The effect of conventional radiofrequency thermocoagulation of femoral and obturator nerves' articular branches on chronic hip pain: a prospective clinical study.

BACKGROUND: Chronic hip pain is one of the most common and difficult-to-treat causes of disability. Our study's primary aim was to investigate the effects of ultrasound and fluoroscopy-guided radiofrequency thermocoagulation of the femoral and obturator nerve articular branches on chronic hip pain, and the secondary aim was to determine its effects on hip function and quality of life. METHODS: Fifty-three patients with hip pain lasting more than three months were enrolled in the study. VPS scale and WOMAC, SF-12 questionnaires were applied to the patients before and in the first, third, and sixth months following the procedure. RESULTS: Of the patients, 60.4% were female, and 39.6% were male. Hip pain was caused by osteoarthritis in 77.1%, postoperative hip pain in 12.5%, malignancy in 8.3%, and avascular necrosis in 2.1%. The VPS scores were 8.9 ± 1.1 (mean±SD) in the baseline period, 2.4 ± 2.5 in the first postoperative week, 3.8 ± 2.5 in the first month, 5.1 ± 2.8 in the third month, and 5.8 ± 2.7 in the sixth month, with a significant decrease in VPS score (P < .001). One patient developed a motor deficit that improved spontaneously. CONCLUSIONS: We concluded that radiofrequency thermocoagulation application to the articular branches of the femoral and obturator nerves provides pain relief, hip function improvement, and better quality of life (better physical component scores but no improvement in mental component scores in SF-12) for up to 6 months in chronic hip pain.

The Efficacy of Electro-Acupuncture Added to Standard Therapy in the Management of Bell Palsy.

OBJECTIVE: To investigate the comparative efficacy of electro-acupuncture when added to standard therapy in patients with Bell palsy in terms of clinical and neurophysiologic outcomes. METHODS: A total of 88 patients with Bell palsy who received standard treatment (ST group; n = 40, mean ± standard deviation age: 39.2 ±â€Š6.6 years, 60.0% were males) or standard treatment plus electro-acupuncture (ST-EA group; n = 48, mean ±â€Šstandard deviation age: 39.5 ±â€Š6.9 years, 58.3% were males) were included. Data on patient demographics, symptoms, comorbidities, and 3-month outcomes on treatment response assessed via House-Brackmann grading system and facial nerve recovery profile and electromyography were recorded. RESULTS: Application of ST-EA versus ST was associated with a significantly higher rate of normal nerve function on 12th week electromyography (66.7% versus 25.0%, P = 0.020), higher frequency of patients with House-Brackmann grade ≤2 in the 3rd week (79.2% versus 45.0%, P = 0.029), 6th week (87.5% versus 45.0%, P = 0.004), and 12th week (95.8% versus 50.0%, P = 0.001), and those with facial nerve recovery profile scores ≥8 in the 6th week (83.3% versus 45.0%, P = 0.011) and 12th week (87.5% versus 50.0%, P = 0.009) of treatment. CONCLUSION: In conclusion, our findings in patients with Bell palsy revealed superiority of electro-acupuncture added to standard therapy over standard therapy alone in terms of improvement of nerve dysfunction, decrease in paralysis severity, and better functional recovery. This seems to indicate the likelihood of electro-acupuncture to be a safe and promising adjunct in the achievement of more satisfactory clinical outcomes in the management of Bell palsy when used in combination with standard medical and physiotherapy.

Evaluation of two different CAD-CAM inlay-onlays in a split-mouth study: 2-year clinical follow-up.

OBJECTIVE: To evaluate the clinical performance of hybrid ceramic inlay-onlay restorations over a 2-year period. CLINICAL CONSIDERATIONS: A total of 30 lithium disilicate glass ceramic (LDC; control group) and 30 hybrid ceramic (HC; test group) inlay/onlay restorations were performed in 14 patients. Clinical evaluations were performed after 1 week, 6 months, 1 year, and 2 years of cementation according to the modified United States Public Health Service (USPHS) criteria, gingival index, and plaque index. The Friedman test was used for the significant difference in time and Wilcoxon signed-rank test was used for the determination of differences. The clinical parameters, gingival and plaque indexes differences in time were analyzed with Chi-square test. No statistically significant difference (P > .05) was found between the two groups in the modified USPHS, gingival index, and plaque index evaluations, whether statistically significant differences were found within groups. The total survival rate was 100% for both groups after 2 years. CONCLUSION: Based on the 2-year data, the tested HC can be considered a reliable material for inlay/onlay restorations. CLINICAL SIGNIFICANCE: The results of this in vivo study suggest that both resin nanoceramic materials and LDC materials have been successfully incorporated in treatments of inlay and onlay restorations. Short-term results showed that resin nanoceramic materials can be counted as a good choice in inlay and onlay restorations in an effort to reduce the treatment time associated with ceramic firing processes.

Two-body wear of occlusal splint materials against different antagonists.

BACKGROUND: This study aimed to demonstrate that the material of the occlusal splint can be chosen according to the needs of individual patients and contribute to the knowledge of the wear rate of these materials. METHODS: In this study, four occlusal splint materials (Sr Ivocap Heat Cured, Valplast, SR Ivocap Elastomer and Eclipse) and three antagonists (natural tooth enamel, inCoris TZI and IPS e.max Press ceramic materials) were used. Each wear test was performed using a chewing simulator (n = 16; test load: 50 N; number of cycles: 10,000, 20,000 and 30,000; continuous rinsing with water at 30 °C for the wet condition). The Shapiro Wilk test was used for normal distribution suitability. Antagonist on average wear quantities both main effects and interactions of material, cycle and condition factors were investigated by Univariate variance analysis. Multiple comparisons were examined using the Games-Howell test. RESULTS: There was a statistically significant effect of the difference in materials on the amount of wear (p < 0.001). Furthermore, there was a statistically significant difference among the mean values of all materials (p > 0.001). The highest mean value was obtained with Eclipse (0,318 µm3), and the lowest mean value was obtained with Valplast (0,134 µm3). CONCLUSION: Our study found differences in the in vitro wear rate among various occlusal splint materials.

Comparison of the Efficacies of Dry Needling and Botox Methods in the Treatment of Myofascial Pain Syndrome Affecting the Temporomandibular Joint.

BACKGROUND: To compare the efficacies of botulinum toxin-A injection and dry needling methods in the treatment of patients with myofascial pain syndrome (MPS) in the temporomandibular joint (TMJ). METHODS: In this prospective study, 40 MPS patients (29 women, 11 men) were randomly assigned to abobotulinum toxin-A injection (Group 1, n = 20) or dry needling (Group 2, n = 20) groups. Pain, crepitation, functional limitation, maximum mouth opening, jaw strength were evaluated at baseline and 6 weeks, and the results in both groups were compared. RESULTS: The average age of the authors' patients was 33.8±8.1. There was a remarkable difference between 2 groups regarding visual analog scale for TMJ pain at rest (P = 0.048). The pain at rest was relieved more effectively in Group 2 at the end of 6 weeks. Improvement in jaw protrusion angles on the right (P = 0.009) and left (P = 0.002) sides was more evident in Group 2 after 6 weeks. There were significant pain relief and functional improvement after treatment in both groups. In Group 2, recovery of the TMJ function was more obvious in 6 weeks following dry needling (P = 0.002). CONCLUSION: The authors suggest that abobotulinum toxin-A injection and dry needling yield satisfactory therapeutic outcomes regarding pain relief and restoration of function in patients with MPS involving TMJ. Further multicentric, randomized, controlled trials on larger series are warranted to obtain more accurate and reliable information.

Clinical and Radiological Comparison of Effects of Platelet-Rich Plasma, Hyaluronic Acid, and Corticosteroid Injections on Temporomandibular Joint Osteoarthritis.

There are few studies in the literature that comparatively evaluate the use of intra-articular orticosteroids (CS), hyaluronic acid (HA), and platelet-rich plasma (PRP). In this study, the authors aimed to compare the clinical results of intra-articular CS, HA, and PRP injections in patients who presented to the authors' clinic with temporomandibular joint (TMJ) pain and clinically diagnosed with TMJ-osteoarthritis. Patients were evaluated in 2 groups as those patients who felt pain on lateral (n = 31), and posterior (n = 43) palpation. Patients who were evaluated in the study were randomly assigned to 3 different treatment groups as Group 1 (PRP), Group 2 (HA), and Group 3 (CS). Pain felt on the TMJ on lateral and posterior palpation was assessed before treatment and every month for 3 months using a 5-point pain scale. Presence of crepitation, loss of function, and loss of strength were assessed before treatment and every month for 3 months. Significant changes were observed in the PRP and HA groups when the patients were evaluated according to the VAS scores evaluated at different follow-up times for TMJ pain on lateral palpation. Significant changes were observed in the PRP, HA, and CS groups when VAS scores were evaluated according to the patients' follow-up times for TMJ pain on lateral palpation. In conclusion, the findings of this study have shown that intra-articular PRP injections decreased TMJ palpation pain more effectively compared with the HA and CS groups.

Clinical performance of pressable glass-ceramic veneers after 5, 10, 15, and 20 years: A retrospective case series study.

OBJECTIVES: To evaluate the long-term clinical performance and survival rate of pressable lithium-disilicate glass-ceramic veneers (LDSVs). MATERIALS AND METHODS: A total of 413 LDSVs were bonded to anterior and posterior teeth by three experienced clinicians between 1998 and 2012. The LDSVs were examined for color/ esthetic match of the glass-ceramic surface (esthetic evaluation), fracture rate, marginal discoloration (staining of the luting cement), and marginal integrity (including caries, clinical evaluation). For clinical and esthetic evaluations, the modified United States Public Health Services (USPHS) score was used in this study. The success rate was determined with a Kaplan-Meier survival analysis. RESULTS: The mean observation time was 11.33 ± 4.85 years. There was no loss to follow-up, all restorations were accounted for in the final analysis. The probability of survival of the 413 veneers was 98% after 5 years, 95% at 10 years, 91% at 15, and 87% at 20 years, indicating a very low clinical failure rate. Of the 413 restorations, complications were occurred in 15 (3.63%) of all restorations, and fractures and debonding in 6 (1.45%) and 9 (2.18%), respectively. CONCLUSIONS: The LDSVs showed high survival rate and very good results for color match and anatomic form and marginal integrity in the long-term analysis. CLINICAL SIGNIFICANCE: The long-term performance of LDSVs can be considered as highly favorable when carefully planned.

Effects of Silica Coating by Physical Vapor Deposition and Repeated Firing on the Low-Temperature Degradation and Flexural Strength of a Zirconia Ceramic.

PURPOSE: To examine the application of physical vapor deposition (PVD) silica coating as an approach to retard low temperature degradation (LTD) for dental applications. Accelerated aging characteristics of heat- and surface-treated zirconia material were also investigated by exposing specimens to hydrothermal treatment. MATERIALS AND METHODS: The specimens (90 disc-shaped specimens [15 mm ×1.2 mm]) were divided into 9 groups (n = 10) according to the test protocol: Ctrl, control (no surface treatment); Ag, autoclave aging; GrAg, grinding + aging; SiAg, silica coating + aging; GrSiAg, grinding + silica coating + aging; 3FAg, 3-time firing + aging; Gr3FAg, grinding + 3-time firing + aging; 5FAg, 5-time firing + aging; Gr5FAg, grinding + 5-time firing + aging. Accelerated aging was performed in a steam autoclave (134°C, 2 bars) for 12 hours. Following each treatment protocol, X-ray diffraction (XRD) analysis was used to estimate the relative amount of monoclinic phase and corresponding transformed zone depth (TZD). Additionally, a biaxial flexure test was used to calculate the flexural strength. Statistical analysis was conducted with one-way ANOVA and Fisher's LSD test (p < 0.05). RESULTS: The tetragonal-to-monoclinic transformation was retarded by PVD silica coating only on ground surfaces. Ground and heat-treated specimens exhibited the lowest monoclinic content after aging. The biaxial flexural strength value of the GrAg group was significantly higher than the values in all of the other groups except the SiAg group. The flexural strength value of the GrSiAg group was significantly higher than that of the 3FAg group. There was no statistically significant difference between the other groups (p > 0.05). CONCLUSIONS: Grinding decreased the susceptibility of zirconia to LTD and increased the flexural strength. PVD silica coating and repeated firing decreased the monoclinic content only in ground specimens during aging.

Clinical procedures, designs, and survival rates of all-ceramic resin-bonded fixed dental prostheses in the anterior region: A systematic review.

OBJECTIVES: The aim of this study is to systematically review all the clinical articles about all-ceramic resin-bonded fixed dental prosthesis (RBFDP) in the anterior region and assess their designs, clinical procedures, and survival rates. A systematic review was conducted after searching electronic databases PubMed/Medline and EBSCOhost Research Databases for articles published in English between 1987 and July 2017. MATERIALS AND METHODS: The inclusion criteria were selected as all clinical studies, original design clinical reports, and clinical reports (follow-up time more than 1 year) as all clinical information in the literature are desired to be included in the present review. RESULTS: The initial electronic search generated 472 articles from PubMed/Medline and 464 articles from EBSCOhost Research Databases. After selection of the articles as per the inclusion criteria, a final sample of 29 original studies is decided as: 1 randomized controlled clinical trial, 4 clinical controlled trials, 4 prospective cohort studies, 2 retrospective cohort studies, 6 original design clinical reports, and 12 clinical reports. After evaluation of the selected articles, it is likely that cantilever design all-ceramic RBFDPs are more successful than two retainer design in the anterior region; however, there is limited evidence for this result in the literature. CONCLUSION: Well-designed randomized controlled clinical trials with large sample size are still needed to achieve more accurate results about the clinical success rate of different RBFDPs designs in the anterior region. CLINICAL SIGNIFICANCE: Indications, designs, abutment teeth preparation, provisionalization, try-in, surface treatment options, and cementation of the all-ceramic resin-bonded fixed dental prostheses are described in this article. Clinical survival rates are also given in detail, so that clinicians can easily compare the current studies and give their own decision about all-ceramic resin-bonded fixed dental prostheses in the anterior region.

Central corneal thickness and corneal curvature in patients with rheumatoid arthritis.

The aims of this study were to determine the central corneal thickness (CCT) and corneal curvature (CC) in patients with rheumatoid arthritis (RA), and to evaluate the correlations between the CCT, CC, RA activity, and RA duration. Fifty-four RA patients (104 eyes; 35 with dry eye, 69 without dry eye) and 21 age- and gender-matched control patients (42 eyes) were enrolled in the study. The CCT and CC were measured by ultrasonic pachymeter and autorefractor-keratometer, respectively. RA activity was assessed using the disease activity score (DAS) 28. The independent samples' t test and Pearson correlation analysis were used in the statistical analyses. Mean CCTs were found to be 535.88 ± 38.24, 530.46 ± 32.88, 538.64 ± 40.64, and 543.40 ± 40.66 µm in all RA eyes, RA with dry eyes, RA without dry eyes, and control eyes, respectively. Mean keratometry (K) readings were found to be 43.84 ± 1.76, 43.73 ± 1.23, 43.90 ± 1.98, and 43.60 ± 1.48 D in all RA eyes, RA with dry eyes, RA without dry eyes, and control eyes, respectively. There were no significant differences in CCT values (p values, 0.293, 0.134, and 0.550, respectively) and K readings (p values, 0.435, 0.681, and 0.402, respectively) between the RA and control eyes. These findings led us to the conclusion that the CCT and K readings were not significantly associated with DAS (p values, 0.678 and 0.812, respectively) and RA duration (p values, 0.108 and 0.080, respectively). Our results show that CCTs and CCs were not significantly different between the RA eyes and control eyes. CCTs and CCs were also not associated with RA activity and RA duration.

Short-Term Effects of Kinesio Taping in Women with Pregnancy-Related Low Back Pain: A Randomized Controlled Clinical Trial.

BACKGROUND Pregnancy-related low back pain is a common condition during pregnancy. Kinesio tape is a drug-free elastic therapeutic tape used for treating various musculoskeletal problems. The aim of this study was to investigate the short-term effects of lumbar Kinesio taping on pain intensity and disability in women with pregnancy-related low back pain. MATERIAL AND METHODS A total of 65 patients with pregnancy-related low back pain were randomly allocated into either Kinesio taping (n=33) or control (n=32) groups. The intervention group was treated with paracetamol plus Kinesio taping, while the control group received only paracetamol. Kinesio taping was applied in the lumbar flexion position, and four I-shaped bands were used. Two bands were attached horizontally, with space correction technique. The remaining 2 bands, 1 on each side of the lumbar spine, were placed vertically, with inhibition technique. Low back pain intensity was measured on a 10-cm visual analogue scale (VAS), and the Roland-Morris Disability Questionnaire (RMDQ) was used for evaluation of disability. RESULTS Pain intensity and RMDQ scores improved significantly in both groups at 5 days compared with baseline. Considering the degree of treatment effect (the change from baseline to day 5), the Kinesio taping group was significantly superior than the control group in all outcome measures (for all, P<0.001). CONCLUSIONS The results of this study indicate that Kinesio taping can be used as a complementary treatment method to achieve effective control of pregnancy-related low back pain.

Effect of Cements at Different Temperatures on the Clinical Performance and Marginal Adaptation of Inlay-Onlay Restorations In Vivo.

PURPOSE: To evaluate the clinical performance of inlays and onlays luted with two different resin cements, mixed at different temperatures and to evaluate the marginal adaptation of the restorations. MATERIALS AND METHODS: One hundred IPS e.max restorations (82 onlays, 18 inlays; 84 molars, 16 premolars) were placed in 50 patients (28 females, 22 males, mean age, 33 years). The restorations were assigned to six groups according to the luting agent temperature (25°C, 37°C, and 54°C) and cement type (Variolink N high viscosity or G-Cem Automix). All restorations were evaluated after 1 week and 1 year by two examiners using modified USPHS criteria. Replicas of 30 selected onlay restorations (5 per group) were assessed for marginal quality under a scanning electron microscope (SEM) at 200×. Marginal adaptation was quantitatively evaluated in terms of percentage of gap formation, and marginal gap width was measured. RESULTS: After 1 year, the total survival rates of the Variolink N high viscosity group and G-Cem Automix group were 100% and 93.8%, respectively. Three debondings occurred with the G-Cem Automix group, one from each temperature group. For 1-year clinical service time, no significant difference was noticed in the marginal adaptation of Variolink N high viscosity groups and the 37°C G-Cem Automix group, while 25°C and 54°C G-Cem Automix groups' marginal adaptation scores decreased (p < 0.05). Regarding the SEM evaluations, Variolink N high viscosity cement groups showed better marginal adaptation than G-Cem Automix cement groups (p < 0.05). Cementation with the cements preheated to 37°C increased continuous margins in both enamel-cement and cement-ceramic interfaces, but these results were not statistically significant (p > 0.05). Cements at different temperatures did not have significant effects on marginal gap widths of the restorations. CONCLUSIONS: The restorations cemented with Variolink N high viscosity cement mixed at the three tested temperatures exhibited better treatment options than the self-adhesive groups. Preheating the self-adhesive cement (G-Cem Automix) to 37°C can be an effective method to have better marginal adaptation than the other self-adhesive groups (25°C, 54°C) tested in this study.

Comparison of marginal and internal fit of press-on-metal and conventional ceramic systems for three- and four-unit implant-supported partial fixed dental prostheses: An in vitro study.

STATEMENT OF PROBLEM: Adaptation is an important factor in the long-term clinical success of implant supported ceramic restorations. Ceramic firings may affect the adaptation of the restoration. PURPOSE: The purpose of this study was to compare the marginal and internal adaptation of 3 different restorative materials and the effect of veneering/pressing on the material used for 3- and 4-unit implant supported fixed dental prostheses. MATERIAL AND METHODS: One mandibular epoxy cast was prepared for 3-unit restorations and one for 4-unit restorations. Impressions of the casts were made and 60 stone die casts (30 3-unit, 30 4-unit) produced. The casts were divided into 3 subgroups: group MCR, conventional metal ceramic restorations; group POM, press-on-metal restorations; group ZIR, computer-aided design/computer-aided manufacturing CAD/CAM) zirconia restorations. A replica technique was used to examine the marginal and internal gap values. A total of 2400 measurements were made by making 40 measurements of each restoration. The data were evaluated statistically using analysis of variance and the least significant difference post hoc test (α=.05). RESULTS: The lowest marginal gaps were found in group POM (81.58 µm) and the highest in group MCR (103.82 µm). The differences in marginal adaptation measurements were found to be statistically significant. The highest values for internal adaptation were found at the occlusal surface in all groups. CONCLUSIONS: Although veneering metal ceramic restorations increased the misfit of the restoration, the marginal discrepancy of the materials (81 to 120 µm) can be considered clinically acceptable.

In Vitro Comparison of Marginal and Internal Fit of Press-on-Metal Ceramic (PoM) Restorations with Zirconium-Supported and Conventional Metal Ceramic Fixed Partial Dentures Before and After Veneering.

PURPOSE: To compare marginal and internal fit between 3- and 4-unit press-on-metal (PoM) ceramic, zirconia-supported, and conventional metal ceramic fixed partial dentures (FPDs) before and after veneering. MATERIALS AND METHODS: Ten pieces for each 3- and 4-unit MC, IPS InLine PoM, and IPS e.max ZirCAD/Zir Press FPDs were produced. Cross-sections from silicone replicas were examined and measured with a light microscope. Occlusal, axial, intermarginal, and marginal mean adaptation scores of cross-sectioned replicas and means of measurements obtained from 4 sites were calculated independently. RESULTS: Mean values for molars were 78.44 ± 32.01 µm (MC), 89.84 ± 29.20 µm (PoM), and 85.17 ± 28.49 µm (Zir). Premolar values were 76.08 ± 27.92 µm (MC), 89.94 ± 23.49 µm (PoM), and 87.18 ± 28.25 µm (Zir). No difference existed between the means of 3- and 4-unit FPDs except the molar-intermarginal region. The mean value of 4-unit FPDs (93.88 ± 25.41 µm) was less than the 3-unit FPDs (103.68 ± 24.55 µm) at the molar-inter marginal region. A gap increase was observed in all sites except the molar-axio-occlusal region after veneering. According to the mean difference, gap increases at the molar-marginal, molar-intermarginal, and premolar-intermarginal regions were statistically significant. A statistical difference was found at the molar-marginal region for 4-unit MCR (p = 0.041) and 4-unit PoM FPDs (p = 0.042) before and after veneering. Gap increase after veneering of 4-unit metal ceramics at molar-intermarginal, premolar-marginal, and premolar-intermarginal regions (p = 0.020; p = 0.015; p = 0.004) was significant. CONCLUSION: The gap measurements of the IPS InLine PoM and IPS e.max ZirCAD/Zir Press groups were all clinically acceptable. No studies on marginal and internal fit in the IPS InLine PoM system have been published to date. This study should be supported with future studies. No significant increase was observed after press-veneering the IPS e.max ZirCAD frameworks with an IPS e.max ZirPress material; therefore, we recommend the use of this combination.

Candida albicans adhesion on reinforced polymethylmethacrylate denture resin: effect of fibre architecture and exposure to saliva.

BACKGROUND AND OBJECTIVES: Fiber-reinforced composites (FRC) are used to reinforce the prosthetic and restorative appliances. This may result in the exposure of the FRCs which may affect the adherence of microorganisms. This study evaluated the adhesion of Candida albicans to a denture base resin (N = 48), reinforced with E-glass FRCs with different architectures [unidirectional (n = 16) and woven (n = 16)], when exposed to either saliva or distilled water. MATERIALS AND METHODS: Specimens without FRC reinforcement served as control (n = 16). After fiber surfaces were exposed, half of the specimens (n = 8/per group) were treated with saliva, the other half was stored in distilled water prior to C. albicans adhesion. The adhered microorganisms were counted under an optical microscope and the data were analyzed. RESULTS: When exposed to distilled water or saliva, specimens with unidirectional (5403.4 cells/cm(2) and 5013.4 cells/cm(2) , respectively) (p = 0.202), woven fibers (4053.5 cells/cm(2) and 3726.6 cells/cm(2) , respectively) (p = 0.283) and specimens without fibers (2250 cells/cm(2) and 2006.8 cells/cm(2) , respectively) (p = 0.423) showed C. albicans adhesion, being not significant. In general, all the specimens exposed to saliva showed 3582.2 cells/cm(2) C. albicans adhesion, while specimens exposed to distilled water showed 3902 cells/cm(2) C. albicans adhesion, yet being not significant (p = 0.436). Regarding fiber type, C. albicans adhesion was significantly affected by the exposed FRC architecture with more favorable results for woven fibers (p < 0.001). CONCLUSION: Polymethylmethacrylate without FRCs collected less C. albicans. The presence of saliva seems to reduce the adhesion.

A randomized controlled trial on the efficacy of intermittent and continuous traction for patients with knee osteoarthritis.

OBJECTIVE: To investigate the efficacy of intermittent and continuous traction in the treatment of knee osteoarthritis. DESIGN: A randomized, controlled, observer-blind seven-week trial. SETTING: Hospital-based outpatient practice. SUBJECTS: Ninety-eight patients with stage 3 knee osteoarthritis according to Kellgren-Lawrence radiological rating scale. INTERVENTIONS: All 98 patients were randomly assigned to three treatment groups, for three weeks (weekends excluded). The control group (n=30, mean age: 59.30±8.16) received hot pack and short wave diathermy; the intermittent group (n=30, mean age: 58.20±7.78) received hot pack, short wave diathermy and intermittent traction; and the continuous group (n=30, mean age: 57.97±9.53) received hot pack, short wave diathermy and continuous traction. OUTCOME MEASUREMENTS: The values of the Turkish version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale, and knee passive range of motion were measured at baseline, three-week and seven-week follow-up. RESULTS: Compared with baseline at weeks 3 and 7, all the outcome measures, except range of motion, were significantly reduced in all groups (all P≤0.001). In terms of the change data from baseline to week 3, both traction groups were significantly superior to the control in the WOMAC physical function scores. Considering the change data from baseline to week 7, both traction groups were significantly superior to the control in the pain scores, physical function and total scores, while only the continuous group was significantly better than the control in the stiffness scores (control: 1.17 ± 1.64; continuous: 2.38 ± 1.44) (P=0.014). Compared with baseline at weeks 3 and 7, range of motion values significantly increased in both traction groups (P<0.05) but not in the control (P>0.05). However, there were no significant differences among the three groups considering the change data from baseline to week 7 in range of motion values (P=0.300). CONCLUSIONS: Joint traction was found to be beneficial for the improvement of pain and physical function loss related to knee osteoarthritis.

The effect of different restorative and abutment materials on marginal and internal adaptation of three-unit cantilever implant-supported fixed partial dentures: an in vitro study.

PURPOSE: Passive fit is generally assumed to be a significant prerequisite for long-term implant success. The aim of this study was to evaluate the precision fit of three-unit implant-supported fixed partial dentures with different restorative and abutment materials on two implant systems: the Straumann and Astra Tech. MATERIALS AND METHODS: Two mandibular epoxy resin models (one for each implant system) were fabricated, and two implants were inserted at the first and second molar region. Poly(vinyl siloxane) impression material was used to make the dental impression. For each implant system, fifteen models were fabricated, and each group was divided into three subgroups (group 1: titanium abutment with metal framework, group 2: titanium abutment with zirconium framework, group 3: zirconium abutment with zirconium framework). The replica technique was used to examine the marginal and internal gap values. For each restoration, 20 measurements were performed, totaling 1200 measurements for all groups. Data were evaluated statistically using ANOVA and LSD post hoc test (p < 0.05). RESULTS: The highest values at internal adaptation measurements were found at the occlusal surface for all groups. When the mean values of the marginal measurements were assessed, the lowest measurements were found in group 3 (51.416 µm), and the highest values were found in group 1 (79.394 µm). There were statistically significant differences between subgroups for marginal measurements (p < 0.05). CONCLUSIONS: As included in our study, marginal measurement values were found to be 46 to 87 µm. The marginal discrepancy of the tested materials could be considered clinically acceptable.

Fracture resistance of manually and CAD/CAM manufactured ceramic onlays.

PURPOSE: This in vitro study aimed to evaluate fracture resistance in lithium disilicate onlays fabricated with IPS e.max Press and IPS e.max CAD systems and luted with different adhesive cements. MATERIAL AND METHODS: Fifty maxillary first molars were prepared using a mesio-occluso-disto-lingual onlay cavity model. Ten onlays from each group were cemented using etch-and-rinse adhesives and high-viscosity composite resin cement, and 10 were cemented with self-adhesive, dual-curing universal resin cement. Fracture resistance was measured. RESULTS: Significant differences were observed between resin cements (p < 0.05) and between materials (p < 0.05), but the interaction of these variables did not produce a significant difference. The fracture resistance of pressable ceramics was significantly higher than that of CAD/CAM onlays (p < 0.05), and Syntac Variolink was significantly higher than that of Multilink Sprint (p < 0.05). CONCLUSION: All groups showed clinically acceptable fracture strength results. According to the study, both the onlay fabrication system and adhesive cements can be a viable treatment option.

Assessment of the severity of temporomandibular disorders in females: Validity and reliability of the Fonseca anamnestic index.

OBJECTIVE: To evaluate the validity and reliability of the Fonseca anamnestic index (FAI) over time in Turkish females. METHODS: Four hundred-fourteen patients who visited the otorhinolaryngology clinic were initially included in the study between January 1, 2018 and January 1, 2019. The Turkish version of the FAI is a self-report instrument that was completed by all of the patients after a brief explanation from the clinician. Cronbach's alpha was calculated using data from the first questionnaire. RESULTS: The results of the first assessment showed 243 patients had no TMD (58.7%), 40 had mild TMD (9.7%), 87 had moderate TMD (21%), and 44 had severe TMD (10.6%). At the second assessment, the respective values were 243 (58.7%), 37 (8.9%), 98 (23.7%), and 36 (8.7%). The internal consistency of the first test was high. CONCLUSION: The FAI can be used to collect a large amount of data easily, at minimal cost.

The effect of different attachment systems with implant-retained overdentures on maximum bite force and EMG.

OBJECTIVE: To compare the effect of different attachment systems with implant-retained overdentures on maximum bite force and muscle activity using electromyography (EMG). BACKGROUND: Denture retention and stability is of considerable interest in prosthetic dentistry. MATERIALS AND METHODS: Thirty-five patients were examined: 15 edentulous patients treated with mandibular implant-retained overdentures (MIRO) and maxillary dentures (MCD) (two implant-ball attachment) (BC); 10 edentulous patients treated with MIRO and MCD (four implants-bar attachments) (BRC); 10 patients with edentulous mandibular treated with MIRO and maxillary fixed partial dentures (MFPD) (two implant-ball attachments) (BF). Before implant placement all patients received new dentures. After using these dentures for 3 months the maximum bite force and electrical activity of masseter muscle were measured. Two or four implants were then inserted into the intraforaminal region. After osseointegration periods, patients were treated with MIRO which duplicated their dentures and after three months the measurements were repeated. The data were collected and statistically analysed. RESULTS: Muscle activity and chewing ability increased in the second period of measurements. Also chewing time was significantly decreased at the first measurements. The highest muscle activity was observed in the group of patients treated with group BF. CONCLUSION: The EMG values of the masseter muscle significantly increased when an implant attachments was used in the overdenture.