Optical properties of contemporary monolithic CAD-CAM restorative materials at different thicknesses.

OBJECTIVE: This study evaluated the optical properties of contemporary monolithic CAD-CAM materials with different chemical compositions. MATERIALS AND METHODS: Totally, 210 rectangular-shaped, A2 shade specimens (12 × 14 mm) were fabricated from VITA Suprinity T, VITA Enamic T, VITA Mark II, GC Cerasmart LT, Lava Ultimate LT, IPS e.max CAD LT and Prettau Anterior blocks and polished to thicknesses of 0.5 ± 0.01 and 1.0 ± 0.01 mm (n = 15 each material). A dental spectrophotometer (VITA Easyshade Compact) was used to calculate the translucency parameter (TP) and opalescence parameter (OP) values of all tested materials. Statistical analysis was performed using one-way analysis of variance, multiple comparison Tukey's test and independent samples t-test (P = .05). RESULTS: In the 0.5-mm thickness group, GC Cerasmart and Prettau Anterior had the highest and lowest translucency values, respectively. VITA Suprinity had the highest OP value, whereas VITA Mark II and Prettau Anterior had the lowest OP values. In the 1.0-mm thickness group, GC Cerasmart and Lava Ultimate had the highest translucency, whereas Prettau Anterior had the lowest translucency. VITA Suprinity and Prettau Anterior had the highest and lowest OP values, respectively. CONCLUSIONS: The optical properties of monolithic restorative materials were influenced by the type and thickness of the material used. CLINICAL SIGNIFICANCE: According to the results of this study, monolithic materials with different chemical compositions have revealed different optical properties. To obtain esthetic restorations and provide shade matching with natural dentition especially for anterior teeth, monolithic materials should be carefully chosen.

Evaluation of female athlete triad and gynecological complaints in young Turkish female athletes.

PURPOSE: Female athlete triad (FAT) is a serious healthcare concern in the young female population. The aim of this study was to determine the prevalence and clinical characteristics of FAT and its relationship with gynecologic complaints of young Turkish female athletes. MATERIALS AND METHODS: This was a cross-sectional survey and included 87 female athletes involved in a variety of sports as a case group and 85 sedentary female university students from Ege and Celal Bayar Universities. All subjects completed a questionnaire consisting of 32 separate questions assessing eating behavior, menstrual status, gynecologic and systemic complaints, psychological problems, and sexual history. SPSS 21.0 was used for statistical analysis. RESULTS: This survey involved 172 females in between to 30 years of age. The age of menarche was found to be significantly lower in the sedentary group (p = 0.00). Late menstruation and oligoamenorrhea were notable complaints among the athletes, and body mass index (BMI) was found to be statistically lower in the athletic group (p = 0.00). Cold hands and hair loss were seen more often in the sedentary group compared to the athletic group (p < 0.05). According to a logistic regression analysis, independent variables (BMI, menstrual status, and bone fractures) were found to be statistically insignificant (p > 0.05). CONCLUSIONS: Excessive sports activity can be hazardous in young female population. Lower BMI might be related to menstrual irregularity. Young female population should be informed about this relationship, especially athletes who are particularly at risk. Certain precautions should be taken into consideration in this population in order to get benefits of sports activity.

Evaluation of marginal/internal fit of chrome-cobalt crowns: Direct laser metal sintering versus computer-aided design and computer-aided manufacturing.

BACKGROUND AND PURPOSE: The purpose of this study was to evaluate the internal and marginal fit of chrome cobalt (Co-Cr) crowns were fabricated with laser sintering, computer-aided design (CAD) and computer-aided manufacturing, and conventional methods. MATERIALS AND METHODS: Polyamide master and working models were designed and fabricated. The models were initially designed with a software application for three-dimensional (3D) CAD (Maya, Autodesk Inc.). All models were fabricated models were produced by a 3D printer (EOSINT P380 SLS, EOS). 128 1-unit Co-Cr fixed dental prostheses were fabricated with four different techniques: Conventional lost wax method, milled wax with lost-wax method (MWLW), direct laser metal sintering (DLMS), and milled Co-Cr (MCo-Cr). The cement film thickness of the marginal and internal gaps was measured by an observer using a stereomicroscope after taking digital photos in ×24. RESULTS: Best fit rates according to mean and standard deviations of all measurements was in DLMS both in premolar (65.84) and molar (58.38) models in µm. A significant difference was found DLMS and the rest of fabrication techniques (P < 0.05). No significant difference was found between MCo-CR and MWLW in all fabrication techniques both in premolar and molar models (P > 0.05). CONCLUSION: DMLS was best fitting fabrication techniques for single crown based on the results.The best fit was found in marginal; the larger gap was found in occlusal.All groups were within the clinically acceptable misfit range.

Marginal bone loss of two implant systems with three different superstructure materials: a randomised clinical trial.

Marginal bone level is a criterion for implant success. The aetiological factors of bone loss have not been clarified. The aim of this study was to evaluate the influence of implant systems and prosthetic materials on the marginal bone loss. Twenty-three patients participated; two implant systems and three superstructure materials were used in this study. Twenty-two of the implants were restored with porcelain fused to base metal alloy (BMA), 25 with porcelain fused to noble metal alloy (NMA) and 20 with zirconium oxide-based ceramics. Radiographs were taken at baseline and 3, 6 and 12 months after loading. Crestal bone-level changes were assessed with digital subtraction radiographs. The effects of superstructure materials and implants were evaluated with one-way anova and independent samples t-test, respectively (α = 0·05). The mean crestal bone loss was found 0·483 mm in 3 months, 0·622 mm in 6 months and 0·816 mm in 12 months. Prosthetic materials were found to have greater effect (ß = 0·575, P = 0·015) on crestal bone loss than implant systems (P > 0·05). The porcelain fused to BMA restorations showed higher crestal bone loss than NMA-based restorations (P = 0·003) at 3 months, (P = 0·038), at 6 months and (P = 0·00) at 12 months; however, crestal bone loss differences between NMA and zirconia were not significant (P = 0·629) at 3 months, (P = 0·974) at 6 months and (P = 1) at 12 months. Within the limitations of this study, our results revealed that rather than the implant systems, prosthetic materials seemed to have an effective role on crestal bone.

Ciliary body cysts in neurofibromatosis: a new coexistence?

PURPOSE: Neurofibromatosis 1 (NF1) is an autosomal dominant, multisystem disorder that also effects the eye. Herein, we aimed to investigate the posterior iris surface and ciliary body morphology of NF1 patients by ultrasonic biomicroscopy (UB). MATERIALS & METHODS: Nine consecutive unrelated subjects with NF1, and as a control group 25 healthy subjects, were included in the study. All patients underwent ophthalmic examination including visual acuity testing, slit-lamp biomicroscopy, tonometry, gonioscopy (Schaffer classification), and dilated ophthalmoscopy, UB. RESULTS: Mean age was 35.1 ± 16.2 (range, 11-57) and 34.5 ± 15.6 (range, 9-60) for NF1 and control groups respectively (p>0.05). Lisch nodules were present in 16 of 18 eyes (88.8%) in NF1 group. Fundoscopic examination of the control group and 15 eyes of NF1 (83.3%) patients was normal, whereas hypoplastic and tilted optic nerve were present in three eyes, and temporally-located bone-spicule-like lesions was present in one eye of the NF1 group. UB revealed ciliary body cyst in 77.7% (14/18) of the eyes among NF1 group, and 8% (4/50) among control group (p<0.05). The mean size of the cysts were 520 ± 191 µ (range, 220-860 µ) and 495 ± 231 µ (range, 300-830 µ) at NF1 and control groups, respectively. Gonioscopic evaluation revealed that 55% of the NF1 patients have an unoccludable anterior chamber angle (Grade 3 or 4), 45% occludable angle (Grade 1 or 2), and 78% irregular pigment patches. However, occludable angle rate was just 4% in the control group, and none of the patients had irregular pigment patches. CONCLUSION: The coexistence of ciliary body cysts and NF1, and the effect of these cysts in the eye should be enlightened with further studies.

The effect of resin cement shade and restorative material type and thickness on the final color of resin-matrix ceramics.

PURPOSE: This study aims to evaluate the effects of cement shade, restorative material type, and thickness on the final color of resin-matrix ceramics. METHODS: Ninety A2 shade resin-matrix ceramic specimens were prepared from Vita Enamic, GC Cerasmart, and Lava Ultimate at 0.5 and 1.0 mm thicknesses. Sixty resin cement disks were fabricated from different shades (A1, A3O, B05, and TR) of RelyX Ultimate at 0.1 mm thickness. CIE color coordinates were measured using a spectrophotometer, and color differences (∆E00) were calculated. Data were statistically analyzed (P =0.05). RESULTS: The ΔE00 values were influenced by the cement shade, restorative material type, thickness, and their interactions (P < 0.05). A3O cement caused clinically unacceptable values for all groups at 0.5 mm thickness and GC at 1.0 mm thickness. A1 and TR cement shades demonstrated visually perceptible but clinically acceptable values, except for VE-A1 and LU-A1 at 0.5 mm thickness. The ∆E00 values of the B05 cement shade were lower than the visually perceptible threshold for both thicknesses except for GC at 0.5 mm thickness. CONCLUSION: The shade of the resin cement and the type and thickness of the resin-matrix ceramic material significantly affected the resulting final color. To provide a shade matching with natural dentition and to obtain esthetic restorations, especially for the anterior teeth, the resin cement shade and resin-matrix ceramic material should be carefully selected.

Molecular typing of Candida albicans strains isolated from denture wearers by repetitive sequence-based PCR.

Long-term use of prosthesis is the most important risk factor for the colonization of Candida species on the mucosal surfaces, which can lead to the development of denture-related stomatitis (DRS). Some individuals wearing prosthesis develop DRS and others do not. C. albicans strains isolated from both groups were genotypically compared. The purpose of this study was to determine whether the strain causing prosthesis stomatitis was different from the other strains genotypically. The study included 90 individuals wearing different prostheses and 20 control individuals with natural teeth. In the study 109 C. albicans strains were used which were isolated from the saliva samples and the mucosal surfaces of the tongues and palates of 51 individuals and then defined phenotypically. Phenotypic diagnosis of the isolates was genotypically verified by using species-specific PCR. For molecular typing, repetitive extragenic palindromic sequence polymerase chain reaction (REP-PCR) was employed. The results of the study revealed that REP-PCR had the capability to separate 109 C. albicans strains and six reference strains into 44 genotypes. Whereas C. albicans strains showed heterogenic distribution, C. albicans strains isolated from the individuals suffering from prosthesis stomatitis showed no specific genotypes. REP-PCR is a simple, fast and low-cost method and helped work on a great number of samples.

Predictive and Prognostic Role of Lipocalin-2 Expression in Prostate Cancer and Its Association with Gleason Score.

Lipocalin-2 has an important role in tumor progression, invasion, and metastasis. However, its role in prostate cancer remains unclear. The objective of this study is to determine the expression level of lipocalin-2 in human prostate cancer tissues and to evaluate the relationship between its expression level and clinicopathologic parameters including response to docetaxel treatment, Gleason score, progression-free survival (PFS), and overall survival (OS). We retrospectively analyzed paraffin-embedded tissue sections from 33 metastatic castrate-resistant prostate cancer (mCRPC) patients whose clinical outcomes had been tracked after docetaxel treatment. The expression status of lipocalin-2 was defined by immunohistochemistry (IHC) using the anti-lipocalin-2 antibody. Lipocalin-2 was highly expressed in 36% of the examined specimens. There was no significant correlation between high lipocalin-2 expression and docetaxel response (p : 0.09). High lipocalin-2 expression was significantly associated with a higher Gleason score (p=0.027). Kaplan-Meier survival analysis failed to show a significant correlation between expression levels of lipocalin-2 and both OS and PFS although patients with high lipocalin-2 levels had a numerically shorter PFS and OS time compared to patients with low levels. Consequently, it is clear that further studies are needed to evaluate the predictive and prognostic role of lipocalin-2 in prostate cancer patients.

Pulley reconstruction with different materials: experimental study.

The digital fibroosseous pulley system is essential for optimum function of the flexor tendons and the continuation of normal hand functions. Different materials have been used for pulley reconstruction in the literature but the ideal material is still controversial. In this study, after the excision of the A2 pulley, pulley reconstructions were performed by using acellular dermal matrix, solvent dehydrated bovine pericardium, fascia lata, and free tendon graft in the rabbit model. The animals were killed at the 8th and 12th weeks and subjected to biomechanical testing. Tendon excursion and work of flexion values were calculated for each digit of the rabbits. As a result, all the reconstructed pulleys were functioning well without a statistically significant difference between the experimental groups. Pulleys reconstructed with acellular dermal matrix and solvent-dehydrated bovine pericardium appear to have the potential to function as effective pulley substitutes.

Clinicopathological evaluation of Marjolin ulcers over two decades.

Malignant changes arising on the previously traumatized or chronically inflamed skin are defined as Marjolin ulcers. They can develop on many different lesions but frequently they are detected on burn scars. Histopathologically, Marjolin ulcers are mostly diagnosed as squamous cell carcinoma and they need special attention when especially located on the lower extremities. In this study, 63 patients treated for Marjolin ulcers between January 2000 and March 2015 were evaluated according to etiology, histological differentiation, primary tumor size, patient age and anatomical localization. Medical records of these patients were reviewed retrospectively. Mean age was 49.7 years. Average interval between the first injury and carcinoma development was 37.9 years. Most frequent etiologic factor was burn scars with 82.5%. Foot was the most frequently affected site with 28.6% and scalp was the second most frequent localization with 25.4%. Squamous cell carcinomas were detected in 88.9% of the patients and basal cell carcinomas were detected in 11.1% of the patients. For treatment, excision and grafting was performed for 48 patients (76.2%), excision and local flaps were used for 10 patients (15.9%) and excision and free flaps were used for five patients (7.9%). Regional lymph node dissection was performed for 12 patients (19%). Average follow up period was 46.5 months. Local recurrences were detected in nine patients (14.3%). In conclusion, Marjolin ulcers are aggressive tumors that require special care. In order to prevent life threatening sequelas of this entity, it is important to know basic aspects of clinical progress, prognostic factors and treatment modalities.

The Effect of Pseudoexfoliation Syndrome on the Retinal Nerve Fiber Layer and Choroid Thickness.

PURPOSE: To investigate thickness of the retinal nerve fiber layer (RNFL) and choroid thickness in patients with pseudoexfoliation syndrome (PEX) and pseudoexfoliation glaucoma (PXG) compared to healthy volunteers. METHODS: This cross-sectional, prospective study included 43 patients with PXG, 45 patients with PEX syndrome, and 48 healthy volunteers. The RNFL and macular thickness were analyzed with standard OCT protocol while choroidal thickness was analyzed with EDI protocol in all subjects. RESULTS: The RNFL thickness was higher in the PEX and control groups compared to the PXG group (p<0.001). The choroid thickness was significantly higher in the control group compared to the PXG and PEX groups (p<0.05). No significant difference was detected between the both groups. CONCLUSIONS: PEX might weaken choroid circulation by accumulating in choroid vessels. The thinner choroid in the PXG group suggests that ischemia affects the duration of PEX and has a role in the development of glaucoma.

Development and Life Table Parameters of Phenacoccus madeirensis Green (Hemiptera: Pseudococcidae) on Four Ornamental Plants.

The development, reproduction, and life table parameters of the Phenacoccus madeirensis Green (Hemiptera: Pseudococcidae) on four ornamental plant species, namely Pelargonium zonale (Geraniaceae), Hibiscus rosa-sinensis, Hibicus syriacus (Malvaceae), and Cestrum nocturnum (Solanaceae) were investigated under controlled conditions (25 ± 2°C, 60 ± 10% R.H., and 16 h photophase). Life table data were analyzed by using an age-stage two-sex life table. The shortest total immature developmental time of females and males for P. madeirensis was obtained on C. nocturnum (20.42 and 21.90 days, respectively). The highest fecundities were 233 and 232 eggs on C. nocturnum and H. syriacus, respectively. The intrinsic rate of increase (r  = 0.1511 day(-1)) and finite rate of increase (λ  =  1.1631 day(-1)) were the greatest when mealybugs were reared on C. nocturnum. Net reproductive rate (R 0  =  129.5 offspring) was the greatest when reared on H. syriacus, but this value was not statistically different from that on C. nocturnum. The shortest mean generation time (T  =  31.3 days) was calculated on C. nocturnum. These results indicate that C. nocturnum and H. syriacus are more suitable hosts than H. rosa-sinensis and P. zonale for P. madeirensis.

Age and gender related changes in bronchial tree: a morphometric study with multidedector CT.

OBJECTIVE: The aims of this study are the identification of differences in the diameter, length, area and branching angles of the trachea and bronchi with gender and age, and the identification of trachea types by using MDCT images. PATIENTS AND METHODS: The thoracic MDCT images of 253 patients (0-74 years old, 142 male and 111 female) were evaluated. Tracheal diameter, tracheal cross-sectional area, diameter and length of bronchi, and several angles of the bronchial tree [e.g. subcarinal angles (SCA), interbronchial angles (IBA)] were measured. RESULTS: Average anteroposterior and transverse diameter of the trachea in adult patients were measured as 15.8 ± 2.9 mm and 17.5 ± 3.7 mm respectively. Average tracheal cross-sectional areas in adult patients were calculated as 160.7 ± 41.3 mm² in females and as 275.7 ± 57.3 mm² in males. Four types of trachea were identified as circular (68% in adults, 73% in children), oval (13%, 15%), rectangular (11%, 5%) and horseshoe shaped (8%, 7%). The average right and left SCA were calculated as 34.5º ± 8.1º and 38.1º ± 8.9º respectively. The average right and left IBA were calculated as 32.4º ± 7.7º and 35.2º ± 8.1º respectively. CONCLUSIONS: The findings of this study may be helpful during bronchoscopy and tube and stent application procedures. MDCT seems to be a convenient technique for the evaluation of the bronchial tree.

Prophylactic antibiotics in plastic and reconstructive surgery.

There is no consensus in the literature on the use of prophylactic antibiotics to prevent postoperative infection. This study was performed to investigate whether the use of prophylactic antibiotics has an effect on postoperative infection rates. A total of 1400 patients were classified into four groups based on their diagnosis. During the induction of anesthesia, half of each group received 2 g of a sulbactam-ampicillin combination and the other half received a placebo (saline solution) intravenously. Wound infection rates were observed in the postoperative period. Age, sex, and operative site of the patients with the same diagnosis were comparable in each group. The white blood cell count and the body temperature reading of each patient were recorded postoperatively. Wounds were observed daily in the postoperative period and graded according to a predetermined scale. Bacteriologic specimens were obtained from patients who had wound infections. According to our clinical experience, antibiotic prophylaxis is not necessary in plastic surgery. At the end of our 6-year study, a significant difference could not be found between the antibiotic prophylaxis and placebo groups.

Reconstruction of facial defects with superficial temporal artery island flaps: a donor site with various alternatives.

Color and texture match is crucial in reconstruction of facial tissue defects. Between March of 1997 and July of 2000, island flaps based on the parietal, anterofrontal, centrofrontal, posterofrontal, and superior auricular branches of the superficial temporal artery were used in the reconstruction of tissue defects localized on different regions of the face in 28 patients. According to the size and the location of the defect, the flap was selected. There were 15 male patients and 13 female patients, with ages ranging between 19 and 74 years. In six of the flaps, venous congestion was observed. Because of the elevation of the eyebrow on the flap side, three patients required a sling to the opposite eyebrow. Excellent color and tissue match and transfer of hair-bearing tissue to the eyebrow and beard areas were achieved with no other complications. Satisfactory aesthetic results were gained.

Infantile digital fibromatosis: an unusual localization.

Infantile digital fibromatosis (recurrent digital fibromatosis) is a rare, benign fibrous growth of childhood. The authors present a case of a 16-year-old child with an infantile digital fibromatosis on the volar surface of the right little finger at the distal interphalangeal joint level. After excision of the tumor, histopathologic diagnosis was shown to be infantile digital fibromatosis. The patient has been free of recurrence for 3 years after surgery.

Investigation of factors influencing burnout levels in the professional and private lives of nurses.

This is a descriptive, cross-sectional and partly analytic study aiming to determine the factors causing burnout in professional and private lives of nurses working in the university and state hospitals in a city. About 333 nurses were reached by sampling method. Data collection was made by a question form consisting of two parts. The first part was developed by the investigators. In this part, data on demographic, professional and private life conditions of individuals were collected. In the second part, "Maslach Burnout Inventory" was used to determine the burnout levels of individuals. The most important findings of the present study are as follows: higher education level, work experience and higher status decrease burnout while working at night shifts increases it. In addition, nurses who have problems in relations with the other team members and are not satisfied with their work conditions have higher levels of burnout. Having difficulty in childcare and in doing house chores, health problems of the nurse herself or her children, economic hardships and difficulties encountered in transportation are other factors increasing burnout.

"Waiting in Araf" research without consent: a Turkish mother's experience.

In this article, a nurse author from Turkey relates the anxiety and struggle that she experienced with the birth of her first baby when, for unknown reasons, the baby experienced acute rectal bleeding after birth. Unsatisfactory doctor-patient relations, abolishment of patient rights, suspicion of research without permission, and clinical iatrogenesis are discussed. The mother describes the 10 days she spent with her child in the hospital as "waiting in Araf." According to Middle Eastern culture, "Araf" is defined in the Koran as a place between Eden and Hell where people who have sinned are required to wait. Though anticipating acceptance into Eden, they wait with fear as they watch Hell on one side, and with hope while watching the happiness of Eden on the other side. The author's story depicts such an experience.

Protective effect of grape seed extract against ischaemia/reperfusion injury in a rat epigastricflap model.

Proanthocyanidins are potent natural antioxidants which belong to a class of polyphenols. Proanthocyanidin-rich extracts are prepared from grape seeds. The effect of grape seed proanthocyanidin extract (GSPE) on the viability of abdominal skin flaps exposed to warm ischaemia and subsequent reperfusion were studied in 40 male Wistar rats. In the control group (group I; n=20), rats were fed with standard, non-purified rat diet, and the study group received GSPE 100 mgkg(-1) per day 1 week prior to surgery and 1 week following surgery. Abdominal island flaps were elevated in both the groups and subjected to 8h of warm ischaemia, followed by reperfusion. Mean flap survival areas in groups I (control group) and II (treatment group) were calculated to be 58.3%+/-11.72 and 81.0%+/-11.88, respectively. Flap survival on day 7 was significantly higher in group II compared to group I (p<0.01). Histopathological semi-quantitative analysis of the specimens revealed infiltration by polymorphonuclear leucocytes, oedema formation and necrosis in group I, whereas neo-vascularisation and fibrosis were the prominent findings in group II.