Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Sabit Ortodontik Tedavi Gören Hastalarda Plak Temizleme Etkinliğinin Değerlendirilmesi
Evaluation of Plaque Cleaning Efficacy in Patients During Fixed Orthodontic Treatment
Ufuk OKa, Sanaz SADRYa
aİstanbul Aydın Üniversitesi Diş Hekimliği Fakültesi, Ortodonti ABD, İstanbul, TÜRKİYE
Turkiye Klinikleri J Dental Sci. 2021;27(1):42-8
doi: 10.5336/dentalsci.2019-72892
Article Language: TR
Full Text
ÖZET
 Amaç: Ortodontik tedavi gören hastalarda plak temizleme etkinliğinin, manuel fırça, elektrikli fırça ve ağız duşu ile kıyaslanması ve plak temizleme etkinliğinin değerlendirilmesidir. Gereç ve Yöntemler: Çalışmaya, yaş aralığı 12-26 yıl olan ve herhangi bir sağlık problemi bulunmayan 60 ortodontik tedavi gören hasta dâhil edilmiştir. Birbirine benzer olacak şekilde 3 gruba ayrılan hastalar çalışma ile bilgilendirilmiş ve seans öncesi başlangıç ve seans sonrası bitim plak indeksi (Pİ) değerleri kaydedilmiştir. Hastalara etkin diş fırçalama yöntemi ve uygun prosedürler birebir gösterilmiş ve seans öncesi plak boyama yöntemi (CURAPROX plaquefinder, CURAGEN AG, Germany) ile ağızda bulunan plak (Pİbaşlangıç) tespit edilmiştir. Grup I'deki hastalara manuel diş fırçası (Oral-B Ortho model, Procter & Gamble, Newbridge, İngiltere), Grup II'deki hastalara ise elektrikli diş fırçası (Oral-B Genius 8000 Professional Care Procter & Gamble, Marktheidenfeld, Almanya), Grup III'deki hastalarda ise ağız duşu (Oral-B Professional Care 8500 DLX OxyJett Center and EB17 brush head, Procter & Gamble, Marktheidenfeld, Almanya) uygulanmıştır. Fırçalama sonrası plak boyama yapılmış ve Pİson değerleri kaydedilmiştir. Bulgular: Elde edilen veriler değerlendirildiğinde, manuel fırçalarla kıyaslandığında çalışma grubu sonuçları daha etkili bulunmuştur ve istatistiksel olarak anlamlıdır (p=0,002). En düşük Pİson değerleri Grup II'de elde edilmiş olup, Grup III ile kıyaslandığında bu fark anlamlı değildir (p=0,560). Tüm gruplar PI değerleri açısından farklılıkları belirlemek için yapılan Friedman testi sonucunda, ortalama değerleri arasındaki farklar istatistiksel olarak anlamlı bulundu. Sonuç: Çalışmamızda her üç grupta da plak boyama ile eğitimler sonucu yaratılan farkındalık sayesinde, Pİ değerlerinde anlamlı farklılıklar sağlanmıştır. Bununla birlikte, ortodontik tedavi gören hastalarda elektrikli diş fırçasının ve ağız duşunun plak temizleme etkinliği, manuel fırçalara üstün bulunmuştur.

Anahtar Kelimeler: Ağız hijyeni; diş plağı; diş fırçalama etkinliği; ağız duşu; elektrikli diş fırçası
ABSTRACT
 Objective: Orthodontic appliances promote dental plaque retention and make tooth-brushing less easy. They result in both quantitative and qualitative changes in dental plaque, exposing orthodontic patients to dental caries and periodontal diseases. To compare plaque cleaning efficacy in patients receiving orthodontic treatment with manual brush, electric brush and mouth shower and to evaluate plaque cleaning efficacy. Material and Methods: Sixty orthodontic patients aged between 12-26 years and without any health problems were included in the study. The patients were divided into three groups, similar to each other, and informed by the study and pre- and post-session modified plaque index (PI) values were recorded. Effective tooth brushing and appropriate procedures were shown to the patients and plaque accumulated in the mouth was determined by plaque staining method (CURAPROX plaquefinder, CURAGEN AG, Germany) before the session. Group I (Group I) patients had a manual toothbrush (Oral-B Ortho model, Procter & Gamble, Newbridge, UK), Group II patients had a 3D toothbrush (Oral-B Genius 7500 Professional Care Procter & Gamble, Marktheidenfeld, Germany), and in Group III, oral shower (Oral-B Professional Care 8500 DLX OxyJett Center and EB17 brush head, Procter & Gamble, Marktheidenfeld, Germany). After brushing, plaque stained PI values were recorded. Results: When the obtained data was evaluated, electric toothbrushes and mouth shower were found superior to manual brushes in plaque cleaning (p=0.020). The lowest PI values were obtained in Group II and this difference was found to be significant when compared with Group I (p=0.560). As a result of Friedman test to determine the differences between time in terms of PI values in all groups, differences between rank mean values of time were found to be statistically significant. Conclusion: In our study, significant differences were obtained in modified PI values due to awareness created by training with plaque staining in all three groups. However, in patients receiving orthodontic treatment, the plaque cleaning efficacy of the electric toothbrush and mouth shower was superior to manual brushes.

Keywords: Oral hygiene; dental plaque; tooth brushing effectiveness; mouth shower; electric toothbrush
REFERENCES:
  1. Zachrisson BU. Cause and prevention of injuries to teeth and supporting structures during orthodontic treatment. Am J Orthod. 1976;69(3):285-300.[Crossref] [PubMed] 
  2. O'Reilly MM, Featherstone JD. Demineralization and remineralization around orthodontic appliances: an in vivo study. Am J Orthod Dentofacial Orthop. 1987;92(1):33-40.[Crossref] [PubMed] 
  3. Dentino AR, Derderian G, Wolf M, Cugini M, Johnson R, Van Swol RL, et al. Six-month comparison of powered versus manual toothbrushing for safety and efficacy in the absence of professional instruction in mechanical plaque control. J Periodontol. 2002;73(7):770-8.[Crossref] [PubMed] 
  4. Laing E, Ashley P, Gill D, Naini F. An update on oral hygiene products and techniques. Dent Update. 2008;35(4):270-9.[Crossref] [PubMed] 
  5. Schätzle M, Sener B, Schmidlin PR, Imfeld T, Attin T. In vitro tooth cleaning efficacy of electric toothbrushes around brackets. Eur J Orthod. 2010;32(5):481-9.[Crossref] [PubMed] 
  6. Thienpont V, Dermaut LR, Van Maele G. Comparative study of 2 electric and 2 manual toothbrushes in patients with fixed orthodontic appliances. Am J Orthod Dentofacial Orthop. 2001;120(4):353-60.[Crossref] [PubMed] 
  7. Kaklamanos EG, Kalfas S. Meta-analysis on the effectiveness of powered toothbrushes for orthodontic patients. Am J Orthod Dentofacial Orthop. 2008;133(2):187.e1-14.[Crossref] [PubMed] 
  8. Vibhute A, Vandana KL. The effectiveness of manual versus powered toothbrushes for plaque removal and gingival health: a meta-analysis. J Indian Soc Periodontol. 2012;16(2):156-60.[Crossref] [PubMed] [PMC] 
  9. Ghassemi A, Vorwerk L, Hooper W, Patel V, Milleman JL, Milleman KR, et al. Comparative plaque removal efficacy of two new powered toothbrushes and a manual toothbrush. J Clin Dent. 2014;25(2):1-5.[PubMed] 
  10. Schätzle M, Imfeld T, Sener B, Schmidlin PR. In vitro tooth cleaning efficacy of manual toothbrushes around brackets. Eur J Orthod. 2009;31(1):103-7.[Crossref] [PubMed] 
  11. Chan DC, Summitt JB, García-Godoy F, Hilton TJ, Chung KH. Evaluation of different methods for cleaning and preparing occlusal fissures. Oper Dent. 1999;24(6):331-6.[PubMed] 
  12. Sigilião LC, Marquezan M, Elias CN, Ruellas AC, Sant'Anna EF. Efficiency of different protocols for enamel clean-up after bracket debonding: an in vitro study. Dental Press J Orthod. 2015;20(5):78-85.[Crossref] [PubMed] [PMC] 
  13. Hutchinson MG. "Intentional use of the Hawthorne effect to improve oral hygiene compliance in orthodontic patients". J Dent Educ. 2003;67(1):9.[Crossref] [PubMed] 
  14. Costa MR, da Silva VC, Miqui MN, Colombo AP, Cirelli JA. Effects of ultrasonic, electric, and manual toothbrushes on subgingival plaque composition in orthodontically banded molars. Am J Orthod Dentofacial Orthop. 2010;137(2):229-35.[Crossref] [PubMed] 
  15. Hickman J, Millett DT, Sander L, Brown E, Love J. Powered vs manual tooth brushing in fixed appliance patients: a short term randomized clinical trial. Angle Orthod. 2002;72(2):135-40.[PubMed] 
  16. Costa MR, Silva VC, Miqui MN, Sakima T, Spolidorio DM, Cirelli JA, et al. Efficacy of ultrasonic, electric and manual toothbrushes in patients with fixed orthodontic appliances. Angle Orthod. 2007;77(2):361-6.[Crossref] [PubMed] 
  17. Nathoo S, Mankodi S, Mateo LR, Chaknis P, Panagakos F. A clinical study comparing the supragingival plaque and gingivitis efficacy of a specially engineered sonic powered toothbrush with unique sensing and control technologies to a commercially available manual flat-trim toothbrush. J Clin Dent. 2012;23 Spec No A:A11-6.[PubMed] 
  18. Silvestrini Biavati A, Gastaldo L, Dessì M, Silvestrini Biavati F, Migliorati M. Manual orthodontic vs. oscillating-rotating electric toothbrush in orthodontic patients: a randomised clinical trial. Eur J Paediatr Dent. 2010;11(4):200-2.[PubMed] 
  19. Borutta A, Pala E, Fischer T. Effectiveness of a powered toothbrush compared with a manual toothbrush for orthodontic patients with fixed appliances. J Clin Dent. 2002;13(4):131-7.[PubMed] 
  20. Torkan S, Oshagh M, Khojastepour L, Shahidi S, Heidari S. Clinical and radiographic comparison of the effects of two types of fixed retainers on periodontium - a randomized clinical trial. Prog Orthod. 2014;27;15(1):47.[Crossref] [PubMed] [PMC] 
  21. Boyd RL, Rose CM. Effect of rotary electric toothbrush versus manual toothbrush on decalcification during orthodontic treatment. Am J Orthod Dentofacial Orthop. 1994;105(5):450-6.[Crossref] [PubMed] 
  22. Unkel JH, Fenton SJ, Hobbs G Jr, Frere CL. Toothbrushing ability is related to age in children. ASDC J Dent Child. 1995;62(5):346-8.[PubMed] 
  23. Frandsen A. Changing patterns of attitudes and oral health behaviour. Int Dent J. 1985;35(4):284-90.[PubMed] 
  24. Jain Y. A comparison of the efficacy of powered and manual toothbrushes in controlling plaque and gingivitis: a clinical study. Clin Cosmet Investig Dent. 2013;27;5:3-9.[Crossref] [PubMed] [PMC] 
  25. McInnes C, Engel D, Martin RW. Fimbria damage and removal of adherent bacteria after exposure to acoustic energy. Oral Microbiol Immunol. 1993;8(5):277-82.[Crossref] [PubMed] 
  26. Levin RP. Waterpik dental water jet: creating value for your patients. Compend Contin Educ Dent. 2009;30 Spec No 1:20-1.[PubMed] 
  27. Cobb CM, Rodgers RL, Killoy WJ. Ultrastructural examination of human periodontal pockets following the use of an oral irrigation device in vivo. J Periodontol. 1988;59(3):155-63.[Crossref] [PubMed] 
  28. Re D, Augusti G, Battaglia D, Giannì AB, Augusti D. Is a new sonic toothbrush more effective in plaque removal than a manual toothbrush? Eur J Paediatr Dent. 2015;16(1):13-8.[PubMed] 
  29. Sharma NC, Lyle DM, Qaqish JG, Galustians J, Schuller R. Effect of a dental water jet with orthodontic tip on plaque and bleeding in adolescent patients with fixed orthodontic appliances. Am J Orthod Dentofacial Orthop. 2008;133(4):565-71.[Crossref] [PubMed] 
  30. Erbe C, Klukowska M, Timm HC, Barker ML, van der Wielen J, Wehrbein H, et al. A randomized controlled trial of a power brush/irrigator/mouthrinse routine on plaque and gingivitis reduction in orthodontic patients. Angle Orthod. 2019;89(3):378-84.[Crossref] [PubMed] 
  31. Tawakoli PN, Sauer B, Becker K, Buchalla W, Attin T. Interproximal biofilm removal by intervallic use of a sonic toothbrush compared to an oral irrigation system. BMC Oral Health. 2015;5;15:91.[Crossref] [PubMed] [PMC] 
  32. Mazzoleni S, De Stefani A, Bordin C, Balasso P, Bruno G, Gracco A, et al. Dental water jet efficacy in the plaque control of orthodontic patients wearing fixed appliance: a randomized controlled trial. J Clin Exp Dent. 2019;1;11(11):e957-e63.[PubMed] [PMC] 

.: 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