Comparison of efficacy and usability of custom mandibular advancement devices fabricated with the conventional method and digital workflow: A pilot clinical study.

PURPOSE: To compare the effects of fabricating methods of custom monoblock mandibular advancement devices (MADs) on usability and efficacy in patients with mild and moderate obstructive sleep apnea (OSA). MATERIALS AND METHODS: Digitally fabricated custom MADs (dMADs) were produced for 11 OSA participants who had previously used conventionally fabricated custom MADs (cMADs). The participants answered a modified usability questionnaire for both MADs, and the average scores that were given to the questionnaire were evaluated by age, sex, and body mass index (BMI), and the scores of cMADs and dMADs were compared. After 6 months of usage of each MAD, the apnea-hypopnea index (AHI), mean and lowest oxygen saturations, and total sleep time were measured for efficacy assessment. Data were analyzed with Cronbach's alpha, Mann-Whitney U, Kruskal-Wallis, Wilcoxon signed-rank, one-way repeated measures analyses of variance, and Bonferroni tests (α = 0.05). RESULTS: Cronbach's alpha was found at 0.834 and 0.722 for the conventional and digital questionnaires, respectively. The usability scores of the dMADs were significantly higher than those of cMADs (p = 0.013). There was no difference in usability scores in terms of sex or BMI (p > 0.05). No statistically significant difference was found for cMAD (p = 0.113) among age groups; however, there was a significant difference for dMAD (p = 0.046). The AHI, mean, and lowest oxygen saturation values were significantly affected by MAD usage (p < 0.001). However, total sleep time values did not differ after the MAD treatments (p > 0.05). Significantly lower AHI and significantly higher lowest oxygen saturation values were observed with dMAD, while both appliances led to similar results for mean oxygen saturation and total sleep time values (p > 0.05). CONCLUSIONS: Participant usability scores were higher for digitally manufactured MADs than conventionally manufactured MADs. However, both conventional and digital MADs were found effective in decreasing the AHI levels and increasing the mean and lowest oxygen saturation values of the participants.

Discovery of Small Molecule COX-1 and Akt Inhibitors as Anti-NSCLC Agents Endowed with Anti-Inflammatory Action.

Targeted therapies have come into prominence in the ongoing battle against non-small cell lung cancer (NSCLC) because of the shortcomings of traditional chemotherapy. In this context, indole-based small molecules, which were synthesized efficiently, were subjected to an in vitro colorimetric assay to evaluate their cyclooxygenase (COX) inhibitory profiles. Compounds 3b and 4a were found to be the most selective COX-1 inhibitors in this series with IC50 values of 8.90 µM and 10.00 µM, respectively. In vitro and in vivo assays were performed to evaluate their anti-NSCLC and anti-inflammatory action, respectively. 2-(1H-Indol-3-yl)-N'-(4-morpholinobenzylidene)acetohydrazide (3b) showed selective cytotoxic activity against A549 human lung adenocarcinoma cells through apoptosis induction and Akt inhibition. The in vivo experimental data revealed that compound 3b decreased the serum myeloperoxidase and nitric oxide levels, pointing out its anti-inflammatory action. Moreover, compound 3b diminished the serum aminotransferase (particularly aspartate aminotransferase) levels. Based on the in vitro and in vivo experimental data, compound 3b stands out as a lead anti-NSCLC agent endowed with in vivo anti-inflammatory action, acting as a dual COX-1 and Akt inhibitor.

Fabricating a custom monoblock mandibular advancement device by using an open-source nondental CAD software program and additive manufacturing: A dental technique.

Custom mandibular advancement devices (MADs) can be fabricated by using either conventional processes or computer-aided design and computer-aided manufacturing (CAD-CAM). The CAD-CAM technique involves digitizing the dental arches of the patients, designing by using a dental CAD software program, and additive manufacturing with a suitable material. This article describes the steps of the design of a custom MAD by using an open-source nondental CAD software program and of the fabrication with additive manufacturing.

Design and fabrication of an interim fixed restoration with an open-source nondental CAD software program and additive manufacturing: A technical report.

This technique aimed to identify the potential of an open-source software program and to present the design and fabrication procedures of a single interim crown with a nondental CAD software program. The steps included defining the margins, establishing the cement interval value, completing the virtual modeling of the crown, and checking the proximal and occlusal contacts by using color mapping.

Effects of sintering protocol and dipping time on the optical properties of monolithic zirconia.

STATEMENT OF PROBLEM: The use of monolithic zirconia for restorations has become popular. However, the effects of the coloring process and sintering procedure on the optical properties of monolithic zirconia remain unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effects of the different sintering protocols and dipping times on the CIELab color parameters, color difference (ΔE00), translucency parameter (TP00), opalescence parameter (OP), and contrast ratio (CR) of monolithic zirconia. MATERIAL AND METHODS: One hundred and fifty monolithic zirconia specimens were prepared and divided into 5 groups according to different dipping times in A2 shade coloring liquid: no immersion (D0), 3 minutes (D3), 5 minutes (D5), 7 minutes (D7), and 9 minutes (D9). The specimens were further divided into 3 subgroups according to different sintering protocols (n=10): classic (C); speed (S); and super-speed sintering (SS). The CIE L∗a∗b∗ values, ΔE00, TP00, OP, and CR values were determined with a spectrophotometer. The data were analyzed with 2-way ANOVA and Bonferroni post hoc tests (α=.05). RESULTS: The effects of the sintering protocol, dipping time, and interaction of the sintering protocol and dipping time were significant for the L∗, a∗, b∗, ΔE00, TP00, OP, and CR parameters (P<.001). The ΔE00 values of the SS groups were significantly higher than those of the C and S groups for all the dipping times assessed. However, only the CD3 and CD5 groups had ΔE00 values below the acceptability threshold (<1.8). Coloring significantly reduced TP00 values and significantly increased OP and CR values in the colored groups compared with those in the D0 groups. The C and S protocols for different dipping times showed similar optical properties in TP00, OP, CR, and ΔE00 (excluding the D0 and D9 groups) compared with the SS protocol. CONCLUSIONS: Different sintering protocols combined with various dipping times significantly affected the optical properties of monolithic zirconia. However, C and S sintering with a 3-minute and 5-minute coloring process yielded more favorable optical results than SS sintering and prolonged dipping times.

Novel and known myxobolids (Cnidaria, Myxozoa) infecting Chondrostoma angorense (Cypriniformes: Leuciscidae) in Turkey.

Turkey has more than 200 endemic freshwater fish species, one of which is the Ankara nase, Chondrostoma angorense Elvira, 1987 (Cypriniformes: Leuciscidae), a food fish in northern Turkey. Like most endemic fish species in Turkey, its myxosporean parasite fauna (Cnidaria: Myxosporea) are not yet described. We surveyed twenty C. angorense from Lâdik Lake in northern Turkey, and identified two myxosporean parasites from gills of these fish: Myxobolus arrabonensis Cech, Borzák, Molnár, Székely, 2015, and a co-infection of a novel species, Myxobolus polati sp. nov. We characterized both infections based on myxospore morphology, morphometry, tissue tropism, small subunit ribosomal DNA sequence and phylogenetic analysis. Plasmodia of both species were observed in gills, but had distinct tropism: M. arrabonensis is an intrafilamental vascular type, and M. polati sp. nov. is an intralamellar vascular type. We identified M. arrabonensis on the basis of myxospore characters and 100% similarity to the type DNA sequence from the closely-related host C. nasus. The small subunit ribosomal DNA sequence of M. polati sp. nov. (1946 base pairs; GenBank Accession number MH392318) had a maximum similarity of 98% with any Myxobolus sp. from other Eurasian cypriniforms. Phylogenetic analysis revealed that M. polati sp. nov. is most closely related to gill-infecting Myxobolus diversicapsularis from Rutilus rutilus (L.). The present study is the first record of myxosporean species infecting C. angorense comprising a novel species, M. polati sp. nov. and a known species M. arrabonensis.

Four novel Myxobolus species (Cnidaria: Myxozoa) infecting Anatolian khramulya Capoeta tinca (Cyprinidae) in northern Turkey.

We identified Myxobolus anatolicus Pekmezci, Yardimci, Yilmaz & Polat, 2014 and 4 novel Myxobolus species from the Anatolian khramulya Capoeta tinca (Cyprinidae) in northern Turkey based on morphology, histology, and phylogenetic analysis. M. karaeri sp. nov. plasmodia were observed in the skin doublets between fin rays, the surfaces of the operculum, the gill arch membrane, and in the skin of the fin base. M. samsunensis sp. nov. plasmodia were observed in epithelial tissue inside and on the surface and midline of the gill filaments. M. cakmaki sp. nov. presented as a typical vascular species, which develops in large plasmodia at the end of the gill filaments. The chondrophilic M. ekingeni sp. nov. was detected by histology inside the cartilaginous gill arch and the cartilaginous gill rays of the filaments. Phylogenetic analysis of small subunit ribosomal DNA sequences revealed that M. karaeri sp. nov. and M. samsunensis sp. nov. were clustered with Myxobolus species that infect gills, scales, and fins of cyprinids. M. cakmaki sp. nov. grouped with Myxobolus species that exclusively infect the gills of cyprinids. No molecular data were available for M. ekingeni sp. nov.

Effect of fabrication techniques on the optical properties of zirconia-based systems.

STATEMENT OF PROBLEM: How the optical properties of zirconia restorations are affected by their differing processing techniques is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effects of 5 different fabrication techniques on the optical properties of zirconia-based systems, including the color difference between the corresponding shades (ΔE∗ab, ΔE00), translucency parameter, opalescence parameter, and fluorescence (ΔE∗ab-FL). MATERIAL AND METHODS: Sixty zirconia disks (IPS e.max ZirCAD) were prepared (0.5 ±0.01mm thick) and veneered by using different techniques (n=15): Group L - layering with fluorapatite ceramic; Group P - pressing with fluorapatite ceramic; Group CB - veneered with pressing followed by layering technique; Group CO - digitally veneered with lithium disilicate glass-ceramic; and Group FZ - prepared from monolithic zirconia (inCoris TZI) (n=15). All the specimens were set to 1.5 ±0.02 mm in thickness. Color measurements were made with a spectrophotometer. Data were statistically analyzed with 1-way ANOVA and the Tukey honestly significant difference, Kruskal-Wallis, Bonferroni (α=.05), Pearson, and Spearman correlation tests (α=.01). RESULTS: Significant differences were found among the groups for all the optical parameters (P<.05). All the groups showed color differences higher than the perceptibility and acceptability thresholds for ΔE∗ab and ΔE00, except the P and FZ groups that showed values lower than the acceptability threshold (ΔE∗ab<2.7). Translucency parameter, opalescence parameter, and ΔE∗ab-FL values ranged between 5.77 and 9.95, between 4.72 and 7.07, and between 1.93 and 3.14, respectively. Strong positive correlations were found between ΔE∗ab and ΔE00, as well as between translucency parameter and opalescence parameter (P<.001). CONCLUSIONS: The optical properties of the zirconia-based systems were significantly affected by the fabrication techniques even when the same nominal shade was used. Therefore, the color reproduction, translucence, opalescence, and fluorescence of the selected materials should be considered for acceptable color matching.

The Relationship Between Parental Affective Temperament Traits and Disruptive Behavior Disorders Symptoms in Children With ADHD.

OBJECTIVE: This study investigated the relationship between parental affective temperaments and the oppositional defiant disorder (ODD) and conduct disorder (CD) symptoms of children with ADHD. METHOD: The sample consisted of 542 treatment-naive children with ADHD and their biological parents. Children were assessed via both parent- and teacher-rated behavioral disorder scales. Parental affective temperament and ADHD symptoms were measured by self-report inventories. The relationships between psychiatric variables were evaluated using structural equation modeling. RESULTS: According to parent-rated behavioral disorder scales, paternal cyclothymic and maternal irritable temperaments were associated with ODD scores, and maternal depressive temperament was associated with CD scores. In terms of teacher-rated behavioral disorder scales, maternal anxious temperament was associated with ODD scores, and paternal cyclothymic and maternal depressive temperaments were associated with CD scores. CONCLUSION: These results suggest that certain parental affective temperaments are related to an increase in symptoms of disruptive behavioral disorders in children with ADHD.

Effect of Veneering Techniques on Shear and Microtensile Bond Strengths of Zirconia-Based All-Ceramic Systems.

PURPOSE: To evaluate shear (SBS) and microtensile (µTBS) bond strengths of zirconia cores veneered using different fabrication techniques. MATERIALS AND METHODS: Seventy-five IPS e.max ZirCAD plates were fabricated and divided into three groups according to the following veneering techniques: layering, pressing, and CAD-on. The specimens of the layering group were veneered with IPS e.max Ceram, and the specimens of the pressing group were veneered with IPS e.max Zir- Press. Veneering ceramics in the CAD-on group were milled from IPS e.max CAD, fused with the core by using a glass-fusion ceramic, and then crystallized. Bond strength tests were performed using a universal testing machine at a crosshead speed of 0.5 mm/min for the SBS test and 1 mm/min for the µTBS test. Mean SBS and µTBS (MPa) were analyzed with one-way ANOVA and Tukey's HSD test (p < 0.05). RESULTS: Significant differences in SBS were observed between the groups (p < 0.05). The mean SBS for the CAD-on group was significantly higher (31.89 ± 5.83 MPa) than those of the layering (14.27 ± 4.45 MPa) and pressing (12.23 ± 3.04 MPa) groups. However, the mean µTBS of the CAD-on (30.41 ± 8.64 MPa), layering (21.71 ± 3.40 MPa) and pressing (20.74 ± 6.36 MPa) groups were not statistically significant (p > 0.05). CONCLUSION: The CAD-on technique showed the highest shear bond strengths of the tested groups, and most of the specimens failed cohesively instead of failing at the adhesive interface.

The impact of anxiety sensitivity on suicidality in adolescents with major depressive disorder.

BACKGROUND: Few studies have examined the link between anxiety sensitivity (AS) and suicidality among adolescents with major depressive disorder; thus, there is a need to explore this relationship in order to fill the research gap. The aim of this cross-sectional study was to examine the association among AS and suicidal behaviour while taking into account the effects of potential third variables such as the presence of anxiety disorders and hopelessness in adolescents with major depressive disorder. SUBJECTS AND METHODS: Participants (n=101) completed self-report measures of depressive symptoms, AS, hopelessness and suicidal ideation severity. The presence of anxiety disorders and suicide attempt history were determined with psychiatric interviews. The association between psychiatric variables was evaluated using structural equation modelling. RESULTS: Results showed that AS cognitive concerns had a positive effect on suicidal ideation mediated by the severity of depression. AS physical concerns had a negative direct effect on suicidal ideation, but there was also a positive relationship among these variables through hopelessness, thus, the total effect of AS physical concerns was not significant. There were also positive relationships between hopelessness and suicidal ideation, and the presence of anxiety disorders to suicide attempt history. CONCLUSIONS: The results of this study suggest that higher AS cognitive concerns may be a risk factor for suicidality through the severity of depression in adolescents who are diagnosed with major depressive disorder.

Association of Reactive-Proactive Aggression and Anxiety Sensitivity with Internalizing and Externalizing Symptoms in Children with Attention-Deficit/Hyperactivity Disorder.

This study evaluates the associations among the symptoms of anxiety, depression, and disruptive behavioral disorders (DBD) in the context of their relationships with reactive-proactive aggression and anxiety sensitivity in children with attention-deficit/hyperactivity disorder (ADHD). The sample consisted of 342 treatment-naive children with ADHD. The severity of ADHD and DBD symptoms were assessed via parent- and teacher-rated inventories. Anxiety sensitivity, reactive-proactive aggression and severity of anxiety and depression symptoms of children were evaluated by self-report inventories. According to structural equation modeling, depression and anxiety scores had a relation with the DBD scores through reactive-proactive aggression. Results also showed a negative relation of the total scores of anxiety sensitivity on DBD scores, while conduct disorder scores had a positive relation with anxiety scores. This study suggests that examining the relations of reactive-proactive aggression and anxiety sensitivity with internalizing and externalizing disorders could be useful for understanding the link among these disorders in ADHD.

Effect of Different Surface Treatments on the Bond Strength of Lithium Disilicate Ceramic to the Zirconia Core.

OBJECTIVE: The aim of this study was to evaluate the effect of different surface treatments [sandblasting, Erbium:Yttrium-Aluminium-Garnet (Er:YAG), and femtosecond lasers] on the shear bond strength (SBS) of the CAD-on technique. BACKGROUND DATA: Although demand for all-ceramic restorations has increased, chipping remains one of the major problems for zirconia-based restorations. MATERIALS AND METHODS: Forty yttrium-stabilized tetragonal zirconia polycrystalline (Y-TZP) zirconia plates (IPS e.max ZirCAD, Ivoclar Vivadent) were cut, sintered (12.4 × 11.4 × 3 mm) and divided into four groups according to the surface treatments (n = 10): a control group with no surface treatment (Group C), sandblasting with 50 µm Al2O3 (Group S), Er:YAG laser irradiation (Group E), and femtosecond laser irradiation (Group F). Also, 40 cylindrical (5 mm diameter, 2 mm height) lithium disilicate (IPS e.max CAD) veneer ceramics were cut and fused to all zirconia cores by a glass-fusion ceramic and crystallized according to the CAD-on technique. Specimens were subjected to shear force using a universal testing machine. The load was applied at a crosshead speed of 0.5 mm/min until failure. Mean SBS (MPa) were analyzed with one way ANOVA (p < 0.05). The failed specimens were examined under a stereomicroscope at ×20 to classify the mode of failure. RESULTS: The highest SBS was observed in Group F (36 ± 3.31 MPa), followed by Group S (33.03 ± 5.05 MPa), and Group C (32.52 ± 10.15 MPa). The lowest SBS was observed in Group E (31.02 ± 4.96 MPa), but no significant differences were found between the control and surface treated groups (p = 0.377). All the specimens showed a mixed type of failure. CONCLUSIONS: Femtosecond laser application increased the bond strength between zirconia-veneer specimens. However, the novel CAD-on technique with no surface treatment also showed high bonding strength. Thus, this technique could prevent ceramic chipping without additional surface treatments.

Relationships among depression, anxiety, anxiety sensitivity, and perceived social support in adolescents with conversion disorder.

OBJECTIVE: This study aimed to assess the relationships of depression, anxiety, anxiety sensitivity, and perceived social support with conversion symptoms in adolescents with conversion disorder (CD). METHODS: Fifty outpatients, aged 8-18 years, who had been diagnosed with CD and members of a control group were assessed using the psychological questionnaires. RESULTS: Compared with controls, adolescents with CD scored higher on the Child Depression Inventory (CDI), Screen for Child Anxiety-related Emotional Disorders (SCARED), Childhood Anxiety Sensitivity Index (CASI) total, CASI physical and cognitive subscales, and Multidimensional Scale of Perceived Social Support family subscale. Multiple regression analysis showed that CDI, CASI total, and CASI cognitive scores predicted the Somatoform Dissociation Questionnaire (SDQ) scores and that CDI and CASI total scores predicted the Children's Somatization Inventory (CSI) scores of subjects. CONCLUSIONS: This study suggest that adolescents with CD had poor psychosocial well-being, and depression, global anxiety sensitivity and anxiety sensitivity cognitive concerns are related to conversion symptoms.

Impact of Symptoms of Maternal Anxiety and Depression on Quality of Life of Children with Cerebral Palsy.

INTRODUCTION: Cerebral palsy (CP) interferes with the quality of life (QOL) of children with CP, and given that parents report having to often guide their children's decision making, it is important to understand the psychosocial factors that have a potential influence on parent-proxy reports. The purpose of this study was to investigate the impact of maternal anxiety and depression symptoms on parent proxy-reported health-related QOL (HRQOL) for children with CP, while controlling other clinical and demographical variables that may have affect HRQOL. METHODS: The HRQOL scores of 97 outpatients with CP, aged 7-18 years, were assessed using the Pediatric QOL Inventory, Parent version (PedsQL-P). Each patient's type of CP, gross and fine motor function levels, severity of intellectual disability (ID), and other clinical variables were recorded. The levels of depression symptoms in each mother were assessed using the Beck Depression Inventory (BDI), and the levels of anxiety symptoms were assessed with the Beck Anxiety Inventory (BAI). RESULTS: According to regression analyses, male gender, severity of ID, and higher mothers' BAI scores had negative effects on the PedsQL-P physical scores, and severity of ID and higher mothers' BDI scores had negative effects on the PedsQL-P psychosocial scores. Regarding the determinants of total HRQOL, severity of ID, GMFCS score, and higher mothers' BDI scores negatively impacted the PedsQL-P total scores. CONCLUSION: Our findings show significant predictor effects of the mothers' anxiety and depressive symptoms, independent from other clinical variables, on the mother-rated HRQOL scores in children with CP.

Color Stability of CAD/CAM Fabricated Inlays after Accelerated Artificial Aging.

PURPOSE: To investigate the influence of accelerated artificial aging on the color stability of three different inlay restorations produced with a CAD/CAM system. MATERIALS AND METHODS: Thirty non-carious human mandibular molar teeth were used. The teeth were embedded in autopolymerizing acrylic resin blocks. Standard Class I inlay cavities were prepared, and the teeth were randomly divided into three groups (n = 10) to fabricate inlay restorations: (1) a feldspathic-ceramic group, (2) a resin nano-ceramic group, and (3) a leucite glass-ceramic group. Optical impressions were made with CEREC software, and the restorations were designed and then milled. The inlays were adhesively cemented with a dual-polymerizing resin cement and left in distilled water at room temperature for 1 week. Color measurements were performed with a spectrophotometer before and after accelerated aging in a weathering machine with a total energy of 150 kJ/m(2) . Changes in color (∆E, ∆L, ∆a, ∆b, ∆C) were determined using the CIE L*a*b* system. The results were assessed using a one-way ANOVA and Tukey's HSD test (p = 0.05). RESULTS: The color changes of the materials ranged from 2.1 to 9.29. The highest color change was seen in the resin nano-ceramic material. This change was not clinically acceptable (∆E > 5.5). No significant differences were found in the ∆L and ∆a values of the test groups. CONCLUSIONS: Color changes were observed in each evaluated material after accelerated aging. All CAD/CAM inlays became darker in appearance, more saturated, a little reddish, and more yellow.

[Adaptation of the Childhood Anxiety Sensitivity Index for Use in Turkey]. / Çocuklar Için Anksiyete Duyarliligi Indeksi'nin Türkçe Formunun Geçerlik ve Güvenilirlik Çalismasi.

OBJECTIVE: Anxiety sensitivity (AS) refers to the fear of anxiety-related sensations. The aim of the present study is to investigate the validity and reliability of Childhood Anxiety Sensitivity Index (CASI) and adapting it into Turkish. METHOD: The study group consisted of 328 healthy individuals whose age between 8-15 years old. All subjects included in the study filled out the Childhood Anxiety Sensitivity Index (CASI) and the State-Trait Anxiety Inventories for Children (STAI-C). RESULTS: The CASI was found to be significantly related to both trait and state anxiety scores (r=0.42 and r=0.32, respectively). It had a high internal consistency (Cronbach a= 0.74) and good test-retest reliability (r= 0.77, p< 0.001). Explorotary factor analyses showed that the CASI is comprised of 6 lower-order factors. However, CASI subfactors was established according to literature as a three factor model: physical, cognitive and social. CONCLUSION: According to the present study, the CASI Turkish version was shown to be a valid and a reliable scale.