Pancreatosteatosis in patients with adrenal incidentaloma: A risk factor for impaired glucose metabolism.

AIMS: Patients with adrenal incidentaloma (AI) are at increased risk of impaired glucose metabolism, which is known to be associated with pancreatosteatosis (PS). We aimed to investigate the risk of developing dysglycemia for patients with non-functioning AI (NFAI) versus those without, and whether the presence of PS predicts future dysglycemia in patients with NFAI. METHOD: In 80 patients with NFAI and 127 controls matched for age, sex, and body mass index, changes in fasting plasma glucose (FPG) and hemoglobin A1c(HbA1c) were evaluated at 2 years. PS was evaluated with data obtained from non-contrast abdominal computed tomography (CT) performed at the initial evaluation. RESULTS: Mean FPG levels increased significantly after 2 years in both groups (P < 0.001, for both), albeit significantly higher among patients than the controls (P = 0.002). The increases in HbA1c and FPG levels were significantly higher among patients with PS than without PS, in the adenoma group (p < 0.001, P = 0.00, respectively). The change in Hba1c levels was associated with the presence of PS in patients with NFAI (p < 0.001). CONCLUSIONS: Our findings suggest that the presence of PS may provide significant information in predicting newly developed dysglycemia in patients with NFAI.

A New Filter Approach Based on Effective Ranges for Classification of Gene Expression Data.

Over the years, many studies have been carried out to reduce and eliminate the effects of diseases on human health. Gene expression data sets play a critical role in diagnosing and treating diseases. These data sets consist of thousands of genes and a small number of sample sizes. This situation creates the curse of dimensionality and it becomes problematic to analyze such data sets. One of the most effective strategies to solve this problem is feature selection methods. Feature selection is a preprocessing step to improve classification performance by selecting the most relevant and informative features while increasing the accuracy of classification. In this article, we propose a new statistically based filter method for the feature selection approach named Effective Range-based Feature Selection Algorithm (FSAER). As an extension of the previous Effective Range based Gene Selection (ERGS) and Improved Feature Selection based on Effective Range (IFSER) algorithms, our novel method includes the advantages of both methods while taking into account the disjoint area. To illustrate the efficacy of the proposed algorithm, the experiments have been conducted on six benchmark gene expression data sets. The results of the FSAER and the other filter methods have been compared in terms of classification accuracies to demonstrate the effectiveness of the proposed method. For classification methods, support vector machines, naive Bayes classifier, and k-nearest neighbor algorithms have been used.

Evaluation of the effectiveness of a mobile application in the management of dental anxiety: A randomised controlled trial.

BACKGROUND: The software, which was developed according to the principle of perceived control, can be installed on tablets and smartphones and used by patients to help them control their anxiety. OBJECTIVE: The aim of this study was to evaluate the effectiveness of a specially designed mobile application developed to provide patients with a sense of anxiety control during the various stages of endodontic treatment. The patients' anxiety was assessed by measuring their salivary cortisol levels. METHODS: A total of 46 patients requiring endodontic treatment were recruited. The patients were randomly assigned to two groups. The experimental group used the special communication application, while the control group did not. Salivary samples were collected from all patients preoperatively, postanaesthesia, and postoperatively. The samples were analysed with an enzyme-linked immunosorbent assay to measure the cortisol levels. RESULTS: A significant difference in cortisol levels was observed between the experimental and the control group (Mann-Whitney U-test, p < .05). This difference was significant in the experimental group in each step (p < .01). No difference was found in the control group steps (p > .05). CONCLUSIONS: Perceived control of anxiety using the specially designed software was effective in reducing salivary cortisol levels.

Dental Anomalies in Consanguineous Marriage: A Clinical-Radiological Study.

OBJECTIVE: This study aimed to evaluate nonsyndromic developmental dental anomalies (DDAs) in individuals born from consanguineous and nonconsanguineous marriages and the possible effects of these marriages on self-reported systemic diseases. METHODS: The study comprised a total of 880 patients aged 16 years or older who applied to our clinic for various dental problems. Based on detailed anamnesis, the patients were divided into 2 groups: individuals born from consanguineous (study group, n = 445) and nonconsanguineous (control group, n = 435) marriages. The parents' consanguinity type was also recorded, as well as the presence of any self-reported systemic diseases. The number, size, erupted, and morphological DDA types were investigated with both clinical and radiological examinations. All data from the 2 groups were recorded, and a statistical analysis was performed. RESULTS: There was a statistically significant relationship between the consanguineous marriage and the size (microdontia), and morphological (dilaceration and taurodontism) DDA types. Additionally, a significant relationship was found between consanguineous marriage and self-reported systemic disease but not between the parents' consanguinity type and systemic disease. CONCLUSION: The results of this study suggest that consanguineous marriage affects DDAs.

Idiopathic coronal resorption in impacted permanent teeth and its relationship with age: radiologic study.

PURPOSE: The purpose of this study was to evaluate the relationship between idiopathic coronal resorption and age in adult patients. MATERIALS AND METHODS: 3405 digital panoramic radiographs present in the archive of the radiology department belonging to 1584 males and 1821 females aged 25 and over were assessed by two oral and maxillofacial radiologists. The patients' age, gender, number of impacted teeth, number and position of teeth with idiopathic coronal resorption and the extent of coronal resorption were recorded on standard forms. RESULTS: A thousand and nine impacted teeth were observed in 622 patients (304 males and 318 females) with a mean age of 36,92 (±10,85). Idiopathic coronal resorption was present in 26 of the 622 patients with a frequency of 4.2%. One patient had two teeth with idiopathic coronal resorption; resulting in as 27 teeth and a frequency of 2.7% according to tooth number. There were 13 (50%) females and 13 (50%) males having idiopathic coronal resorption. There was no significant difference between genders. The presence of idiopathic coronal resorption increased with advanced age (v: 0,193, p<0.05). There was no statistically significant difference between the extent of the coronal resorption and age. CONCLUSION: The presence of idiopathic coronal resorption increases with advancing age. Idiopathic coronal resorption is detected incidentally during radiographic examination. Thus, dentists should consider this situation and should perform periodically radiographic examination of impacted teeth.

Evaluation of the frequency of third molar agenesis according to different age groups.

PURPOSE: Third molars (M3s) are the most common congenitally missing teeth. The aim of this study was to compare the frequency of M3 agenesis in two different age groups. METHODS: This study examined the panoramic radiographic images of 1036 patients. Two groups, each consisting of 518 patients, were arranged based on age ranges. The patients aged 12 to 19 years were in the first group and those 20 years and older were in the second group. The frequency of M3 agenesis was examined in both age groups. The distribution of M3 agenesis by sex and jaw was also recorded, along with the number of M3s affected by agenesis. Chi-square tests were used to examine the relationships between categorical variables. RESULTS: M3 agenesis was observed in 29.3% and 20.5% in the first and second groups, respectively; the difference was statistically significant (P < .01). It was more common in female (27.3%) than in male patients (21.4%), and in the maxilla (11.2%) than in the mandible (5.8%), and the differences were statistically significant (P < .05). It was mostly observed forthemaxilla right M3 (18) (30.9%) and in the single quadrant of the jaws (9.7%). CONCLUSIONS: The frequency of M3 agenesis was more common in patients aged 12 to 19 years than in those aged 20 years and older. Additionally, M3 agenesis was more common in females and in the maxilla.

Knowledge, behavior, and awareness of neonatologists and anesthesiologists about oral complications of intubation and protection methods.

OBJECTIVES: This study aimed to assess awareness of anesthesiologists and neonatologists about oral complications occurring during and after the orotracheal intubation (OTI) in premature infants and their knowledge and behavior regarding protection methods from these complications in clinical practice. METHODS: This study included 94 neonatologists and 137 anesthesiologist. The final version of the questionnaire included 15 items in three main parts: (i) personal information; (ii) awareness about oral complications occurring during and after the OTI in premature infants; (iii) knowledge and behavior regarding protection methods from these complications in clinical practice. RESULTS: A total of 95.7% of neonatologists and 83.2% of anesthesiologists were aware of oral complications related to OTI. The most common complications the anesthesiologists encountered were oral, laryngeal, or pharyngeal region injuries (60.7%) and palatal groove (52.2%) for the neonatologists. The most preferred method for stabilization of the orotracheal intubation tube (OTT) was bonding to the perioral region with an adhesive tape (98.3%). The primary determining factor in the choice of OTT stabilization method was the ease of use (28.2%). A total of 23.8% of the participants were aware of the palatal stabilization device (PSD), whereas only 1.3% used it in their routine and 57.1% of them believed it can prevent complications. CONCLUSIONS: The results showed that neonatologists were more aware of the OTI-related oral complications than anesthesiologists. The knowledge of the participants regarding prevention of these complications is insufficient. Study participants believe in the efficacy of PSD but do not use it in clinical practice for a number of reasons.

Mechanical Allodynia in Healthy Teeth Adjacent and Contralateral to Endodontically Diseased Teeth: A Clinical Study.

INTRODUCTION: The aims of this study were to examine whether teeth adjacent and contralateral to endodontically diseased teeth showed co-occurring mechanical allodynia and to determine whether demographic and clinical variables were involved in such associations. METHODS: Patients with irreversibly inflamed or necrotic permanent first molars or second premolars were examined. From the 348 eligible patients (160 men and 188 women; mean age ± standard deviation = 30.4 ± 10.0 years), data on age, sex, health status, current presence of pain, tooth type, dental arc, and pulpal diagnosis were collected. Percussion testing was applied to all posterior teeth, and the degrees of pain were recorded using a 4-point verbal scale as follows: none to slight (coded as 0) and moderate to severe (coded as 1). Following association rule mining (with minimum support and confidence levels of 0.1), univariate and multiple logistic regression analyses were performed at various stringency levels (α = 0.05). RESULTS: The number of painful associations was greater ipsilaterally than contralaterally and distally than mesially and increased with the severity of percussion pain in the diseased tooth. Successful regression models were established for the ipsilateral (between the diseased tooth and adjacent teeth; current pain: odds ratio = 3.37; 95% confidence interval, 1.94-5.83) and contralateral (between the diseased tooth and the tooth distal to the contralateral symmetrical tooth; dental arc: odds ratio = 2.40; 95% confidence interval, 1.21-4.76) sides (P < .05). CONCLUSIONS: Healthy teeth adjacent and contralateral to symptomatic diseased teeth exhibited percussion sensitivity. Patients' current pain and dental arc, respectively, were involved in such painful associations.

Turkish adaptation and implementation of the modified infection control questionnaire in intraoral digital imaging.

PURPOSE: There are very few studies evaluating the knowledge of dentists about infection precautions in oral radiology. The aim of this study was to assess the psychometric properties of the Turkish version of the modified form of a developed questionnaire and to apply this questionnaire to Turkish dentists. MATERIALS AND METHODS: The questionnaire was applied to a sample of 250 dentists for the scale development [200 for confirmatory factor analysis (CFA) and 50 for control] and 173 dentists for the implementation of the scale. The scale was applied to 200 dentists and construct validity was examined with CFA. For model fit; chi square to df ratio, RMSEA (Root Mean Square Error of Approximation), TLI (Tucker-Lewis Index), CFI (Comparative Fit Index), GFI (goodness of fit index), AGFI (adjusted goodness of fit index) and NFI (normed fit index) were obtained. Also, reliability analysis was applied and itemtotal correlations and Cronbach's alpha values were given. Adapted scale scores using a different sample of 173 dentists were compared according to demographic characteristics. RESULTS: CFA showed good fit statistics (X2/df=1.511, RMSEA=0.057, TLI=0.942, CFI=0.953, GFI=0.926, AGFI=0.900, NFI=0.928) for the scale. Item-total correlations were over 0.30 and Cronbach's alpha was calculated as 0.877. In addition, experienced dentists had higher scores in the dimension of personal hygiene (p<0.05). CONCLUSION: The Turkish version of the modified infection control questionnaire in oral radiology showed adequate psychometric properties. This indicated that it could be a valid and reliable tool for the assessment of infection control in oral radiology among Turkish dentists.

The Differences Between Preterm and Term Birth Affecting Initiation and Completion of Toilet Training Among Children: A Retrospective Case-Control Study.

PURPOSE: This study seeks to investigate the possibility the existence of a difference in terms of start and end dates of toilet training between term and preterm children as well as the possible determining factors. MATERIALS AND METHODS: This study was conducted as a 5-year retrospective case (children born preterm-(32 to <37 weeks) - and control (children born at term (>37 weeks + 1 day)) study. The data were collected with a form consisted of questions about demographic data (12 questions) and toilet traning features (10 questions) through face-to-face interviews with the mothers. A chi-square test and logistic regression analysis were conducted to examine the data. Odds ratio was used as a measure of the relation between levels of the dependent variable. p< .01 and p< .05 values were assumed to be statistically significant. RESULTS: The study examined a total of 133 children including 59 preterm children and 74 children born at term including 60 (45.1%) boys and 73 (54.9%) girls. The possibility of starting toilet training at or before 24 months was found to be 6.4 times greater in full-term children than preterm children (OR=6.493). The logistic regression analysis, which aimed at identifying any variables that might affect end date of toilet training, found that despite the tendency to consider preterm   birth as a factor prolonging the duration of toilet training, the difference was not found to be statistically significant (p= .07). CONCLUSION: This study compared full-term and preterm children in terms of start and end dates of toilet training and found that preterm children start toilet training later than full-term children. Based on the results of the study, it is possible to say that preterm birth, gender and birth order affect start date of toilet training. However there is no difference between term and preterm babies on the end date of toilet training.

A pilot study of the effects of a vacuum sealing barrier method for photostimulable phosphor plates regarding plate damage and prevention of microbiologic cross-contamination.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of a new sealing method for preventing cross-contamination of photostimulable phosphor (PSP) plates. STUDY DESIGN: Twelve new PSP plates were divided into 3 groups (PSP-a, PSP-b, and PSP- c) and placed in 3 different barriers (2 different brands of envelopes and a vacuum sealing method). All plates were exposed to X-rays with an aluminum step wedge, and the images were evaluated for the presence of any artifacts. After radiography, the PSP plates were removed from the barriers. The barriers and the PSP plates were disinfected and culture performed to assess any microorganism burden. Subsequently, the PSP plates were coated again with all barriers. The barriers were then contaminated and microbiologic specimens were collected. Subsequently, the barriers were wiped with alcohol. The PSP plates were removed, and microbiologic specimens were obtained. RESULTS: No artifacts were recorded on the radiographic images on the sensors in any group. Microorganisms were detected on the PSP plates placed in envelopes. No colonization of microorganisms was detected on the vacuum sealed PSP plates. CONCLUSIONS: The new vacuum-sealing method may be useful in preventing cross-contamination of PSP plates during radiographic procedures.

Effects of Low-Level Laser Therapy With a Herbal Extract on Alveolar Bone Healing.

PURPOSE: This study investigated the effect of a gallium-aluminum-arsenide (GaAlAs) diode laser used in low-level laser therapy (LLLT) with the application of Mecsina Hemostopper on mandibular alveolar bone healing. MATERIALS AND METHODS: Standard semispherical bone defects were created in left mandibular diastema sites of 32 female Long-Evans rats. Experimental animals were allocated to 1 of 4 groups: control group (no treatment), laser group (GaAlAs LLLT), Mecsina group, and laser-Mecsina combination group. Liquid Mecsina 0.01 mL was applied to the bone defects. Laser treatment was performed for 7 days after surgery at an energy dose of 10 J/cm2. All animals were sacrificed to observe hard tissue healing histologically, immunohistochemically, and radiologically at 30 days after surgery. RESULTS: Histologic assessment showed significantly more calcified tissue areas and significantly more osteoblast cells in the laser and laser-Mecsina groups than in the other groups (P < .01). Qualitative morphologic assessment showed that more bone tissue was present in the laser-Mecsina group than in the other groups. CONCLUSION: This study showed that LLLT, Mecsina application, and combined treatments were effective in healing alveolar bone among all tested treatment modalities.

Diagnostic accuracy of cone-beam computed tomography in detecting secondary caries under composite fillings: an in vitro study.

PURPOSE: The aim of this in vitro study was to assess the diagnostic performance of cone-beam computed tomography (CBCT) in the detection of secondary carious lesions under composite resin fillings applied to different types of cavities. MATERIALS AND METHODS: Occlusal cavities (O) (n=18), occlusal cavities with mesial or distal component (MO/DO) (n=30), and mesial-occlusal-distal cavities (MOD) (n=30) were prepared in seventy eight extracted human posterior teeth. In half of the cavities in each group, artificial secondary caries lesions were simulated. All cavities were restored by using composite resin. All specimens were embedded in silicone and they were positioned to have approximal contacts. CBCT imaging was done and data were evaluated two times with two week interval by two observers, using a five-point confidence scale. Intra- and inter-observer agreements were calculated with Kappa statistics (κ). The area under (Az) the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy. RESULTS: Intra- (κ =0.89) and inter-observer (κ = 0.79) agreements were found to be excellent. Az values were highest for the O restorations which is followed by the MOD and DO/MO restorations. Az values for MOD and DO/MO restorations were very low and no statistically significant difference was found. Sensitivity for DO/MO restorations and specificity for MOD restorations were found to be the lowest values. CONCLUSION: Diagnostic performance of CBCT was higher in O composite restorations than MOD and DO/MO restorations for secondary caries detection. The use of alternative imaging methods rather than CBCT may be useful for evaluating secondary caries under composite MOD and DO/MO restorations.

The efficiency of operating microscope compared with unaided visual examination, conventional and digital intraoral radiography for proximal caries detection.

Objective. The purpose of this study was to evaluate the efficiency of operating microscope compared with unaided visual examination, conventional and digital intraoral radiography for proximal caries detection. Materialsand Methods. The study was based on 48 extracted human posterior permanent teeth. The teeth were examined with unaided visual examination, operating microscope, conventional bitewing and digital intraoral radiographs. Then, true caries depth was determined by histological examination. The extent of the carious lesions was assessed by three examiners independently. One way variance of analysis (ANOVA) and Scheffe test were performed for comparison of observers, and the diagnostic accuracies of all systems were assessed from the area under the ROC curve (A(z)). Results. Statistically significant difference was found between observers (P < .01). There was a statistically significant difference between operating microscope-film radiography, operating microscope-RVG, unaided visual examination-film radiography, and unaided visual examination-RVG according to pairwise comparison (P < .05). Conclusion. The efficiency of operating microscope was found statistically equal with unaided visual examination and lower than radiographic systems for proximal caries detection.

Clinical evaluation of dose reduction on image quality of panoramic radiographs.

AIM: The purpose of this study was to evaluate the effect of tube current reduction on image quality using medium and regular intensifying screens as well as a digital system for panoramic radiography. METHODS AND MATERIALS: A total of 150 panoramic images of 75 patients were obtained in the study. The initial images were taken at standard exposure settings, and secondary images were exposed with the tube current reduced at different rates. RESULTS: There was no statistically significant difference (p>0.05) between the two exposures for Group 3 (the rate of dose reduction 25%) while a statistically significant difference (p<0.05) was found in Group 4 (the rate of dose reduction 50%) using medium intensifying screens for all observers. No statistically significant difference was found between the two exposures on digital panoramic images. CONCLUSION: According to the results of this study a dose reduction of 25% was achieved for medium intensifying screens and for digital panoramic images without any loss of image quality. CLINICAL SIGNIFICANCE: A substantial reduction in radiation exposure can be achieved in conventional panoramic radiography using a medium intensifying screen and in digital panoramic radiography without any loss of image quality needed for radiological evaluation of anatomical structures and pathological conditions.

In vivo comparison of laser fluorescence measurements with conventional methods for occlusal caries detection.

The purpose of this study was to evaluate the efficiency of the laser fluorescence (LF) (DIAGNOdent) measurements comparing with visual examination and conventional bitewing radiography for occlusal caries detection. The study comprised 44 occlusal surfaces. Three examiners independently evaluated the teeth by visual examination, LF measurements, and bitewing radiographs. After the evaluations, the teeth were opened, and the clinical lesion depth was determined. One-way variance analysis (ANOVA) was performed for comparison of observers. The diagnostic performance of three methods was assessed by using non-parametric tests (Kruskal-Wallis, Mann-Whitney U, and Spearman rank correlation). No statistically significant difference was found between observers (p > 0.05), and statistically significant difference was found between diagnostic systems (p < 0.01). The correlation of LF measurements with the clinical lesion depth was better than visual examination and bitewing radiography. This result concluded that LF may be a useful adjunct to visual examination, and the diagnostic performance of this device seems to be good for occlusal caries detection.

In vitro comparison of four different dental X-ray films and direct digital radiography for proximal caries detection.

This study investigated the efficiency of different speeds of conventional intraoral films and a direct digital system for proximal caries detection. In this study, 48 extracted human posterior permanent teeth were used. Conventional bitewing radiographs and direct digital radiographs were obtained from the teeth. Three observers independently assessed 96 proximal surfaces, each observer had 10 years of experience. The presence or absence of caries was scored according to a five-point scale. True caries depth was determined by histological examination. The diagnostic accuracy of each radiographic system was assessed by means of a receiver operating characteristic (ROC) curve analysis. The mean of areas under the ROC curve (Az) was analyzed by pairwise comparison of ROC curve. The interobserver agreement was evaluated by using ANOVA analysis. The statistical analysis of Az scores exhibited no significant difference for the five imaging modalities (p > 0.05). There was no statistically significant difference between interobserver agreements (p > 0.05). The results of this study showed that the diagnostic performance of E- and F-speed films and direct digital radiography are similar for proximal caries detection.