Volumetric Evaluation of Void/Gap Formation and Microleakage Cementing Fiber Posts on Extracted Teeth with Three Different Cements.

PURPOSE: To evaluate microleakage in roots restored with fiber posts cemented using three different luting cements, to measure the volume of voids/gaps within the obturated/postcemented root canals, and to examine whether microleakage and the volume of voids/gaps were correlated. MATERIALS AND METHODS: Thirty-six extracted human mandibular incisors were decoronated, and the root canals were obturated using gutta-percha and sealer in the experimental groups (n = 30). Six roots were used as controls. A standard post space was prepared, and an identically sized fiber post was cemented in each experimental specimen using one of three luting cements (Panavia F2.0, Bifix SE, GC FujiCEM; n = 10 each). The specimens were scanned using micro-computed tomography, and the volume of voids/gaps was determined. The specimens were then subjected to a fluid filtration assay to evaluate microleakage. RESULTS: The volume of voids/gaps was significantly lower in the GC FujiCEM group, and significantly less microleakage occurred in the Bifix SE group compared with other groups (both p < 0.001). A significant correlation between the volume of voids/gaps and leakage was found only in the Panavia F2.0 group (p = 0.003; r = 0.830). No such correlation was found in the analysis of all groups combined. CONCLUSIONS: The group with the greatest volume of voids/gaps (Bifix SE) showed the least microleakage, and the group with the smallest volume of voids/gaps (GC FujiCEM) showed the most microleakage. Panavia F2.0 ranked between and exhibited significant correlation.

Diagnostic value of signal peptide-CUB-EGF domain-containing protein 1 as an early and late biochemical marker in the ovarian torsion rat model.

AIMS: Signal peptide-CUB-EGF (epidermal growth factor-like protein) domain-containing protein 1 (SCUBE1) is an experimental marker of ischemia that has been previously studied both in rat models and humans. In this study, we aim to investigate the importance of SCUBE1 levels in ovarian torsion using an ovarian torsion model in rats. METHODS: A total of 18 Sprague-Dawley rats were equally divided into three groups. Group 1 (n = 6) was the Sham group and was only given a laparotomy procedure. Group 2 (n = 6) underwent bilateral ovarian torsion and ovarian ischemia lasting 8 h. Group 3 (n = 6) was subjected to bilateral ovarian torsion and ischemia lasting 24 h. Blood samples were collected from all three groups after the operations, and SCUBE1 levels were studied. Ovarian samples were collected, and microscopic evaluation was performed. The correlation of SCUBE1 levels and histopathological findings were investigated. RESULTS: The mean SCUBE1 level of group 3 was statistically higher than other groups (P < 0.01). Follicular degeneration and infiltration of inflammatory cells were, respectively, statistically significant in groups 2 and 3 (P = 0.002 and P = 0.045, respectively). CONCLUSION: SCUBE1 can be useful in diagnosing ovarian torsion during the first 24 h, but more randomized controlled studies are necessary in order to implement it in clinical settings.

Iodine status of pregnant women in a metropolitan city which proved to be an iodine-sufficient area. Is mandatory salt iodisation enough for pregnant women?

The objective of this study was to assess the iodine status of pregnant women in a metropolitan city which was stated as iodine sufficient area after salt iodination program. This multicenter, cross-sectional study was carried out on 3543 pregnant women. Age, gestational weeks, smoking, consumption of iodized salt, dietary salt restriction, history of stillbirth, abortus and congenital malformations were questioned. Spot urine samples were analyzed for urine iodine concentration (UIC). The outcomes were: (a) median UIC in three trimesters of pregnancy and (b) frequency of ID among pregnant women. The median UIC was 73 µg/L. The median UIC was 77 µg/L (1-324), 73 µg/L (1-600) and 70 µg/L (1-1650) in three trimesters of pregnancy, respectively (p: 0.14). UIC <50 µg/L was observed in 36.6% (n: 1295) and UIC<150 µg/L was observed in 90.7% (n: 3214) of pregnant women. Only 1% (n: 34) of the pregnant women had UIC levels higher than 500 µg/L. This study showed that more than 90% of the pregnant women in this iodine-sufficient city are facing some degree of iodine deficiency during their pregnancy. A salt iodization program might be satisfactory for the non-pregnant population, but it seems to be insufficient for the pregnant population.

The effect of residual calcium hydroxide on the accuracy of a contemporary electronic apex locator.

OBJECTIVE: The aim of this study was to evaluate the effect of residual calcium hydroxide [Ca(OH)2] on the accuracy of an electronic apex locator (EAL). MATERIALS AND METHODS: Working lengths (WLs) of 56 extracted maxillary incisors were determined initially by two different methods. The first method used the 'APEX' reading of the EAL as a reference point, 0.5 mm was subtracted and recorded as WL0. The second method used the '0.5' reading and the score was recorded as WL0.5 without subtraction. The roots were prepared to WL0 and divided randomly into three experimental groups (n = 16) (1 mm in group A, 2 mm in group B and 4 mm in group C) and a control (n = 8). Specimens in all experimental groups were filled with Ca(OH)2 paste. Following its removal, WLs were re-determined with the same methods. RESULTS: In group C, pre/post WLs were significantly different (p < 0.05). No significant difference was observed between the other experimental groups and the control group. CONCLUSION: Accuracy of EAL decreased proportionally with the amount of paste remaining at the ±0.5-mm tolerance level. Ca(OH)2 paste remnants may cause incorrect EAL readings.

Corneal biochemical features of patients with vernal keratoconjunctivitis.

BACKGROUND: Vernal keratoconjunctivitis (VKC) is a chronic, bilateral, seasonally exacerbated, allergic inflammation of the ocular surface, involving bulbar and / or tarsal conjunctiva and cornea. The ocular response analyzer (ORA) measures corneal biomechanical properties in vivo by monitoring and analyzing the corneal behavior when its structure is submitted to a force induced by an air jet. This study was designed to examine corneal biomechanical properties and intraocular pressure in patients with VKC, and to compare with control eyes. METHODS: ORA measurements were performed on the both eyes of 26 patients with VKC (group I) and 14 healthy children who served as the control group (group II). Corneal hysteresis (CH), corneal resistance factor (CRF) and intraocular pressure [Goldmann correlated (IOPg) and corneal compensated (IOPcc)] were recorded with ORA. RESULTS: Mean age of patients with VKC and control groups were 11.3 ± 5.8 and 10.6 ± 1.9 years for groups I and II respectively. Mean (± SD) of the CH and CRF readings were 10.1 ± 1.6 versus 10.5 ± 1.6 (p > 0.05) and 9.5 ± 1.7 versus 10.8 ± 1.7 mmHg (p < 0.05), in groups I and II respectively. Mean (± SD) of the IOPg and IOPcc recordings were 13.3 ± 3.4 versus 16.6 ± 3.6 mmHg (p < 0.05) and 14.3 ± 3.4 versus 16.9 ± 3.7 mmHg (p > 0.05) in groups I and II respectively. Statistical analysis revealed significant differences for CRF and IOPg between the study groups. CONCLUSION: The mean CRF and IOPg values of patients with VKC were lower than those of controls. According to the results of our study, one can conclude that corneal biomechanical property, CRF, could be different in VKC patients compared to normals.

Effects of dissolving solutions on the accuracy of an electronic apex locator-integrated endodontic handpiece.

The effects of three dissolving agents on the accuracy of an electronic apex locator- (EAL-) integrated endodontic handpiece during retreatment procedures were evaluated. The true lengths (TLs) of 56 extracted incisor teeth were determined visually. Twenty teeth were filled with gutta-percha and a resin-based sealer (group A), 20 with gutta-percha and a zinc oxide/eugenol-based sealer (group B), and 16 roots were used as the control group (group C). All roots were prepared to TL. Guttasolv, Resosolv, and Endosolv E were used as the dissolving solutions. Two evaluations of the handpiece were performed: the apical accuracy during the auto reverse function (ARL) and the apex locator function (EL) alone. The ARL function of the handpiece gave acceptable results. There were significant differences between the EL mode measurements and the TL (P < 0.05). In these comparisons, Tri Auto ZX EL mode measurements were significantly shorter than those of the TL.

Idiopathic Inflammatory Neuroretinitis Simulating Optic Nerve Sheath Dural Ectasia.

We report a case of a 32-year-old female patient who presented with decreased vision on both eyes and headache. In fundus examination, both eyes had elevation of the optic disc and star shaped hard exudates in the macula. Magnetic resonance imaging was completely normal except the saccular dilatation of bilateral optic nerve sheath. The patient was treated with oral steroids following high-dose intravenous methylprednisolone. She displayed good anatomical and functional results during the follow-up. This case raises the possibility that optic nerve sheath enlargement, probably induced by an idiopathic inflammatory optic neuritis, may simulate dural ectasia of the optic nerve sheath.

Can an apparent diffusion coefficient of uterine fibroid before uterine artery embolization predict potential fibroid response?

OBJECTIVES: ACOG guidance confirms the use of uterine artery embolisation (UAE) as an alternative to hysterectomy or myomectomy. The main objective of this article is to evaluate the ability of preoperative magnetic resonance imaging (MRI) to study the relationship between uterine fibroid reduction and diffusion coefficient (ADC) value after UAE. This is a relevant topic with the growing interest in using ADC as a noninvasive imaging biomarker for monitoring tissue changes and predicting uterine fibroid response to UAE over the past years. MATERIAL AND METHODS: In this prospective controlled non-randomized trial; uterine fibroid volume, fibroid diameter, uterine volume, fibroid ADC and normal myometrium ADC were recorded before and after UAE. Wilcoxon test was used in the analysis of the dependent quantitative data. Pearson correlation coefficients were calculated between post-UAE uterine volume, fibroid volume, and average fibroid diameter reduction and the patient's age, parity, gravidity, fibroid ADC and myometrial ADC before UAE. RESULTS: The mean fibroid volume reduction was 36.0% (range between 17.3-77.7%). Mean fibroid diameter, fibroid volume, uterine volume, and myometrium ADC values after UAE were significantly lower than before the procedure (p = 0.002, < 0.001, 0.001, 0.006 respectively), but the decrease in fibroid ADC is not significant. As a result decrease in fibroid volume was greater as pre-UAE fibroid ADC values increased, and that finding may contribute to the selection of the patients for the procedure. CONCLUSIONS: The ADC value before UAE was positively correlated with fibroid volume reduction.

Effects of simulated lateral canals on the accuracy of measurements by an electronic apex locator.

BACKGROUND: Accurate determination of the apical terminus plays a significant role in the success of root canal therapy, but accuracy may be affected by the presence of accessory canals. OBJECTIVE: To evaluate the accuracy of a ratio-based electronic apex locator for roots with simulated lateral canals. METHODS: Forty-two single-rooted human teeth were randomly divided into 2 groups. For each tooth, the root canal was prepared to the visually determined working length, and the working length was then measured with the Justy II electronic apex locator. Simulated lateral canals (of 2 different diameters) were then prepared at 3 mm (group A) or 6 mm (group B), and the working lengths were measured again with the same instrument. The measurements were analyzed by one-way analysis of variance. RESULTS: For both groups, there were no significant changes in working length after the creation of simulated canals (p > 0.05). CONCLUSION: Measurements obtained with the ratio-based electronic apex locator were not affected by the preparation of simulated lateral canals, and the instrument was able to accurately determine the location of the tooth apex.

Determination of idiopathic female infertility from infrared spectra of follicle fluid combined with gonadotrophin levels, multivariate analysis and machine learning methods.

By in vitro fertilization, oocytes can be removed and the embryo can be cultured, and then trans cervically replaced when they reach cleavage or at the blastocyst stage. The characterization of the follicular fluid is important for the treatment process. Women who applied to the Academic Hospital in vitro fertilization (IVF) Center diagnosed with idiopathic female infertility (IFI) were sought in the patient group. Demographics and clinical gonadotropin measurements of the study population were recorded. Of the 116 follicular fluid samples (n=58 male-induced infertility; n=58 control) were analyzed using the FTIR system. To identify FTIR spectral characteristics of follicular fluids associated with an ovarian reserve and reproductive hormone levels from control and IFI, six machine learning methods and multivariate analysis were used. To assess the quantitative information about the total biochemical composition of a follicular fluid across various diagnoses. FTIR spectra showed a higher level of vibrations corresponding to lipids and a lower level of amide vibrations in the IFI group. Furthermore, the T square plot from Partial Last Square (PLS) analysis showed, that these vibrations can be used to distinguish IFI from the control group which was obtained by principal component analysis (PCA). Proteins and lipids play an important role in the development of IFI. The absorption dynamics of FTIR spectra showed wavenumbers with around 100% discrimination probability, which means, that the presented wavenumbers can be used as a spectroscopic marker of IFI. Also, six machine learning methods showed, that classification accuracy for the original set was from 93.75% to 100% depending on the learning algorithm used. These results can inform about IFI women's follicular fluid has biomacromolecular differentiation in their follicular fluid. By using a safe and effective tool for the characterization of changes in follicular fluid during in vitro fertilization, this study builds upon a comprehensive examination of the idiopathic female infertility remodeling process in human studies. We anticipate that this technology will be a valuable adjunct for clinical studies.

Reproducibility and agreement of clinical diagnosis of occlusal caries using unaided visual examination and operating microscope.

AIM: To assess the reproducibility of clinical diagnosis of occlusal caries using unaided visual examination and examination with an operating microscope (16 x magnification) and to determine the agreement between these 2 methods. MATERIALS AND METHODS: Three experienced dentists used unaided visual examination and an operating microscope to grade, according to a standard caries rating scale, a total of 299 occlusal surfaces in 112 subjects (mean age 28.3 years, standard deviation 0.5 years), during several examination sessions. Intraobserver and interobserver reproducibility was calculated, and agreement in diagnosis of the same teeth by different methods was also determined. RESULTS: The level of intraobserver agreement for the 2 modes of clinical diagnosis was substantial, as indicated by kappa values; however, there was substantial interobserver variability with both techniques. Agreement in clinical diagnosis between the 2 techniques was 62.5% for observer 1 (kappa = 0.483), 65.4% for observer 2 (kappa = 0.531) and 63.5% for observer 3 (kappa = 0.508) (p = 0.001). CONCLUSIONS: Intraobserver agreement with the operating microscope and with unaided visual examination was roughly the same, but interobserver agreement was low with both techniques. For some surfaces, the diagnosis made by a particular observer with unaided visual examination differed from that made with microscopic examination. The diagnoses differed most frequently for surfaces that were scored as sound with unaided visual examination.

Accuracy of two apex-locating handpieces in detecting simulated vertical and horizontal root fractures.

The aim of this study was to evaluate in vitro the effectiveness of TCM Endo V and Tri Auto ZX handpieces in detecting simulated horizontal and vertical root fractures. Forty extracted maxillary incisor teeth were randomly divided into 2 groups as simulated incomplete horizontal and vertical root fractures. Auto reverse and electronic apex locator functions of the 2 handpieces were used in both groups. Repeated measures of analysis test and pairwise comparisons were used for statistical analyses. Both handpieces detected the root fractures in an acceptable range. Furthermore, electronic apex locator function of both devices was more efficient in the process than auto reverse function.

Efficacy of 3 techniques in removing root canal filling material.

OBJECTIVE: Retreatment of a root canal in the case of infection requires complete removal of previous filling material. This study evaluated the efficacy of 3 techniques in removing laterally compacted Resilon/Epiphany and gutta-percha/AH Plus from straight and curved canals during retreatment. MATERIALS AND METHODS: Extracted human teeth (90 maxillary anterior teeth with single,straight root canals and 90 mandibular molars with mesial canal root curvatures of 20 degrees to 35 degrees ) were divided into 6 groups each consisting of 15 straight and 15 curved root canals. Three groups were obturated using gutta-percha/AH Plus and 3 were obturated with Resilon/Epiphany. After 3 weeks storage at 37 degrees C and 100% humidity, all root canal fillings were removed using a Gates Glidden drill, a Gates Glidden drill plus chloroform or a System B device. RESULTS: For all removal techniques, specimens obturated with gutta-percha/AH Plus showed significantly more remnants of obturation material than specimens filled with Resilon/Epiphany for both straight and curved canals (p < 0.05). Removal time was shorter for Resilon/Epiphany than gutta-percha/AH Plus filling for all techniques and for both curved and straight canals. The Gates Glidden drill and Gates Glidden drill plus chloroform removal techniques were significantly faster than the System B technique for both straight and curved canals. The Gates Glidden drill technique was best for straight canals, whereas the Gates Glidden drill plus chloroform was the best technique for curved canals when removing Resilon/Epiphany sealer. CONCLUSIONS: Removal of Resilon/Epiphany filling resulted in fewer remnants and was faster than gutta-percha/AH Plus removal using a Gates Glidden drill with or without chloroform in both straight and curved canals.

Apical accuracy of two apex-locating handpieces in root canal retreatments of root-end resected teeth.

We aimed to evaluate the accuracy of 2 apex locator integrated endodontic motors during retreatment of root-end resected teeth by using 40 extracted incisor teeth. The apical 3 mm of the roots were resected, and the root lengths were recorded as resected length of the roots. Forty roots were randomly divided into 2 groups of 20 to evaluate the 2 handpieces, Tri Auto ZX and TCM Endo V. The working lengths measured during the auto reverse function and during the electronic apex locator function with Tri Auto ZX and TCM Endo V were recorded and compared with resected length of the roots. The repeated measures analysis of variance was used for statistical analyses. Electronic apex locator functions of both devices might be used for apical accuracy, but the auto reverse functions might not be useful to 0.0-mm accuracy in retreatment procedures of root-end resected teeth.

Evaluation of the surface characteristics of used and new ProTaper Instruments: an atomic force microscopy study.

The purpose of this study was to evaluate the topography of new and used ProTaper rotary nickel-titanium (NiTi) instruments by using atomic force microscope. Four new and four used size S1, S2, F1, and F2 instruments were selected for this study. New and used instruments were analyzed on 11 points along a 3-mm section at the tip of the instrument. Quantitative measurements according to the topographic deviations (root mean square) were recorded. Data were analyzed by paired samples t test. Mean root mean square values for used ProTaper instruments were higher than the new ones, and the difference between them was statistically significant. The results of this study showed that used ProTaper instruments demonstrated more surface deformation and wear.

Enlarging characteristics of four nickel-titanium rotary instrument systems under standardized conditions of operator-related variables.

We aimed to describe a computer-controlled testing device and evaluate the amount of material removed by using 4 Ni-Ti systems in simulated root canals. Eighty resin blocks were used. Hero 642, Hero Shaper, ProFile, and ProTaper rotary instruments were used to prepare the canals. Operator-related variables were standardized with the aforementioned device. Preoperative/postoperative photographic images of canals were measured at 11 levels from the apical tip. Statistical analyses were done with one-way analysis of variance, Tukey honestly significant difference, and Bonferroni tests. Significantly more material was removed by the ProTaper at 9 levels, ProFile at 6, and Hero 642 at 2 levels (P < .05); no significant difference was determined at 5 levels. Our results showed that ProTaper and ProFile removed significantly more material than Hero 642 and Hero Shaper at different levels of the curved root canals under controlled conditions of operator-related variables.

Restorative treatment decision making with unaided visual examination, intraoral camera and operating microscope.

This study assessed the restorative treatment options of the occlusal surfaces of teeth examined with unaided visual assistance, an intraoral camera and an operating microscope. Sixty-eight extracted human molars were mounted to perform mouth models with a premolar in contact on both sides. Four observers examined the models in a phantom head, which simulated clinical conditions, using three techniques: unaided visual examination, intraoral camera and operating microscope. The observers were asked to assess the occlusal surface of each tooth and make a treatment decision based on the following scale: 1) the occlusal surface being sound and "not needing a restoration," 2) the occlusal surface having a subsurface or enamel lesion. No operative treatment was needed at this visit, but special attention was given to this surface at recall visits: "preventive care-defer treatment" and 3) the surface had a carious lesion and "needed a restoration." The teeth were then sectioned in the mesio-distal direction and examined under a stereomicroscope with 10x magnification to determine the true extent of caries. Statistical analysis was conducted by calculating percentages and kappa values of the restorative treatment scores based on examinations by four observers. According to all the observers' treatment decisions, the kappa values were found to be 0.341 (p<0.001), 0.471 (p<0.001) and 0.345 (p<0.001) for unaided visual examination, intra-oral camera and operating microscope, respectively. There was a statistically significant difference between the intraoral camera and the other two methods (p<0.05), while there was no significant difference between the unaided visual examination and operating microscope (p>0.05). As a result of a comparison between the unaided visual examination and operating microscope, the use of an intraoral camera improved the restorative treatment decisions of the occlusal surfaces on posterior teeth.

The effect of disruption of apical constriction on periapical extrusion.

The aim of this study was to compare the amount of apical extrusion during manual instrumentation and engine-driven rotary instrumentation in teeth with disrupted apical constriction. Fifty-two teeth were divided into two groups comprising 26 teeth each. Teeth in each group were further divided into two sub-groups, the apices of which were enlarged approximately to a diameter of 0.2 mm and 0.4 mm. One group was instrumented using standardized technique with K-files and the other with ProFile .04 Taper Series 29, while irrigating with sodium hypochlorite. Glass vial model was modified for collection of extruded debris and irrigant as well as to integrate an electronic apex locator to the experimental assemble. The statistical analysis using Student's t test revealed no significant difference between instrumentation with K-files and ProFile .04 taper files (p > 0.05). There was a tendency with both techniques to extrude apically more material as the diameter of the apical patency increased.

The assessment of unaided visual examination, intraoral camera and operating microscope for the detection of occlusal caries lesions.

This study compared the efficiency of unaided visual examination, intraoral camera and operating microscope according to a visual scoring system (ERK) at occlusal caries detection. A total of 84 extracted human molars were mounted to create mouth models with a premolar in contact on both sides. The models were examined in a phantom head simulating clinical conditions by four observers using the three techniques: unaided visual examination, an intraoral camera and on operating microscope according to the ERK scale. The teeth were than sectioned in a mesio-distal direction and examined under a stereomicroscope with 10x magnification for histological validation. The sensitivity, specificity, positive predictive and negative predictive values were calculated for the four observers with three techniques and statistical analyses were performed using Friedman and DUNN tests, while strength of agreement was determined by calculating Kappa values. From the data, mean sensitivity values were cal. culated as 0.26, 0.43, 0.49 and mean specificity values as 0.87, 0.80 and 0.73 for unaided visual examination, intraoral camera and operating micro scope, respectively. The Kappa values ranged between 0.187 and 0.301 for visual examination, 0.328 and 0.459 for intraoral camera and 0.363 and 0.516 for operating microscope. As a result, the use of an intraoral camera and operating microscope improved occlusal caries detection according to the ERK scale.

Microhardness of packable composites used as posts condensed with different methods.

The purpose of this in vitro study was to evaluate the microhardness of packable composite compacted with hand or ultrasonic pluggers in post spaces. A total of 168 extracted human anterior teeth were prepared with Gates Glidden and ParaPost drills after obturation. A primer and a dentin-bonding agent were applied to the etched surface. Half of the specimens were compacted with an ultrasonic tip and the other half with a mechanical hand compactor and all specimens were polymerized for each increment. The roots were then sectioned horizontally from 0, 2.5, 3, 3.5, 4, 4.5, and 5 mm starting from the coronal and sliced 2.5-mm long. The microhardness test was applied to each specimen. There were statistically significant differences between ultrasonically and hand-condensed groups in whole specimens (p < 0.001). There were no significant differences between groups of 0, 2.5, and 3 mm until 3.5 mm was reached. After 3.5-mm depth, there were significant differences between the groups (p < 0.001). Ultrasonic condensation of packable composites provided mechanical advantage over hand condensation in root canals measuring microhardness in different depths. However, when microhardness was measured at different depths, values decreased after the depth of 3.5 mm in both condensation groups.