Effect of Hydrothermal Aging on the Flexural Strength and Microhardness of Materials Used for Additive or Subtractive Manufacturing of Definitive Restorations.

PURPOSE: To evaluate the flexural strength (FS) and microhardness of various CAD/CAM restorative materials intended for definitive use. The effect of hydrothermal aging on the mechanical properties of these materials was also investigated. MATERIALS AND METHODS: A total of 210 bar-shaped specimens (17 × 4 × 1.5 mm ± 0.02 mm) were fabricated via either subtractive manufacturing (SM) methods-reinforced composite resin (SM-CR), polymer-infiltrated ceramic network (SM-PICN), fine-structured feldspathic ceramic (SMFC), nanographene-reinforced polymethyl methacrylate (PMMA; SM-GPMMA), PMMAbased resin (SM-PMMA)-or additive manufacturing (AM) methods with urethane acrylate-based resins (AM-UA1 and AM-UA2). Specimens were then divided into two subgroups (nonaged or hydrothermal aging; n = 15). A three-point flexural strength test was performed, and five specimens from the nonaged group were submitted to microhardness testing. Specimens were subjected to 10,000 thermal cycles, and the measurements were repeated. RESULTS: Regardless of aging, SM-CR had the highest FS (P < .001), followed by SM-GPMMA (P ≤ .042). In nonaged groups, AM-UA2 had a lower FS than all other materials except SM-FC (P = 1.000). In hydrothermal aging groups, AM specimens had lower FS values than other materials, except SM-PMMA. With regard to microhardness, there was no significant difference found between any of the tested materials (P ≥ .945) in the nonaged and hydrothermal aging groups. CONCLUSIONS: The effect of hydrothermal aging on FS varied depending on the type of restorative material. Regardless of aging condition, SM-CR showed the highest FS values, whereas SM-FC had the highest microhardness. Hydrothermal aging had no significant influence on the microhardness of the tested materials.

Fabrication trueness and marginal quality of additively manufactured resin-based definitive laminate veneers with different restoration thicknesses.

OBJECTIVES: To evaluate how restoration thickness (0.5 mm and 0.7 mm) affects the fabrication trueness of additively manufactured definitive resin-based laminate veneers, and to analyze the effect of restoration thickness and margin location on margin quality. METHODS: Two maxillary central incisors were prepared either for a 0.5 mm- or 0.7 mm-thick laminate veneer. After acquiring the partial-arch scans of each preparation, laminate veneers were designed and stored as reference data. By using these reference data, a total of 30 resin-based laminate veneers were additively manufactured (n = 15 per thickness). All veneers were digitized and stored as test data. The reference and test data were superimposed to calculate the root mean square values at overall, external, intaglio, and marginal surfaces. The margin quality at labial, incisal, mesial, and distal surfaces was evaluated. Fabrication trueness at each surface was analyzed with independent t-tests, while 2-way analysis of variance was used to analyze the effect of thickness and margin location on margin quality (α = 0.05). RESULTS: Regardless of the evaluated surface, 0.7 mm-thick veneers had lower deviations (P < 0.001). Only the margin location (P < 0.001) affected the margin quality as labial margins had the lowest quality (P < 0.001). CONCLUSION: Restoration thickness affected the fabrication trueness of resin-based laminate veneers as 0.7 mm-thick veneers had significantly higher trueness. However, restoration thickness did not affect the margin quality and labial margins had the lowest quality. CLINICAL SIGNIFICANCE: Laminate veneers fabricated by using tested urethane-based acrylic resin may require less adjustment when fabricated in 0.7 mm thickness. However, marginal integrity issues may be encountered at the labial surface.

Influence of intraoral scanner and finish line location on the fabrication trueness and margin quality of additively manufactured laminate veneers fabricated with a completely digital workflow.

STATEMENT OF PROBLEM: Knowledge of the fabrication trueness and margin quality of additively manufactured (AM) laminate veneers (LVs) when different intraoral scanners (IOSs) and finish line locations are used is limited. PURPOSE: The purpose of this in vitro study was to evaluate the fabrication trueness and margin quality of AM LVs with different finish line locations digitized by using different IOSs. MATERIAL AND METHODS: An LV preparation with a subgingival (sub), equigingival (equi), or supragingival (supra) finish line was performed on 3 identical maxillary right central incisor typodont teeth. Each preparation was digitized by using 2 IOSs, (CEREC Primescan [PS] and TRIOS 3 [TS]), and a reference LV for each finish line-IOS pair (n=6) was designed. A total of 90 LVs were fabricated by using these files and urethane acrylate-based definitive resin (Tera Harz TC-80DP) (n=15). Each LV was then digitized by using PS to evaluate fabrication trueness (overall, external, intaglio, and marginal surfaces). Each LV was also qualitatively evaluated under a stereomicroscope (×60), and the cervical and incisal margin quality was graded. Fabrication trueness and cervical margin quality were evaluated by using 2-way analysis of variance, while Kruskal-Wallis and Mann Whitney-U tests were used to evaluate incisal margin quality (α=.05). RESULTS: The interaction between the IOS type and the finish line location affected measured deviations at each surface (P≤.020). PS-sub and TS-supra had higher overall trueness than their counterparts. and the subgingival finish line resulted in the lowest trueness (P≤.005). PS and the subgingival finish line led to the lowest trueness of the external surface (P≤.001). TS-sub had the lowest intaglio surface trueness among the TS subgroups, and PS-sub had higher trueness than TS-sub (P<.001). PS-sub and PS-supra had higher marginal surface trueness than their TS counterparts (P<.001). TS resulted in higher cervical margin quality (P=.001). CONCLUSIONS: Regardless of the IOS tested, subgingival finish lines resulted in the lowest trueness. The effect of IOS on the measured deviations varied according to the surface evaluated and finish line location. The cervical margin quality of AM LVs was higher when TS was used.

Optic neuritis in Turkish children and adolescents: A multicenter retrospective study.

BACKGROUND: Various etiologies may underlie optic neuritis, including autoantibody-mediated disorders described in the last decade. We re-examined demographic, clinical, laboratory features and prognostic factors in pediatric patients with autoimmune optic neuritis according to current knowledge. METHODS: Cases of pediatric ON from 27 centers in Türkiye diagnosed between 2009 and 2022 were included for retrospective evaluation. RESULTS: The study included 279 patients, 174 females and 105 males, with a female-to-male ratio of 1.65. The average age at onset was 12.8 ± 3.4 years, and mean follow-up, 2.1 years (range: 1-12.1 years). Patients <10 years old were grouped as "prepubertal" and those ≥10 years old as "others". The diagnoses made at the end of follow-up were multiple sclerosis associated optic neuritis (n = 90, 32.3 %), single isolated optic neuritis (n = 86, 31 %), clinically isolated syndrome (n = 41, 14.7 %), myelin oligodendrocyte glycoprotein antibody associated optic neuritis (n = 22, 7.9 %), and relapsing isolated optic neuritis (n = 18, 6.5 %). Predominant diagnoses were myelin oligodendrocyte glycoprotein antibody associated optic neuritis and acute disseminated encephalomyelitis associated optic neuritis in the prepubertal group and multiple sclerosis associated optic neuritis in the older group. Recurrences were observed in 67 (24 %) patients, including 28 with multiple sclerosis associated optic neuritis, 18 with relapsing isolated optic neuritis, 11 with myelin oligodendrocyte glycoprotein antibody associated optic neuritis, 8 with aquaporin-4 antibody related optic neuritis, and 2 with chronic relapsing inflammatory optic neuropathy. Recurrences were more common among female patients. Findings supporting the diagnosis of multiple sclerosis included age of onset ≥ 10 years (OR=1.24, p = 0.027), the presence of cranial MRI lesions (OR=26.92, p<0.001), and oligoclonal bands (OR=9.7, p = 0.001). Treatment in the acute phase consisted of intravenous pulse methylprednisolone (n = 46, 16.5 %), pulse methylprednisolone with an oral taper (n = 212, 76 %), and combinations of pulse methylprednisolone, plasmapheresis, or intravenous immunoglobulin (n = 21, 7.5 %). Outcome at 12 months was satisfactory, with 247 out of 279 patients (88.5 %) demonstrating complete recovery. Thirty-two patients exhibited incomplete recovery and further combination treatments were applied. Specifically, patients with relapsing isolated optic neuritis and aquaporin-4 antibody related optic neuritis displayed a less favorable prognosis. CONCLUSION: Our results suggest optic neuritis is frequently bilateral in prepubertal and unilateral in peri­ or postpubertal patients. Age of onset 10 or older, presence of oligoclonal bands, and brain MRI findings reliably predict the development of multiple sclerosis. The risk of developing multiple sclerosis increases mostly during the second and third years of follow-up. Relapsing isolated optic neuritis remains a separate group where the pathogenesis and outcome remain unclear. Investigation of predisposing and diagnostic biomarkers and long follow-up could help to define this group.

Effect of material thickness and coffee thermocycling on the color stability and translucency of additively and subtractively manufactured resin-based materials for definitive restorations.

PURPOSE: To evaluate the effect of material thickness and coffee thermocycling on the optical properties of additively (AM) and subtractively manufactured (SM) definitive resin-based materials. MATERIALS AND METHODS: Specimens in 3 thicknesses (1 mm, 1.5 mm, and 2 mm) were prepared from 3 AM (3D-CB, 3D-TH, and 3D-CT) and 2 SM (G-CAM and VE) resin-based materials (n=15). Color coordinates of each specimen were measured after polishing and after 10000 cycles of coffee thermocycling. Color differences (ΔE00) and relative translucency parameter (RTP) values were calculated. After logarithmic transformation, ΔE00 values were analyzed with 2-way analysis of variance, while RTP values were analyzed with generalized linear model test (α=.05). RESULTS: 3D-TH had the highest and G-CAM had the lowest pooled ΔE00 (P≤.004). 3D-CB had higher pooled ΔE00 than VE and 3D-CT (P≤.002). SM specimens, 1.5 mm- and 2 mm-thick 3D-CT, and 1 mm-thick 3D-TH had lower ΔE00 than 1.5 mm- and 2 mm-thick 3D-TH (P≤.036). Most of the AM specimens and 1 mm-thick VE had higher ΔE00 than 2 mm-thick G-CAM (P≤.029). Most of the AM specimens had higher ΔE00 than 1.5 mm-thick G-CAM (P≤.006). RTP values of specimens were 3D-CT, G-CAM, VE, 3D-CB, and 3D-TH in an increasing order (P<.001). Increased thickness and coffee thermocycling mostly reduced RTP (P<.001). CONCLUSION: 3D-TH mostly had higher color change than subtractively manufactured specimens, while G-CAM mostly had lower color change than additively manufactured specimens. Only 1.5 mm- and 2 mm-thick 3D-TH had unacceptable color changes. Thickness and coffee thermocycling mostly reduced the translucency.

Fabrication trueness, intaglio surface adaptation, and marginal integrity of resin-based onlay restorations fabricated by additive and subtractive manufacturing.

PURPOSE: To evaluate the fabrication trueness, intaglio surface adaptation, and marginal integrity of additively- or subtractively manufactured resin-based onlay restorations. MATERIALS AND METHODS: An onlay restoration was designed (Exocad Dental CAD Galway 3.0) and saved as standard tessellation language (STL) file to generate design STL file (DO-STL). By using this design, a total of 45 onlays were fabricated either with additive (3D-printed resin for definitive (Tera Harz TC-80DP, AM-D) and interim (Freeprint temp, AM-I) restorations) or subtractive manufacturing (composite resin, Tetric CAD (SM)) technologies. Onlays were scanned with an intraoral scanner (CEREC Primescan SW 5.2, Dentsply Sirona) and the scans were saved as test STL files (TO-STLs). For trueness evaluation, TO-STLs were superimposed over DO-STL, and root mean square (RMS) values of overall and intaglio surfaces were measured (Geomagic Control X). For the intaglio surface adaptation and marginal integrity, triple scan protocol was performed. Kolmogorov-Smirnov, one-way analysis of variance, and a post-hoc Tukey honestly significant difference test were used to analyze data(α=.05). RESULTS: RMS values of intaglio and overall surfaces, intaglio adaptation, and marginal integrity varied among test groups (P<0.001). AM-D had the greatest overall surface RMS (P <0.001), while SM had the greatest intaglio surface RMS (P<0.001). SM had the highest average distance deviations for intaglio surface adaptation and marginal integrity, whereas AM-D had the lowest (P <0.001). CONCLUSION: Additively manufactured definitive onlays showed lower overall trueness than additively manufactured interim onlays and subtractively manufactured definitive onlays. However, additively manufactured definitive onlays presented high intaglio surface trueness, intaglio surface adaptation, and marginal integrity.

Ocular hemodynamics in epileptic children treated with antiepileptic drugs.

PURPOSE: To evaluate the quantitative measurements obtained for vessel density (VD) of the optic nerve head, macula, peripapillary retinal nerve fibre layer (p-RNFL) and total retinal thicknesses (Trt) by optical coherence tomography angiography (OCT-A) and the choroidal vascular structure using an image binarization method in children with epilepsy using three different antiepileptic drugs (AEDs) and to compare these measurements with healthy participants. METHODS: This observational, cross-sectional study included 124 patients divided into 4 groups: Group-1: patients receiving carbamazepine(n = 30), group-2: patients receiving levetiracetam (n = 31), group-3: patients receiving valproic acid (n = 32), and group 4: healthy controls (n = 31).A fully automated microstructural analysis of the VD of the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and the choriocapillaris (CC) layers and radial peripapillary capillary, and Trt, p-RNFL thickness were analyzed by using OCT-A. Enhanced depth imaging (EDI)-OCT scans of the macula were obtained and the images were binarized using the ImageJ software. RESULTS: The mean age, gender distribution and the duration of epilepsy were similar in all groups. Evaluation of the p-RNFL thickness and perifoveal Trt between the groups showed a statistically significant difference in all quadrants.The p-RNFL thickness was lower in patients receiving carbamazepine and valproic acid. The lowest values of the luminal area and choroidal vascular index (CVI) were found in patients receiving valproic acid; comparison with matched healthy controls showed statistically significant differences. CONCLUSION: Valproic acid and carbamazepine are associated with thinning of the p-RNFL in epilepsy patients, but the macular and radial peripapillary VD were not affected.However, a reduction of choroidal vascular blood flow was found in epilepsy patients taking valproic acid.

A multicenter study of radiologically isolated syndrome in children and adolescents: Can we predict the course?

OBJECTIVES: To evaluate clinical characteristics, imaging features and etiological profile of Radiologically Isolated Syndrome (RIS) along with clinical and radiological follow-up. METHODS: Demographic, clinical and radiological data of patients younger than 18 years fulfilling the criteria for RIS were retrospectively analyzed. RIS was defined by the detection of lesions meeting the revised 2010 McDonald Criteria for dissemination in space on magnetic resonance imaging (MRI) in the absence of any symptoms of demyelinating disease or an alternative cause for the MRI findings. RESULTS: There were total 69 patients (38 girls, 31 boys). The median age at index MRI was 15.7 years, and median follow-up time was 28 months. The most common reason for neuroimaging was headache (60.9%). A first clinical event occurred with median 11 months in 14/69 (20%) of cases. Those with oligoclonal bands (OCB) in cerebrospinal fluid (CSF) and follow-up longer than 3 years were more likely to experience a clinical event (p<0.05): 25% of those with OCB manifested clinical symptoms within the first year and 33.3% within the first two years compared to 6.3% and 9.4%, respectively in those without OCB. Radiological evolution was not associated with any variables: age, sex, reason for neuroimaging, serum 25-hydroxyvitamin D level, elevated IgG index, OCB positivity, total number and localization of lesions, presence of gadolinium enhancement, achievement of 2005 criteria for DIS and duration of follow-up. CONCLUSION: Children and adolescents with RIS and CSF OCB should be followed-up for at least 3 years in order to detect any clinical symptoms suggestive of a demyelinating event. Because disease-modifying treatments are not approved in RIS and no consensus report justifies their use especially in pediatric RIS, close follow-up of OCB-positive patients is needed for early recognition of any clinical event and timely initiation of specific treatment.

Trueness and precision of combined healing abutment scan body system scans at different sites of maxilla after multiple repositioning of the scan body.

OBJECTIVES: To evaluate the accuracy of the scans of the combined healing abutment-scan body (CHA-SB) system located at different sites of the maxilla when SBs are replaced in between each scan. METHODS: Three SBs were seated into HAs located at the central incisor, first premolar, and first molar sites of a maxillary model inside a phantom head, and the model was scanned extraorally (CEREC Primescan SW 5.2). This procedure was repeated with new SBs until a total of 10 scans were performed. Standard tessellation language files of CHA-SBs at each implant location were isolated, transferred into analysis software (Geomagic Control X), and superimposed over the proprietary library files to analyze surface (root mean square), linear, and angular deviations. Trueness and precision were evaluated with one-way analysis of variance and Tukey tests. The correlation between surface and angular deviations was analyzed with Pearson's correlation (α=0.05). RESULTS: Molar implant scans had the highest surface and angular deviations (P≤.006), while central incisor implant scans had higher precision (surface deviations) than premolar implant scans (P=.041). Premolar implant scans had higher accuracy than central incisor implant scans on the y-axis (P≤.029). Central incisor implant scans had the highest accuracy on the z-axis (P≤.018). A strong positive correlation was observed between surface and angular deviations (r = 0.864, P<.001). CONCLUSION: Central incisor implant scans mostly had high accuracy and molar implant scans mostly had lower trueness. SBs were mostly positioned apically; however, the effect of SB replacement can be considered small as measured deviations were similar to those in previous studies and the precision of scans was high. CLINICAL SIGNIFICANCE: Repositioning of scan bodies into healing abutments would be expected to result in similar single crown positioning regardless of the location of the implant, considering high scan precision with the healing abutment-scan body system. The duration of the chairside adjustments of crowns in the posterior maxilla may be longer than those in the anterior region.

Contribution of lowered hemoglobin threshold value in the diagnosis of polycythemia vera: Comparison of 2016 and 2008 WHO criteria.

Polycythemia vera (PV) diagnosis remains a difficult task despite various updates in the 2016 World Health Organization (WHO) diagnostic criteria compared to 2008 criteria. This study aimed to examine the biochemical and clinical features of patients diagnosed with PV using the WHO 2016 criteria but would have been missed by the WHO 2008 criteria, and to ascertain the impact of the lowered thresholds on PV diagnosis. A total of 229 patients with suspected myeloproliferative neoplasms were included in this cross sectional study. The study group was divided with regard to hemoglobin values. Group A consisted of 126 patients with hemoglobin values of ≤ 18.5 g/dL in males and ≤ 16.5 g/dL in females. Group B comprised 103 patients with hemoglobin values of > 18.5 g/dL in males and > 16.5 g/dL in females. The number of PV diagnoses increased to 145 from 87 (increased by 66.67%) when the 2016 diagnostic criteria were employed rather that the 2008 criteria. Mean age and the frequency of female subjects were lower in Group A compared to Group B. The groups were similar in terms of chronic obstructive pulmonary disease/obstructive sleep apnea syndrome, spleen status, smoking status, and mean corpuscular volume, white blood count, neutrophil, eosinophil and platelet values. red blood cells and lactate dehydrogenase values were significantly higher, while lymphocyte counts were significantly lower in Group B. With the introduction of WHO 2016 criteria, we found a significant increase in the number of patients who were candidates for PV testing and were ultimately diagnosed with PV. These findings support the diagnostic value of the 2016 WHO criteria, and by extension, the lowered thresholds for detection of patients requiring further analysis.

Effect of polishing and denture cleansers on the surface roughness of new-generation denture base materials and their color change after cleansing.

PURPOSE: To evaluate the effect of polishing and denture cleansers on the surface roughness (Ra ) of new-generation denture base materials that are additively, subtractively, and conventionally fabricated, while also assessing their color change after cleansing. MATERIAL AND METHODS: One hundred and fifty disk-shaped specimens (Ø10 × 2 mm) were prepared from five denture base materials (one subtractively manufactured nanographene-reinforced prepolymerized polymethylmethacrylate (PMMA) (SM-GC), one subtractively manufactured prepolymerized PMMA (SM-PM), two additively manufactured denture base resins (AM-DT and AM-ND), and one heat-polymerized PMMA (CV) (n = 30). The Ra of the specimens was measured before and after conventional laboratory polishing, while color coordinates were measured after polishing. Specimens were then divided into three subgroups based on the denture cleanser: distilled water, 1% sodium hypochlorite (NaOCl), and effervescent tablet (n = 10). The Ra and color coordinates were remeasured after nine cleansing cycles over a period of 20 days. The CIEDE2000 formula was used to calculate the color differences (ΔE00 ). Two-way analysis of variance (ANOVA) was used to analyze the Ra values before (n = 30) and after (n = 10) cleansing, while repeated measures ANOVA was used to analyze the Ra of material-time point pairs within each denture cleanser (n = 10). ΔE00 data after denture cleansing was also analyzed by using two-way ANOVA (n = 10) (α = 0.05). RESULTS: Before polishing, Ra varied significantly among the materials. SM-GC and SM-PM had the lowest and AM-ND the highest Ra values (P < 0.001). Polishing significantly reduced Ra of all materials (P < 0.001), and after polishing, Ra differences among materials were nonsignificant (P ≥ 0.072). Regardless of the denture cleanser, the Ra of AM-DT, AM-ND, and CV was the highest before polishing when different time points were considered (P < 0.001). After cleansing, AM-ND had the highest Ra of all the materials, regardless of the cleanser (P ≤ 0.017). AM-DT had higher Ra than SM-PM when distilled water (P = 0.040) and higher Ra than SM-GC, SM-PM, and CV when NaOCl was used (P < 0.001). The type of cleanser significantly influenced the Ra of AM-DT, AM-ND, and CV. For AM-DT, NaOCl led to the highest Ra and the tablet led to the lowest Ra (P ≤ 0.042), while for AM-ND, distilled water led to the lowest Ra (P ≤ 0.024). For CV, the tablet led to lower Ra than distilled water (P = 0.009). Color change varied among the materials. When distilled water was used, SM-GC had higher ΔE00 than SM-PM and AM-DT (P ≤ 0.034). When NaOCl was used, AM-ND had higher ΔE00 than SM-GC, SM-PM, and AM-DT, while CV and SM-GC had higher ΔE00 than SM-PM and AM-DT (P ≤ 0.039). Finally, when the tablet was used, AM-ND and CV had the highest ΔE00 , while AM-DT had lower ΔE00 than SM-GC (P ≤ 0.015). CONCLUSIONS: The tested materials had unacceptable surface roughness (>0.2 µm) before polishing. Roughness decreased significantly after polishing (<0.2 µm). Denture cleansers did not significantly affect the surface roughness of the materials, and roughness remained clinically acceptable after cleansing (<0.2 µm). Considering previously reported color thresholds, AM-ND and CV had unacceptable color change regardless of the denture cleanser, and the effervescent tablet led to perceptible, but acceptable color change for SM-GC, SM-PM, and AM-DT.

Role of serostatus in pediatric neuromyelitis optica spectrum disorders: A nationwide multicentric study.

BACKGROUND: Neuromyelitis optica spectrum disorders (NMOSD) are immune-mediated inflammatory disorders of the central nervous system (CNS) mostly presenting as optic neuritis and acute myelitis. NMOSD can be associated with seropositivity for aquaporin 4 antibody (AQP4 IgG), myelin oligodendrocyte glycoprotein antibody (MOG IgG), or can be seronegative for both. In this study, we retrospectively examined our seropositive and seronegative pediatric NMOSD patients. METHOD: Data were collected from all participating centres nationwide. Patients diagnosed with NMOSD were divided into three subgroups according to serology: AQP4 IgG NMOSD, MOG IgG NMOSD, and double seronegative (DN) NMOSD. Patients with at least six months of follow-up were compared statistically. RESULTS: The study included 45 patients, 29 female and 16 male (ratio:1.8), mean age 15.16 ± 4.93 (range 5.5-27) years. Age at onset, clinical manifestations, and cerebrospinal fluid findings were similar between AQP4 IgG NMOSD (n = 17), MOG IgG NMOSD (n = 10), and DN NMOSD (n = 18) groups. A polyphasic course was more frequent in the AQP4 IgG and MOG IgG NMOSD groups than DN NMOSD (p = 0.007). The annualized relapse rate and rate of disability were similar between groups. Most common types of disability were related to optic pathway and spinal cord involvement. Rituximab in AQP4 IgG NMOSD, intravenous immunoglobulin in MOG IgG NMOSD, and azathioprine in DN NMOSD were usually preferred for maintenance treatment. CONCLUSION: In our series with a considerable number of double seronegatives, the three major serological groups of NMOSD were indistinguishable based on clinical and laboratory findings at initial presentation. Their outcome is similar in terms of disability, but seropositive patients should be more closely followed-up for relapses.

Bond strength of additively manufactured composite resins to dentin and titanium when bonded with dual-polymerizing resin cements.

STATEMENT OF PROBLEM: Additively manufactured composite resins for definitive restorations have been recently introduced. The bond strength between these composite resins and different substrates has not been extensively studied. PURPOSE: The purpose of this in vitro study was to measure the shear bond strength (SBS) between additively manufactured composite resins and dentin and titanium substrates and compare those with the SBS between subtractively manufactured polymer-infiltrated ceramic and the same substrates (dentin and titanium), when different dual-polymerizing resin cements were used. MATERIAL AND METHODS: One hundred and eighty cylinder-shaped specimens (Ø5×5 mm) were prepared from 3 materials recommended for definitive restorations: an additively manufactured composite resin (Crowntec [CT]); an additively manufactured hybrid composite resin (VarseoSmile Crown Plus [VS]); and a subtractively manufactured polymer-infiltrated ceramic (Enamic [EN]) (n=60). Specimens were randomly divided into six subgroups to be cemented to the two substrates (dentin and titanium; n=30) with 1 of 3 resin cements (RelyX Universal, Panavia V5, and Variolink Esthetic DC) (n=10). The restoration surface to be bonded was treated according to the respective manufacturer's recommendations. Dentin surfaces were treated according to the resin cement (Scotchbond Universal Plus Adhesive for RelyX Universal, Panavia V5 Tooth Primer for Panavia V5, and Adhese Universal for Variolink Esthetic DC), while titanium surfaces were airborne-particle abraded, and only the specimens paired with Panavia V5 were treated with a ceramic primer (Clearfil Ceramic Primer Plus). SBS was measured in a universal testing machine at a crosshead speed of 1 mm/min. Failure modes were analyzed under a microscope at ×12 magnification. Data were analyzed by using 2-way analysis of variance and Tukey honestly significant difference tests (α=.05). RESULTS: When SBS to dentin was considered, only restorative material, as a main factor, had a significant effect (P<.001); EN had the highest SBS (P<.001), while the difference in SBS values of CT and VS was not significant (P=.145). As for SBS to titanium, the factors restorative material and resin cement and their interaction had a significant effect (P<.001). Within each resin cement, EN had the highest SBS to titanium (P<.001), and within each restorative material, Variolink resulted in the lowest SBS (P≤.010). Overall, EN and RelyX were associated with the highest SBS to titanium (P≤.013). Mixed failures were predominant in most groups. CONCLUSIONS: Regardless of the substrate or the resin cement used, the subtractively manufactured polymer-infiltrated ceramic had higher shear bond strength than the additively manufactured composite resins. The SBS of the additively manufactured composite resins, whether bonded to dentin or titanium, were not significantly different from each other. Regardless of the restorative material, Variolink DC resulted in the lowest SBS for titanium surfaces.

Ocular perfusion characteristics of children with newly diagnosed epilepsy.

BACKGROUND: To investigate the vascular changes of the optic nerve head (ONH) and macula by using optical coherence tomography angiography (OCT-A), and also the choroidal vascular structure by using an image binarization tool in children with newly diagnosed epilepsy and to then compare these parameters with healthy subjects. METHODS: Forty-one epilepsy children and 36 healthy controls were included in this prospective and cross-sectional study.The radial peripapillary capillary (RPC) vessel density (VD) and macular foveal,parafoveal,perifoveal of superficial capillary plexus (SCP),deep capillary plexus (DCP) and choriocapillaris (CC) VD, and CC flow area were analyzed.Enhanced depth imaging (EDI) OCT scans of the macula were obtained and the images were binarized using the ImageJ software (National Institutes of Health, Bethesda, MD, USA).The subfoveal choroidal thickness (SFCT),the area of choroidal, luminal, and interstitial and the percentage of luminal area in the choroid (Choroidal vascular index (CVI)) were analyzed.We also evaluated the thickness of the peripapillary retinal nerve fiber layer (RNFL),the macular ganglion cell layer (GCL), and the inner plexiform layer (IPL). RESULTS: There was a significant decrease in the VD of the CC and the CC flow area in children with epilepsy compared to healthy subjects (p<0.05).However, the VD of the RPC, and of the SCP and DCP of the macula were similar between the two groups(p>0.05).The SFCT,choroidal area,luminal area, and CVI were statistically significant lower in children with newly diagnosed epilepsy compared to healthy subjects. CONCLUSION: This study has demonstrated that the choroidal perfusion from the microcirculation is lower in children with newly diagnosed epilepsy.The pathophysiology of epilepsy and neurodegenerative processes may also include this vascular dysfunction as one of the factors.

Effects of 16% Carbamide Peroxide on Optical Properties of Thermally Aged Monolithic CAD-CAM Glass Ceramics with Different Surface Treatments.

This study aimed to investigate the effects of 16% carbamide peroxide (CP) on the relative translucency parameter (RTP) and color stability of thermally aged CAD-CAM glass-ceramics with glazing or polishing. Three different CAD-CAM blocks-feldspathic (VM), lithium disilicate (IPS), and zirconia-reinforced lithium silicate ceramic (VS)-were used in this study. The specimens were divided into two groups (n=10) according to surface treatments (glazing or polishing). Bleaching treatment with 16% CP was applied to the thermally aged specimens. A spectrophotometer (VITA Easyshade Advance) was used to measure the CIE L*a*b*coordinates of the specimens on white and black backgrounds, and RTP and color difference (ΔE00) values were calculated. The surface topography of the specimens and the atomic weight of the elements were analyzed with scanning electron microscopy and energy-dispersive x-ray. The data were analyzed by using the two-way ANOVA test for ΔE00 values and two-way repeated measures ANOVA test for RTP and color parameters values (a=0.05) and the Tukey post-hoc test was used for multiple comparisons of the groups. RTP values were statistically influenced by material type, bleaching, and finishing technique, and the interaction among these factors was found to be significant (p<0.05). ΔE00 values were statistically influenced by material type, finishing technique, and the interaction among these factors was also found to be significant (p<0.05). IPS presented significantly lower RTP and ΔE00 values for both glazed and polished surfaces (p<0.05). 16% CP bleaching agent caused changes in translucency of aged VM and IPS at different levels. Glazed surfaces presented higher color stability in comparison to mechanically polished surfaces for VS (p<0.05).

CLN3-Associated NCL Case with a Preliminary Diagnosis of Niemann Pick Type C.

Introduction: Neuronal ceroid lipofuscinoses (NCLs) are a broad class of inherited lysosomal storage disorders. Known mutations in at least 13 different genes can result in NCL with variable ages of onset, symptoms, and pathologic findings. Generally, these patients experience cognitive and motor decline, seizures, visual impairment, and premature death. Pathologically, NCL patients display heterogeneous histologic abnormalities, but consistently exhibit neuronal loss, reactive gliosis, and lysosomal accumulation of autofluorescent storage material or lipopigment. Juvenile-onset NCL has been classically referred to as Batten disease. By far the most prevalent NCL is CLN3-associated disease. It is an autosomal recessive condition that is usually caused by mutations in the ceroid-lipofuscinosis, neuronal 3 (CLN3) gene. CLN3 encodes battenin, a ubiquitously expressed transmembrane protein of unknown function that is associated with cellular homeostasis and neuronal survival. The initial clinical symptom of CLN3-associated NCL is central vision loss, which is usually detected between 4 and 9 years of age. Seizures typically begin early in the second decade of life, and affected individuals rarely live beyond their mid-20ies. Case Presentation: Herein, we describe a 16-year-old patient with CLN3-related juvenile NCL with a preliminary diagnosis of Niemann Pick Type C disease. The proband showed characteristic clinical signs, including epilepsy, ataxia, psychomotor regression, dementia, and visual impairment with an unusual elevation of lyso-sphingomyelin-509 (Lyso-SM-509; 812 nmol/L, normal 1-33 nmol/L). A homozygous NM_001042432.2(CLN3):c.233dup (p.Thr80fs) variant was detected at exon 4 of CLN3. Diagnosis of NCL was difficult due to the pronounced elevation of LysoSM-509. Discussion: LysoSM-509 is a biomarker which is elevated especially in Niemann Pick Type C. We can consider that a high LysoSM-509 level might be also an indicator of NCL, especially NCL type 3.

Corpus callosum thickness: A predictive factor for the first drug efficiency of self-limited epilepsy with centrotemporal spikes (selects)?

OBJECTIVE: To investigate the existence of a possible linkage between the thickness of corpus callosum (CC) regions and the first antiepileptic drug response in patients with Selects. MATERIALS AND METHODS: CC thickness of 68 patients with Selects and 42 healthy controls between 4 and 12 years of age were measured using brain magnetic resonance imaging (MRI). Clinical and EEG features of newly diagnosed Selects patients were recorded. Patients were divided into two groups: good-response (patients without seizures within 24 weeks) and poor-response (patients with ≥ 1 seizure within 24 weeks). Thickness of CC was compared between patients (good-response and poor-response groups).and healthy controls. RESULTS: The thicknesses of genu and isthmus were significantly reduced in the Selects group than healthy controls. Isthmus and splenium were significantly thinner in poor responders than those in the good-response group (p = 0.005 and p < 0.001, respectively). The total number of seizures was negatively correlated with the thickness of the body, isthmus, and splenium (p < 0.001). There was no significant difference in CC thickness of the children with and without electrical status epilepticus in sleep (ESES). The thickness of the isthmus and splenium were significantly thinner in patients receiving ≥ 2 antiepileptic drugs (p = 0.002 and p = 0.001, respectively). CONCLUSIONS: Our study highlights the notable differences in areas of CC in Selects patients. These changes may help uncover the underlying cause of seizure recurrence and antiepileptic drug (AED) response. Different thinner parts of CC may be a protective mechanism to prevent seizure spread to other brain regions. CC thickness can be used as a new radiologic biomarker for predicting first AED response and seizure recurrence in Selects patients.

Clinical utility of serum tryptase levels in pediatric anaphylaxis.

Introduction: This study aimed to evaluate the preliminary diagnosis, demographic characteristics, and outcomes of patients whose serum total tryptase levels were measured while in a tertiary pediatric hospital and to ascertain the role of serum tryptase levels in the etiology, diagnosis, severity, and course of systemic anaphylaxis. Methods: Patients ages between 1 month and 17 years who were followed up in the pediatric emergency department or as inpatients and with a diagnosis of immediate-type reactions between September 1, 2019, and August 31, 2021, were included in the study. Patient data were obtained retrospectively by examination of medical records and patient observation forms. Results: It was determined that serum tryptase levels were measured in a total of 310 patients during the study period. One hundred and fifty-five patients who met the defined diagnostic criteria were named as the anaphylaxis group and their data were detailed. The serum tryptase elevation was detected in 15.5% of the patients among the samples that met the anaphylaxis diagnostic criteria. No relationship was found between the serum total tryptase levels, the triggering factor, and the severity of anaphylaxis. Discussion: Anaphylaxis is a complex syndrome that involves different phenotypes that develop with various triggers in which different immunologic pathways, cell types, and mediators play a role. Serial measurements, including the basal value measured at least 24 hours after the symptoms disappear, are useful to confirm the diagnosis and guide the diagnostic tests during the follow-up, especially allergy evaluation.

SELEX against whole-cell bacteria resulted in lipopolysaccharide binding aptamers.

Nucleic acid aptamers are target-specific oligonucleotides selected from combinatorial libraries through an iterative in vitro screening process known as Systemic Evolution of Ligands by Exponential Enrichment (SELEX). In this report, the selection of bacteria differentiating ssDNA aptamer candidates from a combinatorial library through the whole-cell SELEX method was performed. The enriched SELEX pool was sequenced using Illumina Next-Generation Sequencing (NGS) technology and analyzed for the most abundant sequences using CLC Genomics Workbench. The sequencing data resulted in several oligonucleotide families from which three individual sequences were chosen per SELEX based on the copy numbers. The binding performance of the selected aptamers was assessed by flow cytometry and fluorescence spectroscopy, and the binding constants were estimated using binding saturation curves. Varying results were obtained from two independent SELEX procedures where the SELEX against the model gram-negative bacterium Escherichia coli provided more selective sequences while the SELEX library used against gram-positive bacterium Listeria monocytogenes did not evolve as expected. The sequences that emerged from E. coli SELEX were shown to bind Lipopolysaccharide residues (LPS) and inhibit LPS-induced macrophage polarization. Thus, it can be said that, performed whole-cell SELEX could be resulted as the selection of aptamers which can bind LPS and inhibit LPS induced inflammation response and thus can be candidates for the inhibition of bacterial infections. In future studies, the selected aptamer sequences could be structurally and chemically modified and exploited as potential diagnostic tools and therapeutic agents as LPS antagonists.

Discrimination of Receptor-Mediated Endocytosis by Surface-Enhanced Raman Scattering.

Cellular energy required for the maintenance of cellular life is stored in the form of adenosine triphosphate (ATP). Understanding cellular mechanisms, including ATP-dependent metabolisms, is crucial for disease diagnosis and treatment, including drug development and investigation of new therapeutic systems. As an ATP-dependent metabolism, endocytosis plays a key role not only in the internalization of molecules but also in processes including cell growth, differentiation, and signaling. To understand cellular mechanisms including endocytosis, many techniques ranging from molecular approaches to spectroscopy are used. Surface-enhanced Raman scattering (SERS) is shown to provide valuable label-free molecular information from living cells. In this study, receptor-mediated endocytosis was investigated with SERS by inhibiting endocytosis with ATP depletion agents: sodium azide (NaN3) and 2-deoxy-d-glucose (dG). Human lung bronchial epithelium (Beas-2b) cells, normal prostate epithelium (PNT1A) cells, and cervical cancer epithelium (HeLa) cells were used as models. First, the effect of NaN3 and dG on the cells were examined through cytotoxicity, apoptosis-necrosis, ATP assay, and uptake inhibition analysis. An attempt to relate the spectral changes in the cellular spectra to the studied cellular events, receptor-mediated endocytosis inhibition, was made. It was found that the effect of two different ATP depletion agents can be discriminated by SERS, and hence receptor-mediated endocytosis can be tracked from single living cells with the technique without using a label and with limited sample preparation.