The accuracy of Cameriere methods in Turkish children: chronological age estimation using developing teeth and carpals and epiphyses of the ulna and radius.

The aim of the present study was to develop a specific formula by measuring the developing teeth, carpal bones, and epiphyses of the ulna and radius to determine the chronological age in Turkish children. The left developing permanent mandibular teeth were evaluated, and the number of teeth with closed apex was recorded. The distance between the inner sides of open apex/apices was measured by using the ImageJ program and divided by the tooth length. The sum of the normalized open apices was also calculated. The carpal area (Ca), covering the epiphyses of ulna and radius and the carpal bones, was measured on the X-rays of left hand. The areas of each carpal bone and epiphyses of the ulna and radius were measured, and these measurements were added together to obtain the bone area (Bo). The Bo/Ca ratio between the total area of carpal bones and the carpal area was calculated to normalize the measurements. The accuracy of the equations formulated by Cameriere was evaluated, and a new regression equation was developed accordingly. The new formula showed no statistically significant difference between the chronological and the estimated age for females, males, and total sample. The new formula, which hit the age with 72.80% accuracy, was more successful in predicting chronological age than other adjusted regression equations. The new regression model, created for the Turkish children by using both developing teeth and hand-wrist bones, was considerably successful in estimating the chronological age.

Preliminary data on clinical performance of bulk-fill restorations in primary molars.

CONTEXT: In pediatric clinic practice, bulk fill composite is gaining importance for shortened clinical time with a limited shrinkage. AIMS: The present study evaluated the 1 year clinical performance of bulk fill composite and conventional composite material in occlusal caries of primary molars. SETTINGS AND DESIGN: The study was designed as randomized single blind clinical trial and a total of 160 restorations were placed in the cavities of the 80 patients. MATERIALS AND METHODS: Each patient received two restorations: one with Filtek Z250 (3M ESPE, St Paul, MN 55144, USA); the other restored with Filtek Bulk-Fill Restorative (FBF) (3M ESPE, St Paul, MN, USA). All restorations were clinically evaluated after baseline, 6 months, and 1 year in terms of retention, color matching, marginal discoloration, marginal adaptation, secondary caries, surface texture, anatomic form, and postoperative sensitivity. STATISTICAL ANALYSIS USED: Besides the descriptive statistical methods, the Friedman test and the Wilcoxon Signed Ranks were used. RESULTS: Bulk fill was found to be worse compared to control with regard to postoperative sensitivity at baseline without statistical significance (P > 0.05). All of the evaluated restorations were retained and were still in function after 1 year (P > 0.05). With respect to marginal discoloration and marginal integrity, there were no significant differences between bulk fill and composite restorations at all intervals (P > 0.05). CONCLUSIONS: Based on this short term data, restoration of Class I cavities with both bulk fill and conventional composite restorations can be performed successfully. Postoperative sensitivity can be an issue with the restorations completed with Bulk fill restorative.

Dental anxiety and oral health-related quality of life in children following dental rehabilitation under general anesthesia or intravenous sedation: A prospective cross-sectional study.

PURPOSE: The study aimed to investigate dental anxiety and oral health-related quality of life among children undergoing dental rehabilitation under general anesthesia (GA) and intravenous sedation (IVS). MATERIALS AND METHODS: Participants were 99 healthy children aged 3-5 or 6-12 years operated under GA or IVS. Dental anxiety before treatment and 1 month postoperatively were measured using the Frankl behavior scale (FBS), the venham picture test (VPT), the early childhood oral health impact scale (ECOHIS), and the children's fear survey schedule-dental subscale (CFSS-DS). Data were analyzed using Student's t-test and Mann-Whitney U-test. RESULTS: ECOHIS scores decreased in all groups. VPT scores increased in the 3-5-year-olds treated under GA (P = 0.003). Postoperative CFSS-DS anxiety scores were lower in IVS groups. FBS scores were significantly higher for both age groups (P < 0.001). There was no effect of numbers of extracted or treated teeth. CONCLUSIONS: Dental rehabilitation under GA and IVS improved the quality of life and dental behavior. In the 6-12-year-olds, there was no statistically significant difference between children undergoing dental operations under GA and those undergoing dental operations under IVS. Dental anxiety decreased in 3-5-year-olds after treatment under GA but not after IVS.

Effect of Biodentine on secondary caries formation: An in vitro study.

PURPOSE: To compare the effects of two materials, Biodentine and conventional glass-ionomer cement (CGIC), on secondary caries formation around restorations when used as a dentin replacement material. METHODS: 30 approximal cavities were prepared on mesial and distal surfaces of 15 caries-free human premolar teeth extracted for orthodontic or periodontal reasons. Cavities were filled with A: Biodentine as a base + Filtek Z250 composite (n = 15) or B: CGIC as a base + Filtek Z250 composite (n = 15). The materials were applied according to the manufacturers' instructions. Teeth were thermocycled, and placed in a demineralizing solution for 5 weeks. Secondary caries formation was assessed using the International Caries Detection and Assessment System (ICDAS) II and quantitative computer- aided image measurement of caries depth. RESULTS: The computer-aided measurements showed that the Biodentine group had significantly lower lesion depth measurements than the CGIC group (P = 0.004). However, there was no significant difference among the groups based on the ICDAS II scores (P > 0.05).

The effect of temperature and contact time of sodium hypochlorite on human roots infected with Enterococcus faecalis and Candida albicans.

The aim of this study was to evaluate the effectiveness of 2.5 % NaOCl at different temperature and time intervals on Enterococcus faecalis and Candida albicans-infected human roots. A total of 112 root cylinders prepared from extracted single-rooted humans were infected by E. faecalis (Group A, n = 56) or C. albicans (Group B, n = 56); 3 root cylinders served as negative controls. Both groups were further divided into 6 subgroups according to three contact times (30 s, 1 min, 5 min) with NaOCl at two different temperatures (25 or 37 °C). Microorganism growth was controlled at the 24th and 48th hours. Statistical analysis was performed using the Chi-square test. While NaOCl at 25 °C for 5 min was the most effective irrigation regimen to eliminate E. faecalis (p < 0.001), NaOCl at 37 °C for 5 min exhibited significantly superior antifungal properties (p < 0.05). At the same contact times, difference in the temperature of NaOCl did not affect the growth of either E. faecalis or C. albicans. As a result, the irrigation time of NaOCl was more effective than the temperature to eliminate E. faecalis, while pre-heating of NaOCl to 37 °C increased its effectiveness on C. albicans at 5 min contact time.

Otodental syndrome: a case presentation in a 6-year old child.

BACKGROUND: Otodental syndrome is a rare condition characterised by globodontia, and sensorineural high frequency hearing loss. To date, only 20 cases of otodental syndrome have been reported. CASE REPORT: A 6 year-old girl presented with a chief complaint of delay in the eruption of primary canines. Following clinical, radiographic and audiologic evaluations, the patient was diagnosed with otodental syndrome. CONCLUSION: Globodontia is a diagnostic feature of the otodental syndrome, which often provides the path to discovery of the associated hearing loss. Missing teeth, arch-size discrepancies, chewing problems and teething disturbances are the other major complications.

Effect of two anti-erosion pastes on surface roughness of different restorative materials.

AIM: The aim of this study was to investigate the effect of two antierosive pastes, Pronamel and Tooth Mousse Plus, on surface roughness of two composite (Filtek Supreme Ultra Universal Restorative and TPH Spectrum Restorative), one compomer (Dyract Extra), and two conventional glass ionomer restorative materials (Ionofil U and SDI) MATERIALS AND METHODS STUDY DESIGN: 14 discs (10 mm diameter x 2 mm thickness) were prepared for each material (n =14 x 5). The discs were randomly divided into two groups to receive either GC Tooth Mousse Plus application or Sensodyne Pronamel application with toothbrush. The surface roughness of the brushed samples were recorded by laser profilometer. STATISTICS Wilcoxon, Kruskal Wallis test and multiple comparison tests were used to analyse the data. RESULTS: It was revealed that the surface roughness of the Filtek Supreme, TPH, Dyract and Riva Selfcure materials were not affected from application of either pastes (p>0.005). However, surface roughness of manually mixed glass ionomer (Ionofil U) was significantly increased when brushed with both Tooth Mousse and Pronamel paste (p<0.001). CONCLUSION: Neither Pronamel, nor Tooth Mousse caused a significant change on the surface roughness of tested restorative materials except Ionofil U. It was significantly increased following brushing with either paste.

Effect of laser and air abrasion pretreatment on the microleakage of a fissure sealant applied with conventional and self etch adhesives.

AIM: The purpose of this study was to investigate the effects of different pretreatment protocols along with different bonding agents on the microleakage of a fissure sealant material. METHOD: A total of 144 freshly extracted noncarious human third molars were used The teeth were randomly assigned into three groups with respect to the pretreatment protocol employed: A. Air Abrasion B. Er,Cr:YSGG laser C. No pretreatment (Control). In each group specimens were further subjected to one of the following procedures before application of the sealant: 1. %36 Phosphoric acid-etch (AE) (DeTrey Conditioner 36/Denstply, UK) 2.AE+Prime&Bond NT (Dentsply, UK) 3. Clearfil S3 Bond (Kuraray, Japan) 4. Clearfil SE Bond (Kuraray, Japan). All teeth were sealed with the same fissure sealant material (Conseal F/SDI, Australia). Sealed teeth were further subjected to thermocycling, dye penetration test, sectioning and quantitative image analysis. Statistical evaluation of the microleakage data was performed with two way independent ANOVA and multiple comparisons test at p = 0.05. For qualitative evaluation 2 samples from each group were examined under Scanning Electron Microscopy. RESULTS: Microleakage was affected by both the type of pretreatment and the subsequent bonding protocols employed (p < 0.05). Overall, the highest (Mean = 0.36 mm) and lowest (Mean = 0.06 mm) microleakage values were observed in samples with unpretreated enamel sealed by S3+Conseal F and samples with laser pretreated enamel sealed by Acid Etch+Prime&-Bond+Conseal F protocols, respectively (p < 0.05). In the acid-etch group samples pretreated with laser yielded in slightly lower microleakage scores when compared with unpretreated samples and samples pretreated with air abrasion but the statistical significance was not important (p = 0,179). Similarly, when bonding agent is applied following acid-etching procedure, microleakage scores were not affected from pretreatment protocol (p = 0,615) (intact enamel/laser or air-abrasion). For both all-in one and two step self etch adhesive systems, unpretreated samples demonstrated the highest microleakage scores. CONCLUSIONS: For the groups in which bonding agent was utilized, pretreatments did not effected microleakage. Both the tested pretreatment protocols and adhesive procedures had different effects on the sealing properties of Conseal F in permanent tooth enamel.

A comparative study of qualitative and quantitative methods for the assessment of adhesive remnant after bracket debonding.

The amount of the residual adhesive after bracket debonding is frequently assessed in a qualitative manner, utilizing the adhesive remnant index (ARI). This study aimed to investigate whether quantitative assessment of the adhesive remnant yields more precise results compared to qualitative methods utilizing the 4- and 5-point ARI scales. Twenty debonded brackets were selected. Evaluation and scoring of the adhesive remnant on bracket bases were made consecutively using: 1. qualitative assessment (visual scoring) and 2. quantitative measurement (image analysis) on digital photographs. Image analysis was made on scanning electron micrographs (SEM) and high-precision elemental maps of the adhesive remnant as determined by energy dispersed X-ray spectrometry. Evaluations were made in accordance with the original 4-point and the modified 5-point ARI scales. Intra-class correlation coefficients (ICCs) were calculated, and the data were evaluated using Friedman test followed by Wilcoxon signed ranks test with Bonferroni correction. ICC statistics indicated high levels of agreement for qualitative visual scoring among examiners. The 4-point ARI scale was compliant with the SEM assessments but indicated significantly less adhesive remnant compared to the results of quantitative elemental mapping. When the 5-point scale was used, both quantitative techniques yielded similar results with those obtained qualitatively. These results indicate that qualitative visual scoring using the ARI is capable of generating similar results with those assessed by quantitative image analysis techniques. In particular, visual scoring with the 5-point ARI scale can yield similar results with both the SEM analysis and elemental mapping.

Effect of ozone pretreatment on the microleakage of pit and fissure sealants.

OBJECTIVE: This study investigated the effect of ozone pretreatment on the microleakage and marginal integrity of pit and fissure sealants placed with or without a self-etch 6th generation adhesive. STUDY DESIGN: Freshly-extracted, human third molars were randomly assigned into two main groups (n = 48): Group A: Fissures were pretreated with ozone; Group B: Fissures were left untreated. The teeth were further randomly divided into two subgroups (n = 24/each) so that half of teeth were sealed with a conventional fissure sealant (Fissurit F, Voco, Germany), while the remaining half received the same sealant bonded with a self-etch adhesive (Clearfil Protect Bond, Kuraray, Japan). Following thermal cycling (1000X), the specimens were subjected to dye penetration within 0.5% basic fuchsin for 24h. The extent of dye penetration was measured by image analysis. Kruskal Wallis and Mann-Whitney U tests were used for statistical analysis of the data (p = 0.05). Two randomly-selected sections from each group were observed under SEM RESULTS: In all groups, ozone pretreatment significantly reduced the extent of microleakage (p < 0.001). SEM investigation demonstrated better adaptation of the sealants in ozone-pretreated groups. Clearfil Protect Bond did not improve the marginal seal of Fissurit F (p > 0.05). CONCLUSION: Ozone pretreatment favorably affected the marginal sealing ability of the tested fissure sealants.

Do really parents brush their children's teeth better?

AIM: Plaque removal from first permanent molar teeth was evaluated when conventional and a new silicone tooth and gum brush was used. Also, the effectiveness of parents' brushing was compared with childrens'. MATERIALS AND METHODS: Study design: This crossover clinical study was conducted with 9 children aged 5 to 7 years, with 18 mandibular first permanent molar teeth which were partially erupted. Four appointments were planned at one-week intervals and at every appointment, dental plaque on teeth was disclosed first. At their first appointment, the children were given a conventional toothbrush, and at their second appointment they were given a silicone tooth andgum brush . Then, at the third appointment, parents performed brushing with a conventional toothbrush, and then brushed with a silicone tooth & gum brush at the fourth appointment. Before and after brushing, photographs were taken for baseline and final plaque scores to determine Occlusal Plaque Index with Image Analysis Software Program. STATISTICS: Anova was used for comparison of groups with p<0.05 considered to be significant. RESULTS: There was statistically significant difference between baseline and final plaque scores among all of the groups (p<0.05) but, there was not statistically significant difference between the groups (p>0.05). CONCLUSIONS: Children under the age of nine are usually believed to lack the developmental skills needed to brush their own teeth, and as a result, the silicone tooth & gum brush might be recommended instead of brushing with parents.

In vitro evaluation of casein phosphopeptide-amorphous calcium phosphate as a potential tooth transport medium: viability and apoptosis in L929 fibroblasts.

Casein phosphopeptides (CPP) are derived from casein, which accounts for 80% of the total protein in bovine milk . The purpose of this in vitro study was to evaluate the potential use of a CPP-amorphous calcium phosphate (CPP-ACP) preparation as a transport medium for avulsed teeth. L929 fibroblastic cell line was plated in 24-well culture plates. Following incubation, the cells were treated with 10(-3), 10(-4), 10(-6), 10(-8), 10(-12) dilutions of a water-based CPP-ACP paste (Tooth Mousse, GC Corp., Tokyo, Japan). Untreated cells served as controls. The L929 cells were counted at the 1st, 3rd and 7th days. Propidium iodide/acridine orange staining was used to assess apoptosis of treated cells and of the positive control. For each concentration (dilution), statistical analysis of cell survival within time was performed using two-way analysis of variance (ANOVA, P = 0.05). One way ANOVA and Tukey tests were applied to compare the effect of different concentrations on cell survival at each evaluation day (P = 0.05). Except for the 10(-3) and 10(-4) dilutions, all groups demonstrated an increase in cell numbers at days 1 and 3, followed by a decrease at day 7. Irrespective of the increase or decrease in cell viability, time-dependent changes for each dilution group were significantly different. Cells in the 10(-3) and 10(-4) dilution groups demonstrated a rapid apoptotic response. A relatively few number of apoptotic cells were observed in the 10(-6) and 10(-8) dilution groups, while no sign of apoptosis was evident in the 10(-12) dilution group and control. These results suggest that when highly diluted, the tested CPP-ACP preparation may help preserve L929 cell viability in the short term without inducing apoptosis.

Microleakage of self-etch primer/adhesives in endodontically treated teeth.

BACKGROUND: The authors evaluated the coronal marginal leakage of endodontically treated teeth bonded with four self-etching adhesives and one total-etch adhesive system. MATERIALS AND METHODS: The investigators prepared Class II cavities in 60 extracted human premolars. They performed conventional endodontic therapy using a resin-based sealer and gutta-percha points. They randomly assigned each tooth to a group receiving one of the following adhesives: Adper Prompt L-Pop (3M ESPE, Seefeld, Germany), Clearfil SE Bond (Kuraray, Osaka, Japan), FL Bond (Shofu, Kyoto, Japan), Single Bond (3M ESPE) or Xeno III (Dentsply De Trey, Konstanz, Germany). They restored all teeth with resin-based composite material (Z250, 3M ESPE). Specimens underwent thermocycling and dye penetration and were sectioned longitudinally. The authors photographed the sections under a stereomicroscope. They transferred the images to an IBM-compatible personal computer for quantitative assessment of dye penetration using image analysis software. They analyzed data by means of Kruskal-Wallis and Mann-Whitney U tests (P = .05) and evaluated two specimens from each group under scanning electron microscopy. RESULTS: None of the tested self-etch adhesives completely eliminated microleakage. Dye leakage was restricted to the coronal cavity walls; it did not migrate toward the pulp chamber or toward the root canal. Single Bond and Clearfil SE Bond showed significantly lower dye penetration values at occlusal and gingival margins. CONCLUSIONS: The coronal sealing performance of the tested self-etch adhesive systems in endodontically treated teeth was material-dependent. The use of Clearfil SE Bond in such teeth can help achieve a marginal seal comparable to that achieved with Single Bond.

Er,Cr:YSGG laser pretreatment of primary teeth for bonded fissure sealant application: a quantitative microleakage study.

PURPOSE: Laser pretreatment of dental hard tissues prior to preventive or restorative procedures has been a subject of research. Unground primary enamel bears a prismless superficial layer which is known to be acid resistant. This in vitro study was conducted in order to evaluate the potential use of Er,Cr:YSGG laser in the pretreatment of occlusal surfaces of primary teeth prior to bonded fissure sealant application. MATERIALS AND METHODS: Occlusal surfaces of human primary mandibular molars were used (n =140). After pretreatment with Er,Cr:YSGG laser (group A) or not (group B), occlusal fissures were treated with one of the following in each of 7 subgroups (n = 10): 1. phosphoric acid-etch only; 2. Clearfil SE Bond; 3. FL Bond; 4. Adper Prompt L-Pop; 5. NRC+Prime & Bond NT; 6. One-Up Bond F; 7. Xeno III. All teeth were sealed with Fissurit F. The specimens were thermocycled (1000 times) and stored thereafter in distilled water at 37 degrees C for 8 months. Following immersion in 0.5% basic fuchsin solution, three bucco-lingual sections were made from each tooth. They were digitally photographed and the extent of dye penetration along the enamel-sealant interface was measured (in mm) with image analysis software. RESULTS: There was no difference between the Er,Cr:YSGG laser pretreated group (group A) and the nonlased grou (group B) (p > 0.05). The lowest microleakage values were observed in subgroups A1 and B1. Within the laser pretreated group, subgroups A1, A4, and A5 showed lower microleakage scores when compared to subgroups A2, A3, A6, and A7 (p < 0.05). As for the nonlased group, subgroups B1, B3, B4, and B5 demonstrated significantly lower microleakage scores than subgroups B2, B6, and B7 (p < 0.05). CONCLUSION: Er,Cr:YSGG laser pretreatment was not found to influence the resistance to microleakage of bonded fissure sealant application in primary teeth.

Qualitative and quantitative evaluation of enamel after various stripping methods.

INTRODUCTION: In this study, we investigated ultramorphology, surface roughness, and microhardness of permanent and deciduous tooth enamel after various stripping methods. METHODS: One hundred twenty deciduous and permanent teeth (n = 60 each) were used. Qualitative (scanning electron microscopy) and quantitative (surface roughness and microhardness tests) experiments were carried out in the following experimental groups: group 1, stripping disk; group 2, diamond-coated metal strip; group 3, stripping disk and Sof-Lex discs (3M-ESPE, Seefeld, Germany); group 4, diamond-coated metal strip and Sof-Lex discs; group 5 (chemical stripping), 37% orthophosphoric acid in conjunction with diamond-coated metal strip; group 6 (control), no stripping. Surface roughness values (Ra) for permanent and deciduous enamel were evaluated with Welch analysis of variance (ANOVA) and Tamhane tests, and Kruskal-Wallis and Mann-Whitney tests, respectively. Microhardness values were evaluated statistically with Kruskal-Wallis, 1-way ANOVA, and Duncan tests. RESULTS: Deciduous and permanent teeth showed similar results in terms of surface roughness and surface morphology. Groups 3 and 4 had the smoothest deciduous and permanent enamel surfaces, whereas chemical stripping (group 5) produced the roughest surfaces in both enamel types. Stripping did not lead to a significant change in the microhardness of permanent enamel. CONCLUSIONS: All stripping methods significantly roughened the enamel surfaces. Polishing the stripped surface with Sof-Lex discs decreased the roughness.

Accuracy of the third molar index for assessing the legal majority of 18 years in Turkish population.

In the last few years, forced and unregistered child marriage has widely increased into Turkey. The aim of this study was to test the accuracy of cut-off value of 0.08 by measurement of third molar index (I3M) in assessing legal adult age of 18 years. Digital panoramic images of 293 Turkish children and young adults (165 girls and 128 boys), aged between 14 and 22 years, were analysed. Age distribution gradually decreases as I3M increases in both girls and boys. For girls, the sensitivity was 85.9% (95% CI 77.1-92.8%) and specificity was 100%. The proportion of correctly classified individuals was 92.7%. For boys, the sensitivity was 94.6% (95% CI 88.1-99.8%) and specificity was 100%. The proportion of correctly classified individuals was 97.6%. The cut-off value of 0.08 is a useful method to assess if a subject is older than 18 years of age or not.

The reliability of Cameriere's method in Turkish children: a preliminary report.

Dental age estimation in children is an important issue both legally and medically. Currently, however, there is a lack of contemporary dental age estimation standards for a Turkish population. This study assessed the accuracy of Cameriere's method by examining the panoramic radiographs of 573 healthy Turkish children between the ages of 8 and 15 years. Radiographs of the left permanent developing mandibular teeth, except wisdom teeth, were evaluated. All subjects were divided into 7 groups according to their chronological age. The Intra-class Correlation Coefficient was used to determine the intra- and inter-observer agreement error. A comparison of the distributions of estimation errors among age groups was performed using the Nemenyi test. There were no significant differences between inter-observer (p=0.352), and intra-observer readings after 2 weeks (p=0.275 and p=0.273, respectively). The dental age was underestimated when using Cameriere's method with a mean difference of -0.35 years (-0.24 years for girls and -0.47 years for boys). The median values of the differences between dental and chronological age were -0.44 years in boys (range: -3.70, 4.06) and -0.21 years in girls (range: -2.74, 3.29). In addition, the differences between dental and chronological ages in the different age groups decreased with increasing chronological age. Results from the Nemenyi test implied that Cameriere's method is more accurate for girls than for boys in this cohort of a Turkish population.

Prevalence and predictors of atrial fibrillation in rheumatic valvular heart disease.

The highest frequency of AF in RHD occurs in those with mitral stenosis, mitral regurgitation, and tricuspid regurgitation in combination. AF, while occurring in 29% of patients with isolated mitral stenosis and in 16% with isolated mitral regurgitation, is an infrequent finding (1%) in patients with aortic valvular disease. Left atrial diameter by univariate analysis, and age and left atrial diameter by multivariate analysis have been shown to be the most important parameters to determine the occurrence of AF in patients with RHD.

Predictors of left ventricular thrombus formation in patients with anterior myocardial infarction: role of activated protein C resistance.

BACKGROUND: Left ventricular mural thrombus formation is a well-recognised consequence of acute anterior myocardial infarction. The vast majority of left ventricular thromboses occur in patients with anterior myocardial infarction and depressed left ventricular function. OBJECTIVE: To evaluate the factors predicting left ventricular thrombus formation in patients similar for left ventricular function and left ventricular score indexes. METHODS: We evaluated 45 consecutive patients who met the inclusion criteria of anterior myocardial infarction resulting in apical, anterior or septal asynergy (akinesia, dyskinesia), without non-Q-wave myocardial infarction, dilated cardiomyopathy, or renal or hepatic dysfunction. Patients were divided into two groups: group I with, and group II without, left ventricular mural thrombus. The groups were compared for clinical, echocardiographic and hematologic parameters (activated protein C resistance (APC-R), protein S and antithrombin III). RESULTS: Smoking and ACP-R were significantly greater in group I than in group II (P < 0.05 and P < 0.005 respectively). Multivariate regression analysis showed that APC-R was an independent risk factor for left ventricular thrombus formation in the patient group selected. Antithrombin III and protein S concentrations were not statistically different between two groups. All other clinical and echocardiographic characteristics of the patients were similar in both groups. CONCLUSION: APC-R is an independent risk factor for left ventricular thrombosis in patients with anterior myocardial infarction resulting in septal or anterior and apical akinesia or dyskinesia.