Comparison of the Outcomes of Anterior Cervical Discectomy and Fusion and Cervical Disc Replacement for Cervical Disc Disease.

OBJECTIVE: To compare the radiological outcome and development of heterotopic ossification (HO) following single-segment anterior cervical discectomy and fusion (ACDF) and cervical disc replacement (CDR) for cervical disc herniation and evaluate their impact on surgical success. STUDY DESIGN: Descriptive comparative study. Place and Duration of the Study: Neurosurgery Department at Bozyaka Education and Research Hospital, Izmir, Turkiye, between January 2020 and June 2022. METHODOLOGY: Patients aged 18-70 years with radicular neck pain unresponsive to conventional medical treatment and an MRI-confirmed diagnosis were included. Patients with osteoporosis (OP) were excluded. Patients were randomised into two treatment groups (ACDF and CDR) and stratified by age and symptom severity. Radiographic assessments and HO classification according to McAfee were performed. RESULTS: Among the included patients, 56 underwent ACDF and 45 underwent CDR. The mean patient age was 48.29 ± 9.530 and 41.84 ± 7.239 years in the ACDF and CDR groups, respectively (p <0.001). The postoperative disc height increased in both groups. The T1 slope was significantly higher preoperatively and in the early postoperative period in the CDR group than in the ACDF group (p = 0.001). HO was graded as 1, 2, 3, and 4 in 28 (27.7%), 6 (5.9%), 7 (6.9%), and 4 (3%) patients, respectively. CONCLUSION: ACDF and CDR provided similar improvements in radiological measurements and pain relief. Although both procedures significantly enhanced the patient's quality of life and disability scores, HO was more prevalent following CDR during long-term follow-up. KEY WORDS: Cervical disc replacement, Anterior cervical discectomy and fusion, Spinal surgery techniques, Heterotopic ossification.

The evaluation of retrobulbar fat tissue in Graves' orbitopathy with shear-wave ultrasound elastography.

PURPOSE: To evaluate retrobulbar adipose tissue of patients with active and inactive Graves' orbitopathy (GO) by shear-wave ultrasound elastography (SWE). METHODS: Followed-up in our ophthalmology clinic due to GO, 72 eyes of 36 patients and 38 eyes of 19 healthy controls were included in this cross-sectional case-control study. Graves' patients were divided into two subgroups under clinical activity score (CAS): active Graves' orbitopathy (AGO) (CAS ≥ 3) and inactive Graves' orbitopathy (IGO) (CAS < 3). SWE measurement values of retrobulbar adipose tissue of all participants were recorded in meters/second, and the intergroup comparisons were performed. RESULTS: Thirty-four eyes of 17 patients in AGO, 38 eyes of 19 patients in IGO, and 38 eyes of 19 participants in the control group were included in the study. Mean values measured from retrobulbar adipose tissue through SWE were 1.00 ± 0.01 m/sec in AGO, 1.16 ± 0.01 m/sec in IGO, and 0.94 ± 0.01 m/sec in the control groups. Even so, the mean SWE value was significantly higher in the IGO group than in the other groups (p < 0.001). Mean SWE values were significantly higher in the AGO group than in the controls (p = 0.008). In the correlation analysis performed, a significant positive correlation was found between SWE and Hertel exophthalmometer measurement values (p = 0.026, r = 0.212), and thyroid-stimulating hormone receptor antibody (TSHR-Ab) levels (p = 0.018, r = 0.224). CONCLUSION: We detected SWE values of retrobulbar adipose tissue high in GO, especially in the IGO group. Such a situation, which we associated with the development of fibrosis, may be an indicator of unresponsiveness to immunomodulatory treatments.

Left and right ventricular function by echocardiography, tissue doppler imaging, carotid intima media thickness, and asymmetric dimethylarginine levels in female adolescents with vitamin D deficiency.

BACKGROUND: The aim of our study was to assess left and right ventricle systolic and diastolic functions in female adolescents with vitamin D deficiency using conventional echocardiography and pulsed-wave tissue Doppler imaging and to investigate carotid intima media thickness and asymmetric dimethylarginine levels. METHODS: Sixty-six female adolescents were enrolled in this study. The female adolescents were divided into a vitamin D deficiency group (n: 34) and a control group (n: 32). All subjects underwent laboratory blood tests, including asymmetric dimethyl arginine, complete two-dimensional, pulse, and tissue Doppler echocardiography, and measurement of the carotid intima-media thickness. RESULTS: The vitamin D-deficient female adolescent group had normal left and right ventricle systolic and diastolic functions and normal global systolic and diastolic myocardial performance. In the patients with vitamin D deficiency, the carotid intima-media thickness was higher than that in the controls. In the patients within the vitamin D deficiency group, vitamin D was found to be positively correlated with magnesium and negatively correlated with phosphorus and left atrial dimension. CONCLUSIONS: The results of this study demonstrate that vitamin D deficiency in female adolescence is associated with normal myocardial geometry and function. Although it has been associated with normal levels of asymmetric dimethyl arginine concentration, high measured carotid intima-media thickness may reflect endothelial dysfunction.

Evaluation of Main Lacrimal Gland through Shear-wave Ultrasound Elastography in Patients with Low Schirmer Value

OBJECTIVE: To compare main lacrimal gland values through shear-wave elastography (SWE) in patients with low Schirmer value and unspecified Sjögren's syndrome (SS) with healthy controls. MATERIAL AND METHOD: Admitted to the ophthalmology department with Schirmer value <10 mm, randomly selected 46 eyes of 46 patients evaluated for Sjögren's syndrome (SS) in the rheumatology department between December 2022 and April 2023 were classified as low Schirmer group (LSG). Randomly selected 48 eyes of 48 patients at a similar age with Schirmer value >10 mm were included as controls. Main lacrimal gland SWE measurements in LSG and control groups were recorded and compared as meter/second (m/sec). RESULTS: Mean SWE values of the main lacrimal gland were measured as 2.78 ± 0.66 m/sec and 2.26 ± 0.29 m/sec in LSG and controls. SWE measurements were significantly higher in LSG patients than in controls (p<0.001). No significant correlation was found in the analysis between the Schirmer and the main lacrimal gland SWE values in LSG patients (p=0.702, r=0.058). No significant correlation was also detected between the Schirmer and main lacrimal gland SWE values in controls (p=0.097, r=0.242). No significant relationship was also found between age, gender, body mass index (BMI), and SWE values (p=0.351, p=0.493, p=0.328, respectively). CONCLUSION: Mean SWE value of the main lacrimal gland was determined as significantly higher in patients with aqueous lacrimal insufficiency without SS than in controls. We consider that SWE measurements may be an imaging method to support the diagnosis of aqueous lacrimal insufficiency and used in follow-ups of those with dry eye syndrome (DES) in the future.

Non-invasive hemoglobin estimation from conjunctival images using deep learning.

Hemoglobin, a crucial protein found in erythrocytes, transports oxygen throughout the body. Deviations from optimal hemoglobin levels in the blood are linked to medical conditions, serving as diagnostic markers for certain diseases. The hemoglobin level is usually measured invasively with different devices using the blood sample. In the physical interpretation, some signs are traditionally used. These signs are the palms, face, nail beds, pallor of the conjunctiva, and palmar wrinkles. Studies have shown that conjunctival pallor can yield more effective results in detecting anemia than the pallor of the palms or nail beds. This study is aimed to predict the hemoglobin level by deep learning method, non-invasive, cheap, fast, high accuracy, and without creating medical waste. In this context, conjunctival images and age, weight, height, gender, and hemoglobin values were collected from 388 people who donated blood to the Turkish Red Crescent. A dataset was generated by augmenting the gathered data with body mass index data. Within the scope of this investigation, the limits of agreement (LoA) value at a 95% confidence interval was computed to be 1.23 g/dL, while the bias was established as 0.26 g/dL. The mean absolute percentage error (MAPE) values were determined to be 3.4%, and the root mean squared error (RMSE) was calculated to be 0.68 g/dL. These findings exhibit a successful outcome compared to similar investigations, signifying that this non-invasive method can be employed for hemoglobin level estimation. Furthermore, the estimated hemoglobin levels could aid in diagnosing several hemoglobin-related ailments.

Prediction of gastric cancer by machine learning integrated with mass spectrometry-based N-glycomics.

Early and accurate diagnosis of gastric cancer is vital for effective and targeted treatment. It is known that glycosylation profiles differ in the cancer tissue development process. This study aimed to profile the N-glycans in gastric cancer tissues to predict gastric cancer using machine learning algorithms. The (glyco-) proteins of formalin-fixed parafilm embedded (FFPE) gastric cancer and adjacent control tissues were extracted by chloroform/methanol extraction after the conventional deparaffinization step. The N-glycans were released and labeled with a 2-amino benzoic (2-AA) tag. The MALDI-MS analysis of the 2-AA labeled N-glycans was performed in negative ionization mode, and fifty-nine N-glycan structures were determined. The relative and analyte areas of the detected N-glycans were extracted from the obtained data. Statistical analyses identified significant expression levels of 14 different N-glycans in gastric cancer tissues. The data were separated based on the physical characteristics of N-glycans and used to test in machine-learning models. It was determined that the multilayer perceptron (MLP) was the most appropriate model with the highest sensitivity, specificity, accuracy, Matthews correlation coefficient, and f1 scores for each dataset. The highest accuracy score (96.0 ± 1.3) was obtained from the whole N-glycans relative area dataset, and the AUC value was determined as 0.98. It was concluded that gastric cancer tissues could be distinguished from adjacent control tissues with high accuracy using mass spectrometry-based N-glycomic data.

Comparison of the Mesiodistal Angulations of Canine and Molar Teeth in Different Types of Orthodontic Malocclusions: A Retrospective Study.

(i) Objective: Changes in the mesiodistal axial angulations of teeth with orthodontic treatment have been a topic of interest in orthodontics for many years, although it has not been clarified enough yet. Therefore, this present study aimed to compare mesiodistal axial angulations of canine and first molar teeth by measuring from pre- and post-treatment panoramic radiographs in different types of orthodontic malocclusions. (ii) Materials and Methods: In the study, the mesiodistal axial angulation angles of the lower-upper canines (teeth numbered 13, 23, 33, and 43) and first molars (teeth numbered 16, 26, 36, and 46) were compared on panoramic radiographs taken pre- (T0) and post- (T1) orthodontic treatment of 353 patients: 237 female (mean age 14.74 ± 2.96) and 116 male (mean age 14.44 ± 2.50), who had not received any prior orthodontic treatment. The groups were formed according to pre-/post-treatment, gender, angle classification, skeletal classification, bilaterally first premolar extraction/non-extraction, and the use/non-use of miniscrews in the extraction cases. The mesiodistal angulations between the long axes of both the lower and upper canines and first molars and the interorbital plane were measured separately and recorded. The reliability analysis between the repeated measurements was evaluated using the intraclass correlation coefficient (ICC). For statistical analysis, a paired sample t-test and Wilcoxon test were used for the normally and non-normally distributed data, respectively. For the between-groups comparison, independent sample t-test and one-way ANOVA were used for normally distributed data, while the Mann-Whitney U and Kruskal-Wallis tests were used for non-normally distributed data. A value of p < 0.05 was considered statistically significant. (iii) Results: ICCs showed excellent reliability, ranging from 0.804 to 0.913 in other teeth, yet were good in tooth 43 (ICC = 0.712). Regardless of the groups, statistically significant differences were found between the T0 and T1 angulations for all teeth, except teeth 13 and 16. In all groups, the increase in the angulations of teeth 33 and 43 and the decrease in the angulations of teeth 36 and 46 (except skeletal class 3) were found to be statistically significant. The T0 and T1 angulation changes in the miniscrews in the used and non-used groups in extraction cases were similar to the differences found in all teeth, regardless of the groups. There was no significant difference between gender, skeletal classes, and angle classes in the amounts of change in the mesiodistal angulations. (iv) Conclusion: It was concluded that orthodontic treatment caused significant changes in the mesiodistal axial angulation of the canine and the first molar teeth. Furthermore, the fact that the angulations tended to increase in the lower canine teeth and decrease in the lower first molar teeth revealed the importance of tooth movement control, especially in orthodontic mechanics in the mandibula.

Nocardia cyriacigeorgica brain abscess with Pemphigus vulgaris: first report.

Nocardia brain abscess is an uncommon but potentially life threatening opportunistic infection that generally occurs in immunocompromised patients. Nocardia cyriacigeorgica is a recently described species rarely reported as a cause of human disease. Pemphigus vulgaris is managed with immunosuppression. There have been four prior reports of brain abscess caused by Nocardia cyriacigeorgica.

Long-term follow-up results of surgically treated patients with foraminal and far lateral disc herniations.

PURPOSE: Foraminal and far lateral disc herniations are rarer cause of nerve root compression. There are reports regarding the outcome, however long-term follow-up results of surgically treated patients are few. The purpose of this retrospective study is to analyze the clinical characteristics and long-term surgical outcomes of the foraminal and far lateral disc herniations. MATERIALS AND METHODS: The 114 patients who underwent an operation for foraminal and far lateral disc herniaitions were reviewed. Visual analogue scale of back and leg pain, the ocurrence of motor deficit and sensory dysesthesia before and after operations were used to compare the results of early and long-term outcome. RESULTS: A total of 114 telephone interviews were conducted. The mean follow up was 134 months. Complete relief of symptoms were reported by 77 patients (67.1%). The average VAS of radicular leg pain was 7.5 Post-operatively the average VAS of radicular pain decreased to 2.2. Preoperatively, 9 patients (7.6%) had motor deficit and 17 (14.4%) patients had sensory dysesthesia. Post-operatively 9 (100%) of the patients showed motor, and 12 (70.6%) of the patients showed sensory improvement. In 17 patients with hypoesthesia the complaints continued during 2 weeks to 6 months. They were given gabapentin as medical treatment, however 5 of these patients still have sensory dysesthesia. The outcome was: 67.1% excellent (77 patients), 26.3% good (30 patients), 6.1% fair (7 patients). CONCLUSION: The far lateral approach is a minimally invasive and safe procedure with low complication rates.

Estimation of biochemical factors affecting survival in intensive care COVID-19 patients undergoing chest CT scoring: A retrospective cross-sectional study.

Coronavirus disease 2019 (COVID-19) is a rapidly spreading deadly respiratory disease that emerged in the city of Wuhan in December 2019. As a result of its rapid and widespread transmission, the WHO declared a pandemic on March 11, 2020 and studies evaluating mortality and prognosis in COVID-19 gained importance. The aim of this study was to determine the factors affecting the survival of COVID-19 patients followed up in a tertiary intensive care unit (ICU) and undergoing chest computed tomography (CT) scoring. This retrospective cross-sectional study was conducted with the approval of Usak University Medical Faculty Ethics Committee between July and September 2020. It included 187 symptomatic patients (67 females, 120 males) with suspected COVID-19 who underwent chest CT scans in the ICU. Demographics, acute physiology and chronic health evaluation (APACHE II), chest CT scores, COVID-19 real-time polymerase chain reaction (RT PCR) results, and laboratory parameters were recorded. SPSS 15.0 for Windows was used for the data analysis. The ages of the patients ranged from 18 to 94 and the mean age was 68.0 ±â€…13.9 years. The COVID-19 RT PCR test was positive in 86 (46.0%) patients and 110 patients (58.8%) died during the follow-up. ICU stay (P = .024) and total invasive mechanical ventilation time (P < .001) were longer and blood urea nitrogen (BUN) was higher (P < .001) in the nonsurvivors. Patients with an APACHE II score of 23 and above had a 1.12-fold higher mortality rate (95% CI 0.061-0.263). There was no significant difference in total chest CT score between the survivors and nonsurvivors (P = .210). Chest CT score was not significantly associated with mortality in COVID-19 patients. Our idea that COVID-19 will cause greater mortality in patients with severe chest CT findings has changed. More studies on COVID-19 are needed to reveal the markers that affect prognosis and mortality in this period when new variants are affecting the world.

A novel combined deep learning methodology to non-invasively estimate hemoglobin levels in blood with high accuracy.

Hemoglobin is an essential protein found in blood and should not fall below a certain level in humans. Today's methods of hemoglobin measurement are mostly invasive. This study aims to perform a non-invasive estimation of hemoglobin levels using age, height, weight, body mass index, gender, and nail images of individuals. Data was collected from 353 volunteers aged 1 to 92 years. Two different data sets were created using these data: a numerical dataset and a nail image set. A combined deep learning model was put forward using both the model created for numerical data and the model created for nail images. In this study, bias was calculated as 0.03 g/dL, and the limits of agreement value in the 95% confidence interval was calculated as 1.09 g/dL. The calculated mean absolute percentage error values were 2.09%, and the root mean squared error was 0.56 g/dL. After entering the necessary data into the system, the estimated average resulting time was 0.09 s. The results of this study have shown success compared to the results of similar studies, and this method can be used for non-invasive hemoglobin level estimation. The recommended approach is more comfortable than invasive methods and gives much faster results.

Effect of Scanned Area and Operator on the Accuracy of Dentate Arch Scans with a Single Implant.

Studies have shown the effect of the operator and scanned areas on the accuracy of single implant scans. However, the knowledge on the scan accuracy of the remaining dental arch during single implant scans, which may affect the occlusion, is limited. The aim of this study was to investigate the effect of scanned areas and the operator on the scan accuracy of a dentate arch while scanning a single implant. A dentate model with an anterior implant was digitized with a laboratory scanner (reference scan). Three operators with similar experience performed 10 complete- and 10 partial-arch scans (left 2nd molar to right canine) with an intraoral scanner (TRIOS 3), and these scans were superimposed over the reference. The accuracy was analyzed at 22 points in complete-arch and at 16 points in partial-arch scans on 2nd molars and incisors. Data were evaluated with 2-way ANOVA and Tukey HSD tests (α = 0.05). The trueness of the total scanned area was higher in partial- than in complete-arch scans (p < 0.001). The trueness and precision of the scans were higher in the anterior site compared with the posterior in complete- (trueness: p ≤ 0.022, precision: p ≤ 0.003) and partial-arch (trueness: p ≤ 0.016, precision: p ≤ 0.016) scans of each operator and when the operator scan data were pooled. The complete-arch scan's precision was not influenced by the operator (p ≥ 0.029), whereas the partial-arch scans of operator 1 and 2 were significantly different (p = 0.036). Trueness was higher in partial- compared with complete-arch scans, but their precision was similar. Accuracy was higher in the anterior site regardless of the scan being a partial- or a complete-arch. The operator's effect on the accuracy of partial- and complete-arch scans was small.

Trueness and precision of combined healing abutment-scan body system depending on the scan pattern and implant location: An in-vitro study.

OBJECTIVE: To test the effect of scan pattern and the location of the implant on the trueness and precision of implant scans when the combined healing abutment-scan body (CHA-SB) system is used. MATERIAL AND METHODS: A partially edentulous maxillary model with CHA-SBs secured on implants at 3 different sites in the left quadrant (central incisor, first premolar, and first molar) was fabricated. The model was scanned with an industrial light scanner to generate a master reference model (MRM) file. An intraoral scanner (TRIOS 3) was used to perform the test scans (n = 8) with 4 different scan patterns (SP1, SP2, SP3, and SP4) with an intraoral scanner. The test scans were superimposed over the MRM file with a metrology software to calculate the distance deviations of the CHA-SB system. Data were analyzed with a 2-way analysis of variance and Tukey's honestly significant difference tests for accuracy (α = .05). RESULTS: Trueness (P = .001) and precision (P = .018) were significantly affected by the interaction between the scan pattern and implant location. The implant located at the central incisor site (56.7 ± 35.9, 36.2 ± 18.6) had higher trueness than that of located at the premolar site (94.1 ± 20.4, 100.3 ± 20) when SP2 (P = .037) and SP4 (P = .002) were used. The implant at the molar site (71.9 ± 25.7, 147.2 ± 49.7) had trueness either similar to (when SP2 was used, P ≥ .276) or lower than (when SP4 was used, P ≤ .024) those of others. Scans of the central incisor and premolar implants had the lowest trueness when scanned with SP1 (P ≤ .009), while the scans of molar implant showed higher trueness when performed by using SP2 and SP3 when compared with SP4 (P ≤ .005). When SP4 was used, the implant at the molar site had lower precision (43 ± 18.9) than the implants located at the central incisor (14.1 ± 11) and premolar sites (15.4 ± 11.3) (P = .002). Scan patterns affected the scan precision of central incisor implant (P = .009), as SP4 (14.1 ± 11) led to a higher precision than SP1 (47.7 ± 27) (P = .006). CONCLUSIONS: The scan accuracy of combined healing abutment-scan body system was affected by scan pattern and implant location. SP1, which involved palatal and rotational scans resulted in the lowest trueness for central incisor and premolar implants, while the scans of the central incisor implant showed the highest trueness among different sites when SP4 was used. However, the scan pattern and implant site had a minor effect on precision. Scan precision at different implant sites only differed when SP4 was used, which resulted in the lowest precision for molar implant.

Association of serum elabela levels with carotid artery stenosis in patients with non-cardioembolic ischemic stroke.

Aim: Elabela (ELA) is a peptide of the apelinergic system and is known to play a role in endothelial homeostasis and vascular pathobiology. In this study, the relationship between carotid artery stenosis, which is the main culprit, and ELA level in patients with non-cardioembolic ischemic stroke was investigated. Materials & methods: Cross-sectional observation included two groups of 40 patients with critical carotid artery stenosis and 40 patients with age-sex matched noncritical carotid artery stenosis. Results: ELA levels were significantly higher in the noncritical stenosis group. ELA had a significantly moderate negative correlation with the carotid score (r = -0.334, p = 0.003), maximal carotid plaque length (r = -0.413, p < 0.001) and degree of stenosis (r = -0.397, p < 0.001). Conclusions: There is a significant inverse correlation between critical carotid artery disease and ELA level in patients with non-cardioembolic ischemic stroke.

Accuracy of Different Complete-Arch Digital Scanning Techniques with a Combined Healing Abutment-Scan Body System.

PURPOSE: Investigate the effects of three different complete-arch digital implant scanning techniques used with a combined healing abutment-scan body (CHA-SB) system on the accuracy (trueness and precision) and scan time. MATERIALS AND METHODS: A poly(methyl methacrylate) master model simulating an edentulous maxilla was fabricated with four parallelly inserted dental implants. A CHA-SB system was attached to each implant. The model surface was scanned using a structured blue light industrial extraoral scanner to achieve a reference model standard tessellation language file (MRM-STL). Three different scanning techniques-(1) conventional technique with unmodified master model, (2) scan body splinting technique using orthodontic elastic ligatures and plastic splint materials, and (3) land-marking technique using pyramid-shaped glass-ceramic markers-were performed. Fourteen consecutive digital scans were made by using an intraoral scanner (IOS) for each technique, converted to an STL file, and superimposed on the MRM-STL. Trueness and precision were calculated for each technique. The scan time was also recorded. The data were analyzed with one-way analysis of variance (ANOVA) and Tukey honest significant difference (HSD) tests (α = .05). RESULTS: Effects of different scanning techniques on the trueness (distance and angular deviations; P < .001) and scan time (P = .002) were statistically significant. For precision, different scanning techniques had only a significant effect on the distance deviation (P < .001). CONCLUSION: Regarding trueness and precision, none of the scanning techniques was superior to others. The scan body splinting technique led to significantly less scan time.

Comparison of fit accuracy between conventional and CAD/CAM-fabricated band-loop space maintainers.

AIM: The aim of this in vitro study was to evaluate the band fit of metallic band-loop space maintainers fabricated by conventional and 3D printing technologies for clinical applications. DESIGN: Sixteen digital intraoral impressions were selected, and resin models were printed with a 3D printer. Forty band-loop space maintainers were fabricated (20 each for both the conventional and digital groups). To evaluate the band fit of conventional and CAD/CAM-fabricated space maintainers, cement space was visualized with low-viscosity condensation silicone material on resin models. Digital evaluation was carried out using dual scan method by superimposing two scans of resin models covered with or without a silicone layer on the abutment tooth. The mean quadratic deviation (root mean square, RMS) was calculated. The RMS values between the groups were evaluated with Student's t test. Statistical significance was set at p < .05. RESULTS: No statistical significance was found between the conventional and digital groups (p = .56). CONCLUSIONS: Within the limitations of this study, the band fit of conventional and CAD/CAM-fabricated space maintainers had no difference. Future research into CAD/CAM-fabricated appliances from different perspectives such as fracture strength and patient comfort is warranted.

Effect of scan pattern on the scan accuracy of a combined healing abutment scan body system.

STATEMENT OF PROBLEM: A recently introduced scan body combined with a contoured healing abutment enables digital scans of the implant while its healing abutment shapes the soft tissue for an appropriate emergence profile. However, information on the effect of different scan patterns on the scan accuracy of this new system is lacking. PURPOSE: The purpose of this in vitro study was to evaluate the effect of scan pattern on the accuracy of digital implant scans by using a combined healing abutment-scan body system. MATERIAL AND METHODS: A combined healing abutment-scan body system was secured on a single implant at the right first molar site in a dentate mandibular model. A master reference model was generated by scanning the model with an industrial light scanner. The model was then scanned with 4 different scan patterns (SP-A, SP-B, SP-C, and SP-D) by using an intraoral scanner (TRIOS 3). Test scans (n=8) were superimposed over the master reference model by using a metrology software, and distance and angular deviations were calculated. Distance and angular deviation data were analyzed with a multivariate analysis of variance and the Tukey honestly significant difference tests for trueness and precision (α=.05). RESULTS: Distance deviations (trueness [P=.461] and precision [P=.533] deviations) in the scans were not significantly affected by the scan pattern. Scan pattern affected the trueness (P=.001) and precision (P=.002) when angular deviations were considered. In terms of trueness, SP-D resulted in the highest angular deviations in scans (P≤.031), while the difference in deviations in scans obtained by using other scan patterns was not significant (P≥.378). When angular deviation data were considered, SP-D resulted in lower scan precision than SP-A (P=.014) and SP-B (P=.007). The precision of scans using SP-C was similar to the precision of the scans made by using other scan patterns (P≥.055) in terms of angular deviations. CONCLUSIONS: The scan accuracy of a combined healing abutment-scan body system was affected by the scan pattern. The scans performed with SP-D presented the lowest accuracy considering the angular deviation data and, therefore, may be the least favored among the patterns tested for scanning a combined healing abutment-scan body system.

Investigating the effect of bruxism on maxillary arch length and width in children using three-dimensional digital model analysis.

BACKGROUND: Bruxism is defined as repetitive jaw-muscle activity characterized by the grinding and clenching of teeth. The prevalence of bruxism in children is extensive, and it can cause irregularities in dental arches. The study aimed to investigate the presence of any effects of bruxism on maxillary arch length and width in children using three-dimensional (3D) digital model analysis. METHOD: This study evaluated 30 children with bruxism. For every child with bruxism, a case control without bruxism was selected and matched for gender, age, and dentition. Digital models of the patients' maxilla were obtained with a 3D intraoral scanner, and width and length measurements between the reference points on the maxilla were obtained on the digital models. RESULTS: The mean age of the study group was 9.13 ± 1.27. Insignificance differences were found between females and males within and between groups in terms of maxillary width and length. Insignificant difference was found between the control and study groups when the lengths of 3R-3L, 4R-4L, 5R-5L, 6R-6L, and IP-M were compared (p > 0.05). CONCLUSION: Based on the study results, there were no differences in the maxillary arch length and width in patients with bruxism and patients without bruxism.

Parapharyngeal prestyloid vagal paraganglioma.

Vagal paragangliomas (VPs) are rare tumors arising from paraganglionic tissue within the vagal nerve's perineurium. Usually, benign vascular tumors, VPs tend to invade the surrounding structures. Herein, we report the case of a VP presenting as a neck mass, which was evaluated as a glomus caroticum tumor preoperatively. A 65-year-old female complaining of a left-sided neck mass and intermittent hoarseness was assessed and operated on for possible glomus caroticum tumor. During the tumor excision, the vagal nerve was also involved, and hence, sacrificed. Histopathological examination revealed an encapsulated tumor associated with a nerve and ganglion and immunohistochemical staining tested positive for succinate dehydrogenase, confirming the diagnosis of VP. Postoperative residual hoarseness was corrected by vocal rehabilitation. While evaluating a retropharyngeal prestyloid neck mass, a VP should always be considered. Surgical excision involving vagal scarification, followed by vocal rehabilitation may be the appropriate treatment strategy.