34. Spångberg L. Biological effects of root canal filling materials. 4. Effect in vitro of solubilised root canal filling materials on HeLa cells. Odontol Revy. 1969;20(3):289-99. [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