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 < 0.001). 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.

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.

Evaluation of the physical and emotional effects of the COVID-19 pandemic on patients with fibromyalgia and chronic low back pain: A multicenter cross-sectional controlled study.

Objectives: This study aimed to investigate the physical and emotional effects of the coronavirus disease 2019 pandemic in patients with fibromyalgia syndrome (FMS) and chronic low back pain (CLBP) patients. Patients and methods: The cross-sectional controlled study was performed with 1,360 participants (332 males, 1,028 females; mean age: 42.3±12.5 years; range, 18 to 65 years) between September 2020 and February 2021. The participants were evaluated in three groups: the FMS group (n=465), the CLBP group (n=455), and the healthy control group (n=440). Physical activity, pain levels, and general health status before and during the pandemic were evaluated in all participants. Stress levels were analyzed with the perceived stress scale (PSS) in all groups, and disease activity was analyzed with the fibromyalgia impact questionnaire (FIQ) in patients with FMS. Results: Patients with FMS had worsened general health status and pain levels during the pandemic compared to the other groups (p<0.01). The FMS group showed significantly higher PSS scores than those in other groups (p<0.01). There was a weak-positive correlation between FIQ and PSS parameters in patients with FMS (p<0.05, r=0.385). Conclusion: The general health status, pain, and stress levels of the patients with FMS and CLBP tended to worsen during the pandemic. This high-stress level appeared to affect disease activity in patients with FMS.

Comparison of the Effects of Electroacupuncture and Melatonin on Nerve Regeneration in Experimentally Nerve-Damaged Rats.

Background: Development of methods to accelerate nerve regeneration in peripheral nerve damage is important. Electroacupuncture is a new therapeutic method that combines traditional acupuncture with modern electrotherapy. Melatonin has been shown to reduce nerve damage. Objectives: In this study, we aimed to determine and compare the therapeutic effects of electroacupuncture and melatonin on rat sciatic nerve injury. Methods: A total of 56 adult male Wistar Albino rats were divided into four study groups with 14 animals in each group: intact control (group I), subcutaneous saline (group II), subcutaneous melatonin (group III), and electroacupuncture (group IV). Surgical procedure including unilateral (right) sciatic nerve injury was applied to groups II, III, and IV. Saline and melatonin started immediately after surgery for six weeks, while electroacupuncture was given two weeks after surgery for 3 weeks. Functional and histological assessments were used as outcome measurements. Results: Sciatic nerve damage caused a significant decrease in nerve conduction velocity. Both electroacupuncture treatment and melatonin treatment significantly increased the nerve conduction velocity. Both sciatic functional recovery and histological regeneration were faster in these treatment groups compared to the saline. However, no significant difference was observed between the two treatment groups. Conclusion: Electroacupuncture and melatonin are promising alternative treatment strategies for peripheral nerve damage and can be examined in detail in future studies.

The Clinical and Radiologic Outcomes of Early Loaded Implants After 5 Years of Service.

PURPOSE: To evaluate the 5-year results of the clinical and radiographic outcomes of three types of early loaded implants. MATERIALS AND METHODS: Seventy-five implants were placed in the posterior mandible or maxilla in 30 patients. Three types of implants (Straumann SLActive, Astra OsseoSpeed, and Thommen Implant System) were used. Definitive restorations were made after 8 weeks of implant placement. The radiographs were taken at the placement of the prosthesis, at 6 months, and at 1- and 5-year follow-ups. Clinical and radiologic data were evaluated for all types of implants. The Wilcoxon signed rank test, least significant differences, and Mann-Whitney U were used to test for statistically significant differences (P < .005). RESULTS: Twenty-four patients and 62 implants were evaluated after 5 years. The mean marginal bone loss was 0.20 ± 0.40 mm, 0.21 ± 0.05 mm, and 0.25 ± 0.36 mm after 1 year and 0.32 ± 0.22 mm, 0.31 ± 0.26 mm, and 0.42 ± 0.36 mm after 5 years for the Straumann, Astra, and Thommen groups, respectively. After 5 years, the mean peri-implant probing depth level was 1.75 ± 0.49 mm, 1.87 ± 0.48 mm, and 1.92 ± 0.57 mm for the Straumann, Astra, and Thommen groups, respectively. No peri-implantitis was detected after 5 years of loading. CONCLUSION: All groups of implants showed a stable peri-implant probing depth and marginal bone level. The survival rate was high and bone loss was low at 5 years; thus, early loading may be a useful procedure that allows reduction in treatment time.

The effects of COVID-19 on Physical Medicine and Rehabilitation in Turkey in the first month of pandemic.

OBJECTIVES: The outbreak of novel coronavirus-2019 (COVID-19) has affected Turkey very seriously, as well as all around the world. Many urgent and radical measures were taken due to the high contagious risk and mortality rate of the outbreak. It is noteworthy that isolation recommendations and the provision of health services for pandemic have a negative impact on Physical Medicine and Rehabilitation (PMR) services. In this study, we aimed to evaluate the effects of COVID-19 on the PMR services and physiatrists immediately after the first month of pandemic in Turkey. PATIENTS AND METHODS: An online survey consisting of 45 items was sent to the members of the Turkish Society of Physical Medicine and Rehabilitation. The main goal of the survey was to evaluate the changes in the provided service of PMR and conditions of physiatrists one month after the first reported COVID-19 case in Turkey. RESULTS: A total of 606 PMR specialists and residents responded to the survey. The mean number of the patients visited the outpatient clinics was 148.2±128.5 per week before the pandemic, it significantly decreased to 23.4±33.1 per week after the first month of the reported first COVID-19 case. Similarly, the mean number of the patients of inpatient service significantly decreased from 21.7±39.3 per week to 2.5±10.0 per week after the first month of the pandemic. Most of the residents (69%) reported that their training was seriously affected due to pandemic. From the economic aspect, 69.2% of the participants who were working at private hospitals reported a decrease in their monthly salary, and 21% of them were sent to an unpaid vacation. A total of 21.9% of private-practice institutions paused their services. During the first month, 46.9% of the participants were assigned to the different services such as COVID-19 inpatient service, emergency or COVID-19 outpatient clinics. According to the Republic of Turkey, Ministry of Health guideline and algorithm, 15.7% of the physicians were in the category of healthcare workers with suspected COVID-19. CONCLUSION: The COVID-19 pandemic affected seriously both the services and the PMR physicians as early as the first month. This effect is expected to become worse, when the duration of pandemic prolongs. Proper arrangements and measures should be planned to ameliorate the negative effects of the pandemic on the patients and PMR physicians.

A cutaneous metastasis of bronchogenic carcinoma: Milia-like lesions with dermatomal pattern.

Clinical presentation of cutaneous metastases is often variable. Presented case had an intriguing cutaneous metastasis of bronchogenic squamous cell carcinoma. Lesions were characterized by dermatomal pattern with milia-like papules, plaques, and nodules.

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.

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.

Retrospective Analysis of Lithium Disilicate Laminate Veneers Applied by Experienced Dentists: 10-Year Results.

PURPOSE: To report on the 10-year clinical treatment outcomes for a strictly applied clinical protocol for pressable lithium disilicate glass-ceramic laminate veneers (LDLVs) placed by two experienced dentists. MATERIALS AND METHODS: A 10-year follow-up assessment of 364 LDLVs placed in 41 patients was undertaken with the clinical criteria color/esthetic match of the porcelain surface, chipping and fracture occurrence, marginal discoloration, and integrity, assessed using the modified United States Public Health Service scoring system. RESULTS: After 10 years, the survival rate was 97.4%. Complications occurred in 1.64% of the restorations (fractures and debonding in 0.55% and 1.09%, respectively). CONCLUSION: A strict, repeatable protocol for placing veneers with experienced dentists yielded good results.

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 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.

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.

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 and Radiographic Evaluation of Early Loaded Maxillary Anterior Implants: Three-Year Follow-up.

The aim of this study was to evaluate clinical and radiologic results up to 3 years in patients treated with early loading of anterior implants supporting single-tooth all-ceramic restorations. Twenty-four patients were treated with 29 screw-type implants in the anterior maxilla. The implants were evaluated by clinical and radiographic parameters. Clinical parameters Plaque Index (PI), Sulcus Bleeding Index (BI), peri-implant probing depth (PD), and marginal bone loss (MBL) were recorded. At the recall examinations, all implants were successfully integrated, demonstrating healthy peri-implant soft tissues as documented by standard clinical parameters. No biologic complications were observed. There was no statistically significant increase in MBL between the baseline and recall stages (P > .05). Early loaded maxillary anterior implants supporting single-tooth restorations reveal successful clinical and radiographic outcomes when treatment steps were performed.

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.

Child's quality of life and mother's burden in spastic cerebral palsy: a topographical classification perspective.

Objective To evaluate the child's quality of life (QoL), mother's burden, and correlation between these parameters in children with spastic cerebral palsy (CP). Methods Children with spastic CP (n = 120; mean age: 8.64 ± 3.45 years; range: 2-17 years) were classified into three groups of diplegia, hemiplegia, and quadriplegia based on topographical classification. The Pediatric Quality of Life Inventory and Zarit Burden Interview were used to determine the child's QoL and the mother's burden scores, respectively. Results Children's QoL scores were lower in the quadriplegia group than in the hemiplegia and diplegia groups (except for emotional functioning). The mother's burden was lower in the quadriplegia group than in the other groups, and it was lower in the diplegia group than in the hemiplegia group. Increases in children's QoL scores were associated with decreases in the mothers' burden scores. Conclusion Children's QoL is associated with the mother's burden in spastic CP, and quadriplegic children and their mothers are more affected. The burden of mothers ranked the highest in the quadriplegia group, followed by the diplegia group and the hemiplegia group. Topographical classification is a good indicator for children's QoL and the mother's burden in spastic CP.

Marginal Adaptation and Fracture Resistance of Lithium Disilicate Laminate Veneers on Teeth with Different Preparation Depths.

The purpose of this study was to evaluate the marginal adaptation and fracture load of ceramic laminate veneers on teeth with different preparation depths. A total of 75 extracted intact human maxillary central incisors were prepared with three different preparation depths (P) and assigned to the following five groups (n = 15): P1 (0.3-mm depth of preparation; preparation entirely in enamel); P2 (0.5-mm depth of preparation; preparation in enamel and dentin complex); P3 (1-mm depth of preparation; preparation entirely in dentin); P4 (no preparation, only surface roughening); and P5 (unrestored, intact teeth as control). A total of 60 lithium disilicate laminate veneers were fabricated. The marginal adaptation of the veneers was evaluated by light microscope and scanning electron microscope after cementation with resin cement. Finally, the veneers were loaded until fracture at a 90-degree angle to the lingual surface of the tooth. Statistical analyses were performed using analysis of variance and Tukey multiple range test. There was a significant difference between the marginal gap value of the distocervical measurement points of P1 and P2 and the distal measurement points of P3 and P4 (P = .33 and P = .017, respectively). The highest fracture resistance values were observed in the P5 group (mean: 389.55 ± 22 N) and the P2 group (mean: 322.86 ± 79.38 N), and the lowest values were observed in the P3 group (mean: 219.21 ± 60.74 N). The marginal adaptation of the laminate veneer restorations was not related to the depth of preparation. Mean fracture resistance of laminate veneers with 0.5-mm preparation depth was greater than that of the 0.3-mm and 1-mm preparation depth laminate veneers and those with no preparation.

[Atypical Lipomatous Tumour of the Hand]. / Atypischer lipomatöser Tumor der Hand.

Atypical lipomatous tumours (ALT) are rare semi-malignant adipose tissue tumours with the potential to transform into sarcomas. They may occur throughout the body, although the hands are very rarely involved. We present the case of a 49-year-old man with a lipomatous tumour measuring 8×4 cm at the dorsum of the right thumb. MRI demonstrated an inhomogeneous signal after contrast medium application. The tumour was excised in its entirety. Since histology confirmed the diagnosis of an ALT, the thumb was irradiated. The patient remained free of recurrence. An ALT has to be suspected if a lipomatous tumour is very large. We recommend an MRI prior to surgery in tumours larger than 5 cm. Excision should follow oncologic principles.