Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Protez Türlerinin Kondil Bölgesindeki Trabeküler Kemik Yoğunluğuna Etkisinin İncelenmesi: Retrospektif Klinik Çalışma
Investigation of the Effect of Prosthesis Types on Trabecular Bone Density in the Condyle Region: Retrospective Clinical Study
Begüm ÜNLÜ KURŞUNa, Ender AKANa
aİzmir Kâtip Çelebi Üniversitesi Diş Hekimliği Fakültesi, Protetik Diş Tedavisi ABD, İzmir, Türkiye
Turkiye Klinikleri J Dental Sci. 2022;28(2):418-25
doi: 10.5336/dentalsci.2021-84143
Article Language: TR
Full Text
ÖZET
 Amaç: Alt-üst her iki çenesinde de tam, hareketli bölümlü ve sabit olmak üzere farklı tip protez kullanan hastaların protez öncesi ve sonrası alınan radyografilerinde kondilde meydana gelen trabeküler kemik değişimlerinin fraktal boyut (FB) analizi kullanılarak değerlendirilmesidir. Gereç ve Yöntemler: Yaşları 55-67 arasında değişen, 21'i tam, 27'si hareketli bölümlü, 25'i sabit protez kullanan, 20'si tam doğal dişli bireylerden oluşan kontrol grubu olmak üzere toplam 93 hastanın panoramik radyografisi arşivden seçilerek retrospektif olarak değerlendirilmiştir. Seçilen her hasta için tedavi öncesi ve sonrası kontrol panoramik radyografileri üzerinden sağ ve sol kondilin subkortikal bölgesi ve geometrik olarak ortasından 84x84 piksel kesitler seçilmiştir. Her bir bölge için trabeküler kemiğin FB analizi yapılarak FB değerleri hesaplanmıştır. Bulgular: Tam ve hareketli bölümlü protez kullananlarda hesaplanan FB değerlerinde zamana bağlı istatistiksel olarak anlamlı azalma gözlenirken (p<0,01), sabit protez kullananlarda (p=0,09) ve kontrol grubunda (p=0,22) istatistiksel olarak anlamlı bir fark bulunmamıştır. Zamana bağlı olarak FB değerlerinde meydana gelen değişimlerle protez türü arasındaki ilişkinin istatistiksel olarak anlamlı olduğu görülmüştür (p<0,01). Tam protez kullananlar ile sabit protez kullananlar (p<0,01) ve kontrol grubu (p<0,01) arasında meydana gelen değişimlerin ve aynı zamanda hareketli bölümlü protez kullananlar ile sabit protez kullananlar (p=0,02) ve kontrol grubu (p=0,02) arasındaki değişimlerin istatistiksel olarak anlamlı olduğu gözlenmiştir. Sonuç: Çalışmanın sınırlılıkları dâhilinde zamanla tam dişsiz veya fazla sayıda dişsizliğe sahip ve hareketli protez kullanmakta olan hastalarda kondilde meydana gelen trabeküler kemik yoğunluğu değişimin sabit protez kullanan ve tam dişli hastalara göre daha yüksek olduğu gözlenmiştir. Bu nedenle zamana bağlı olarak, farklı tür protez kullanan hastalarda kondiler trabeküler kemikte oluşabilecek kemik değişimin en aza indirgenebilmesi için meydana gelebilecek olan diş kayıpları erken teşhis edilip gerekli müdahale yapılmalıdır. Dişsiz hastalarda öncelikle sabit protezler tercih edilmelidir.

Anahtar Kelimeler: Mandibular kondil; hareketli protez; sabit protez
ABSTRACT
 Objective: The aim of this study is to evaluate the trabecular bone changes that occur in the condyle with panoramic radiograps taken before and after from the patients using different types of prostheses, including full, partial removable and fixed in both upper and lower jaws by using fractal dimension (FD) analysis. Material and Methods: Panoramic radiographs of a total of 93 patients aged between the ages of 55 and 67, consisting of 21 full, 27 removable partial, 25 fixed prosthesis, and 20 natural complete teeth in the control group, were selected from the archive and retrospectively analyzed. For each selected patient, 84x84 pixel sections were selected from the subcortical area and the geometric center of the right and left condyles on the panoramic radiographs before and after treatment. Fractal FD values were calculated by performing FD analysis of trabecular bone for each region. Results: It was observed that the statistically significant decrease in the calculated FD values depending on time in those using complete and removable partial dentures (p<0.01) and no statistically significant difference was found in those using fixed prostheses (p=0.09) and in the control group (p=0.22). It was noted that the relationship between the changes in FD values depending on the time and the type of prosthesis was statistically significant (p<0.01). It was statistically significant changes obtained between using complete denture-fixed prosthesis (p<0.01) and the control group (p<0.01), as well as those using removable partial denturesfixed prostheses (p=0.02) and the control group (p=0.02). Conclusion: Within the limitations of the study, it was found that the trabecular bone density change occurring in the condyle was higher in patients with complete edentulous or excessive toothless and using removable prostheses compared to patients with fixed prostheses and full teeth. For this reason, in order to reduce the change in condylar trabecular bone according to prosthesis type by the time, tooth losses that may occur should be diagnosed early and necessary intervention should be performed, and fixed prostheses should be preferred primarily in edentulous patients.

Keywords: Mandibular condyle; removable prosthesis; fixed prosthesis
REFERENCES:
  1. Okeson JP. Part I. Functional Anatomy. Management of Temporomandibular Disorders and Occlusion. 4th ed. St. Louis: Mosby; 1997. p.109-26. [Link] 
  2. Yavuz Ö, Yılmaz N, Öğütcen Toller M. TME kapsül içi rahatsızlıklarda oklüzal rehberliğin öneminin araştırılması [Evaluation of importance of the occlusal guidance in TMJ capsule disorders]. Cumhuriyet Üniversitesi Dişhekimliği Fakültesi Dergisi. 1999; 2(1):17-20. [Link] 
  3. De Boever JA, Carlsson GE, Klineberg IJ. Need for occlusal therapy and prosthodontic treatment in the management of temporomandibular disorders. Part I. Occlusal interferences and occlusal adjustment. J Oral Rehabil. 2000;27(5):367-79. [Crossref]  [PubMed] 
  4. Bataglion C, Hotta TH, Matsumoto W, Ruellas CV. Reestablishment of occlusion through overlay removable partial dentures: a case report. Braz Dent J. 2012;23(2):172-4. [Crossref]  [PubMed] 
  5. Swelem AA, Gurevich KG, Fabrikant EG, Hassan MH, Aqou S. Oral health-related quality of life in partially edentulous patients treated with removable, fixed, fixed-removable, and implant-supported prostheses. Int J Prosthodont. 2014;27(4):338-47. [Crossref]  [PubMed] 
  6. Özkan KY. Complete Dentures Prosthodontics. 1st ed. İstanbul: Springer Quintessence; 2018. [Link] 
  7. Mericske-Stern RD, Taylor TD, Belser U. Management of the edentulous patient. Clin Oral Implants Res. 2000;11 Suppl 1:108-25. [Crossref]  [PubMed] 
  8. Giesen EB, Ding M, Dalstra M, van Eijden TM. Reduced mechanical load decreases the density, stiffness, and strength of cancellous bone of the mandibular condyle. Clin Biomech (Bristol, Avon). 2003;18(4):358-63. [Crossref]  [PubMed] 
  9. Amorim VC, Laganá DC, de Paula Eduardo JV, Zanetti AL. Analysis of the condyle/fossa relationship before and after prosthetic rehabilitation with maxillary complete denture and mandibular removable partial denture. J Prosthet Dent. 2003;89(5):508-14. [Crossref]  [PubMed] 
  10. Wadhwa S, Kapila S. TMJ disorders: future innovations in diagnostics and therapeutics. J Dent Educ. 2008;72(8):930-47. [Crossref]  [PubMed]  [PMC] 
  11. Coşgunarslan A, Soydan Çabuk D, Canger EM. Effect of total edentulism on the internal bone structure of mandibular condyle: a preliminary study. Oral Radiol. 2021;37(2):268-75. [Crossref]  [PubMed] 
  12. Abdel-Fattah RA. Incidents of symptomatic temporomandibular (TM) joint disorders in female population with missing permanent first molar(s). Cranio. 1996;14(1):55-62. [Crossref]  [PubMed] 
  13. Fallahi HR, Alikazaemi M, Javidi P, Kazemi P, Behbudi A, Zanganeh T. Evaluation of the relationship between partial edentulism and TMJ disorders. Biosci Biotech Res Asia. 2016; 13(3). [Crossref] 
  14. Mandelbrot BB. The Fractal Geometry of Nature. 3rd ed. New York: W.H. Freeman and Co; 1982. [Link] 
  15. Gumussoy I, Miloglu O, Cankaya E, Bayrakdar IS. Fractal properties of the trabecular pattern of the mandible in chronic renal failure. Dentomaxillofac Radiol. 2016;45(5):201503 89. [Crossref]  [PubMed]  [PMC] 
  16. de Molon RS, de Paula WN, Spin-Neto R, Verzola MH, Tosoni GM, Lia RC, et al. Correlation of fractal dimension with histomorp hometry in maxillary sinus lifting using autogenous bone graft. Braz Dent J. 2015;26(1): 11-8. [Crossref]  [PubMed] 
  17. Geraets WG, van der Stelt PF. Fractal properties of bone. Dentomaxillofac Radiol. 2000;29(3):144-53. [Crossref]  [PubMed] 
  18. Hatcher DC, Faulkner MG, Hay A. Development of mechanical and mathematic models to study temporomandibular joint loading. J Prosthet Dent. 1986;55(3):377-84. [Crossref]  [PubMed] 
  19. Brennan DS, Spencer AJ, Roberts-Thomson KF. Tooth loss, chewing ability and quality of life. Qual Life Res. 2008;17(2):227-35. [Crossref]  [PubMed] 
  20. Miyaura K, Morita M, Matsuka Y, Yamashita A, Watanabe T. Rehabilitation of biting abilities in patients with different types of dental prostheses. J Oral Rehabil. 2000;27(12):1073-6. [Crossref]  [PubMed] 
  21. Alzarea BK. Temporomandibular disorders (TMD) in edentulous patients: a review and proposed classification (Dr. Bader's Classification). J Clin Diagn Res. 2015;9(4):ZE06-9. [Crossref]  [PubMed]  [PMC] 
  22. Serman RJ, Conti PCR, Conti JV, Salvador MCG. Prevalence of temporomandibular dysfunction in patients with double denture. J Bras Orofac Occlusion TMJ Pain. 2003;3:141-44. [Link] 
  23. White SC, Rudolph DJ. Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88(5):628-35. [Crossref]  [PubMed] 
  24. Bonakdarchian M, Askari N, Askari M. Effect of face form on maximal molar bite force with natural dentition. Arch Oral Biol. 2009;54(3): 201-4. [Crossref]  [PubMed] 
  25. Bakke M. Bite force and occlusion. Seminars in Orthodontics. 2006;12(2):120-6. [Crossref] 
  26. Bouvier M. Effects of age on the ability of the rat temporomandibular joint to respond to changing functional demands. J Dent Res. 1988;67(9):1206-12. [Crossref]  [PubMed] 
  27. Newton JP, Yemm R, Abel RW, Menhinick S. Changes in human jaw muscles with age and dental state. Gerodontology. 1993;10(1):16-22. [Crossref]  [PubMed] 
  28. Helkimo E, Carlsson GE, Helkimo M. Bite force and state of dentition. Acta Odontol Scand. 1977;35(6):297-303. [Crossref]  [PubMed] 
  29. Mağat G, Büyükerkmen EB, Şener SÖ. Evaluation of the effect of fixed prosthesis on trabecular structure of condyle: radiographic texture analysis. Türkiye Klinikleri Diş Hekimligi Bilimleri Dergisi. 2018;24(2):77-83. [Crossref] 
  30. Lawrence MJ, Sabra A, Thomas P, Obaid DR, D'Silva LA, Morris RH, et al. Fractal dimension: a novel clot microstructure biomarker use in ST elevation myocardial infarction patients. Atherosclerosis. 2015;240(2):402-7. [Crossref]  [PubMed] 
  31. Zeytinoğlu M, İlhan B, Dündar N, Boyacioğlu H. Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs. Clin Oral Investig. 2015;19(2):519-24. [Crossref]  [PubMed] 
  32. Wilding RJ, Slabbert JC, Kathree H, Owen CP, Crombie K, Delport P. The use of fractal analysis to reveal remodelling in human alveolar bone following the placement of dental implants. Arch Oral Biol. 1995;40(1):61-72. [Crossref]  [PubMed] 
  33. Arsan B, Köse TE, Çene E, Özcan İ. Assessment of the trabecular structure of mandibular condyles in patients with temporomandibular disorders using fractal analysis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017;123(3): 382-91. [Crossref]  [PubMed] 
  34. McNamara JA Jr, Hinton RJ, Hoffman DL. Histologic analysis of temporomandibular joint adaptation to protrusive function in young adult rhesus monkeys (Macaca mulatta). Am J Orthod. 1982;82(4):288-98. [Crossref]  [PubMed] 
  35. McNeill C. Fundamental Treatment Goals. Science and Practice of Occlusion. 1st ed. Chicago: Quintessence Pub; 1997. p.306-48. [Link] 

.: 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