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Introduction and Objectives: We aimed to point out the ureteral access facility and obstruction removal efficiency of mini-URS in the use of proximal ureteral stone management in children under five-year-old., Patients: We retrospectively reviewed the data of 26 children who underwent mini-URS-LL for obstructive stones in proximal ureter between January 2016 and August 2018. The effectiveness of the mini-URS-LL was assessed based on the feasibility, reliability, and success of the technique., Results: Mean age was 3 ± 1.3 years, and 11 (42.3%) patients were ≤2 years old, remaining 15 (57.7%) were aged 3-5 years. Mean stone size was 9.11 ± 3.02 mm. A stone-free status was obtained at the end of 31 ureteroscopic procedure in 24 (92.3%) patients. The mean age was found significantly higher in patients who had the procedure without pre-stenting than the others who did (P = .027). No perioperative complication was experienced., Conclusion: In preschool-age children, laser lithotripsy with mini-URS may be a safe technique in the hands with advanced endo-urological skills but it has low efficacy with higher rates of prestenting causing additional anesthesia sessions., (Copyright © 2021 AEU. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Many surgical techniques, as well as dressing models, were identified in the treatment of hypospadias. There are many publications in the literature that are the result of the effort to find the ideal dressing after hypospadias surgery. The dressing has some benefits; however, it has some adverse effects. The present study aimed to discuss outcomes of the patients who have been operated through the tubularized incised plate urethroplasty (TIPU) method and followed with and without dressing postoperatively., Methods: Patients operated on through the TIPU method between March 2015 and August 2019 were reviewed retrospectively. The patients were divided into two groups, dressing and undressing. Preoperative hypospadias severity was evaluated according to the Glans-Urethral Meatus-Shaft (GMS) scoring method. The care results of the patients were recorded. Postoperative outcomes were compared according to the Hypospadias Objective Scoring Evaluation (HOSE) scale, and statistical analyses were conducted. The results of both groups were compared statistically., Results: One hundred and nineteen patients were divided into two groups: dressing (n = 56) and nondressing (n = 63). The patients' average age was 3.54 ± 2.97 years in group 1 and 3.50 ± 3.01 years in group 2 (p = 0.940). There was not any statistically significant difference between the two groups for demographic data. Minimal bleeding had stopped in three patients in the nondressing group spontaneously before discharging. No severe edema or hematoma, which might have concerned the parents, appeared. Two (3.5%) and 3 (4.7%) patients underwent a maximum of three urethral dilation sessions in dressing and nondressing groups, respectively (p = 0.556). We found no significant difference between groups in the comparison of preoperative GMS and postoperative HOSE scoring., Discussion: The most important limitation of the study is that it is retrospective. Pre- and postoperative scoring systems are objective. The data obtained in the literature show that surgeons prefer to apply dressings commonly after the TIPU technique. Advantages and disadvantages of dressing are mentioned in the literature. Even if the paradigm is dressing in hypospadias surgery, according to the results of our study, dressing may not affect the functional and cosmetic results of TIPU repair., Conclusion: Postoperative functional and cosmetic results of TIPU in hypospadias appear to be independent of dressing. However, the results must be supported by further research., (© 2021 S. Karger AG, Basel.)

Background and Objectives: Caudal epidural anesthesia is a widely used popular technique for postoperative analgesia but it has potential side effects and duration of analgesia is short. Quadratus lumborum block (QLB) was found to be an effective method for postoperative analgesia in lower abdominal surgeries. In this double-blind prospective randomized trial, we aimed to compare the postoperative analgesic efficacies of QLB and the caudal block in pediatric patients undergoing inguinal hernia repair and orchiopexy surgeries under general anesthesia., Materials and Methods: After approval was obtained from the ethics committee, in this prospective randomized double-blind trial, 53 patients under general anesthesia undergoing inguinal hernia repair and orchiopexy surgeries randomly received caudal block or QLB. Demographic data, postoperative analgesic requirement, Face, Legs, Activity, Cry, and Consolability (FLACC) scores at 30 min, 1, 2, 4, 6, 12 and 24 hours, parent satisfaction scores and complications were recorded., Results: The study included 52 patients, after excluding one patient because of a failed caudal block. There were no significant differences between the groups based on demographic data (p>0.05). The number of patients who required analgesics in the first 24 hours was significantly lower in QLB group (p=0.001). Postoperative 4, 6, 12 hours FLACC scores were significantly lower in the QLB group (p<0.001, p=0.001 and p<0.001, respectively). Parent satisfaction scores were higher in the QLB group (p=0.014)., Conclusion: According to the results of this study, QLB can provide much more effective analgesia than caudal block without adjuvants in multimodal analgesia management of children undergoing inguinal hernia repair and orchiopexy surgeries., Trial Registration Number: NCT03294291., Competing Interests: Competing interests: None declared., (© American Society of Regional Anesthesia & Pain Medicine 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

This case report describes a multidisciplinary approach using orthodontic forced eruption to facilitate prosthetic restoration of a subgingivally fractured maxillary permanent central incisor. A 14-year-old male patient presented at the pediatric dental clinic due to unesthetic appareance and for management of a fractured maxillary right central incisor tooth. Intraoral examination revealed that the maxillary right central incisor had sustained a crown-root fracture with pulp exposure. We treated the tooth endodontically and performed orthodontic root extrusion with a modified Hawley appliance prior to prosthetic rehabilitation. Approximately 2-3 mm of extrusion of the tooth was obtained within 8 weeks. A fiber post was then inserted into the root canal, and final restoration was completed with an all-ceramic crown. Follow-up 18 months after treatment revealed good periodontal health, esthetics and normal function.

Objective: We aim to study left atrial (LA) strains in patients with hypertensive response to exercise (HRE) and determine their usefulness in predicting masked hypertension (HT)., Methods: Ninety-eight normotensive patients who had HRE were included and were divided into two groups after masked HT had been diagnosed by ambulatory blood pressure monitoring. Conventional echocardiographic parameters and two-dimensional speckle-tracking echocardiography-based LA strain parameters were compared., Results: Patients with masked HT have higher left ventricle mass index (LVMI) (88.1±11.3 vs. 82.5±8.7 g/m, P<0.05), left atrium maximum volume index (LAVI) (34.5±5.1 vs. 30.2±5.6 ml/m, P<0.001), lower global longitudinal LA strain during ventricular systole (GLAs-res) (32.5±8.9 vs. 40.2±9.1%, P<0.001), and lower global longitudinal LA strain during late diastole (GLAs-pump) (15.8±4.1 vs. 18.1±5.8%, P<0.05). In univariate analysis, a good negative correlation was found between GLAs-res versus LAVI (r=-0.451, P<0.001), GLAs-res versus LVMI (r=-0.457, P<0.001) and a moderate negative correlation was present between GLAs-pump versus LAVI (r=-0.317, P<0.001) and GLAs-pump versus LVMI (r=-0.288, P<0.05). GLAs-res and LAVI were found to be independent predictors of masked HT. Receiver-operating characteristic analysis was carried out. Area under the curve to predict masked HT was 0.729 (95% confidence interval: 0.623-0.832, P<0.001). GLAs-res less than 33.1% predicted masked HT with 73% sensitivity and 61.5% specificity., Conclusion: LA strain parameters were impaired in patients with masked HT and can be used to predict the presence of masked HT in patients with HRE.

Objective: The aim of this study was to determine the role of left-sided mechanical parameters in postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass grafting (CABG)., Methods: Ninety patients with coronary artery disease and normal left ventricular (LV) function in sinus rhythm were enrolled in the study. Preoperative LV and left atrial (LA) mechanics were evaluated by two-dimensional (2D) speckle-tracking echocardiography (STE), including strain and rotation parameters, and volume indices. Patients were monitored in order to detect POAF during the postoperative period., Results: Twenty-three of 90 patients (25.6%) developed POAF. Age (p<0.001) and preoperative beta blocker usage (p=0.001) were the clinical parameters associated with POAF. Left atrial maximum volume index (LAV[max]i) increased, and peak left atrial longitudinal strain (PALS) was impaired in POAF patients (p=0.001, p<0.001, respectively). Left ventricular twist (LVtw) and left ventricular peak untwisting velocity (UntwV) were augmented in POAF patients (p=0.013, p=0.009, respectively). Receiver operating characteristic analysis showed N-terminal pro-brain natriuretic peptide (NT-proBNP) levels above 70 pg/ml and predicted POAF with a sensitivity of 74% and specificity of 78% (area under curve: 0.758, 95% confidence interval [CI] 0.631-0.894, p<0.001). Logistic regression analysis demonstrated that age (odds ratio [OR] 1.1, CI 1.01-1.20, p=0.034), preoperative beta blocker usage (OR 8.84, CI 1.36-57.28, p=0.022), NT-proBNP (values >70 pg/ml, OR 22.377, CI 3.286-152.381, p<0.001), PALS (OR 0.86, CI 0.75-0.98, p=0.023), and UntwV (OR 1.02, CI 1.00-1.04, p=0.029) were the independent predictors of POAF., Conclusion: The combination of 2D STE, clinical, and biochemical parameters may help predict POAF.

Background: Spontaneous early patency of infarct-related artery (IRA) on arrival for primary percutaneous coronary intervention is associated with better short- and long-term prognosis in patients with ST-segment elevation myocardial infarction (STEMI). We aimed to investigate whether the hemographic parameters on admission are associated with spontaneous IRA patency., Methods: This was a retrospective study of 1,625 patients with acute STEMI who underwent primary percutaneous coronary intervention<12 hours after the onset of symptoms., Results: Angiography showed patent IRA (prethrombolysis in myocardial infarction [TIMI] grade 3 flow) in 160 (9.8%) patients. Neutrophil count on admission (7.8±2.4×10³/μL versus 9.7±3.8×10³/μL; P<0.001) was significantly lower and lymphocyte count (2.4±1.0×10³/μL versus 1.9±1.1×10³/μL; P<0.001) on admission was significantly higher in the patent IRA group. Neutrophil to lymphocyte ratio (NLR) was significantly lower in the patent IRA group (4.1±3.2 versus 6.9±5.5; P<0.001). Admission leukocyte counts (13±4.0×10³/μL versus 12±3.4×10³/μL; P<0.001) and NLR (7.2±5.8 versus 5.5±4.4; P<0.001) of the patients with TIMI thrombus score≥4 were significantly higher than patients with TIMI thrombus score<4. In the multivariate analysis, NLR≥4.5 (3.17 [95% confidence interval: 2.04-4.92]; P<0.001) was found to be independently predicting an occluded IRA on initial angiography with a sensitivity of 62.7% and a specificity of 70%., Conclusions: NLR on admission is significantly related to angiographic thrombus burden and spontaneous early IRA patency in patients with acute STEMI.

An 11-year-old girl was admitted to our hospital with a history of fatigue, effort dyspnea, and chest pain. On transthoracic echocardiography, the parasternal short-axis and apical four-chamber color Doppler flow imaging showed a structure matching the level of the coronary sinus and pouring into the right ventricle. On multi-slice computed tomography, the circumflex artery became immediately narrowed just before draining in to the base of the right ventricle, close to the septal leaflet of the tricuspid leaflet, and the Qp/Qs was 1.6. Congenital coronary-cameral fistula is an infrequent condition that establishes a direct link between coronary arteries and cardiac chambers. Although coronary artery fistulae are commonly asymptomatic, they may cause severe symptoms depending on the severity of the shunt, and may be treated medically, surgically or by transcatheter closure. In this case report, we present a patient with a huge circumflex artery-to-right ventricle fistula treated successfully with a duct occluder device.

Objectives: Enhanced matrix metalloproteinase-8 (MMP-8) activity in the early post-myocardial infarction (MI) period has been related to early remodeling. However, it has been demonstrated that plasma MMP-8 level has a biphasic profile, and the relation between the late plasma levels and remodeling is unclear. We evaluated the plasma MMP-8 levels and its correlates 20±3 months after acute MI., Study Design: 58 post-MI patients and 26 control subjects underwent quantitative single-photon emission computed tomography (SPECT) and echocardiography. The plasma MMP-8 levels were measured and its correlates were investigated., Results: The MMP-8 levels were significantly higher in post-MI patients [median 3.88 ng/ml, interquartile range (1.88-6.43) vs. 0.67 ng/ml (0.34-2.47); p<0.001]. Plasma MMP-8 levels were significantly correlated with left ventricular ejection fraction (LVEF) (ρ=0.34, p=0.009), end diastolic volume index (EDVi) (ρ=-0.39, p=0.002) and end systolic volume index (ESVi) (ρ=-0.40, p=0.002)., Conclusion: Plasma MMP-8 levels were found to still be high in post-MI patients 20±3 months after the index event. The levels were significantly correlated with left ventricular volume indices and LVEF. We speculate that, in contrast to the relation between the higher early MMP-8 activity and the extent of cardiac remodeling, higher late levels may be associated with relative preservation of left ventricular systolic function.

Objectives: To evaluate short term results of percutaneous patent ductus arteriosus (PDA) closure in a cohort of pediatric and adult patients following closure with the Amplatzer Ductal Occluder (ADO-1 and ADO-2) and Amplatzer Septal Occluder (ASO) devices., Study Design: A total of 48 patients (17 male and 31 female; range 3 to 39 years) were included in this study. All patients were evaluated with transthoracic echocardiography (TTE) before intervention. Percutaneous closure was performed under fluoroscopy through anterograde or retrograde route. Aortagraphy was performed to measure and classify the ductus arteriosus. Residual shunt through ductus was controlled by aortography at the tenth minute and by TTE 24 hours and three months after the procedure., Results: The released device was ADO-1 in 25 patients (51.2%), ADO-2 in 22 patients (45.8%), and ASO in one patient. Mean follow-up was 13.2 months. In 97.9% of patients, the occluder was placed into the ductus without any complication. In one patient, the device embolized to the left pulmonary artery during implantation. Aortography performed ten minutes after the procedure showed complete closure in 38 patients without residual defect. TTE revealed trace amounts of residual shunt within the device in two patients, flow around the device in two patients 24 hours after implantation, and residual shunt in only one patient three month after intervention., Conclusion: Transcatheter closure of PDA with ADO-1 and ADO-2 devices has low morbidity and mortality with high rates of success in selected patients.

We present an unusual case of giant caseous calcification of the mitral annulus in a 58-year-old female patient. The mass was detected during echocardiography and was defined as a big, round echodense lesion attached to the posterior mitral ring annulus. The patient was further evaluated with a full spectrum of cardiac noninvasive imaging modalities and the diagnosis was confirmed. Caseous calcification of the mitral annulus is a rare entity usually diagnosed by transthoracic echocardiography. Since it is very important to differentiate it from cardiac tumors, complimentary imaging modalities could be used for this purpose if a doubt exists about the diagnosis.

Stent thrombosis remains an unresolved problem despite advances in coronary revascularization. Incomplete stent apposition (malapposition) and incomplete endothelialization of stent struts, which is more commonly seen with drug-eluting stents, are the primary causes of late or very late stent thrombosis. Optical coherence tomography (OCT) is a novel modality for imaging of these potentially fatal conditions. Coronary angiography performed for non-ST elevation myocardial infarction in a 60-year-old male patient with a three-year history of sirolimus-eluting stent implantation to the left anterior descending coronary artery showed stent thrombosis. In addition to his regular aspirin and clopidogrel therapy, heparin and tirofiban infusions were started. Repeat coronary angiography five days later showed nearly complete disappearance of the thrombus. Further examination with OCT to evaluate stent malapposition and endothelialization revealed separation of stent struts from the vessel wall. Balloon dilatation was performed and complete apposition of the stent struts against the vessel wall was achieved, which was further confirmed by OCT. This represents the first OCT application in our country in a case of very late stent thrombosis.

Objective: To investigate the effects of different acids and etching times on the bond strength of glass fiber-reinforced composite (FRC) posts to composite core material., Method and Materials: Twenty-six FRC posts (FRC Postec Plus) were randomly divided into 13 groups (each n = 2). One group received no surface treatment (control). The posts in the other groups were acid etched with 35% phosphoric acid and 5% and 9.6% hydrofluoric acid gel for four different etching times (30, 60, 120, and 180 seconds). A cylindric polytetrafluoroethylene mold was placed around the treated posts and filled with dual-cure composite core material (MultiCore Flow). All samples were light cured for 60 seconds. After 24 hours of water storage, the specimens were sectioned perpendicularly to the bonded interface under water cooling to obtain 2-mm post-and-core specimens. Eight specimens were made from each group. Push-out tests were performed at a crosshead speed of 0.5 mm/min using a universal testing machine. Data were analyzed by one-way ANOVA followed by the Tukey honestly significant difference test (alpha = .05)., Results: The lowest bond strength was observed in the control group (12.51 megapascal [MPa]). No statistical significant difference was observed among group H5-120 (20.31 MPa), group H9-120 (20.55 MPa), or group P-180 (20.57 MPa) (P > .05). These groups demonstrated the highest bond strength values (P < .05)., Conclusion: For the FRC posts, all acid-etching procedures tested showed significantly increased bond strength when compared with the control group. Acid-etching with 5% hydrofluoric acid and 9.6% hydrofluoric acid for 2 minutes and with 35% phosphoric acid for 3 minutes (groups H5-120, H9-120, and P-180, respectively) demonstrated the highest bond strength values between the FRC post and composite core material. Although the bond strength was increased by prolonged acid etching, the microstructure of the FRC posts might have been damaged.

We investigated the effects of different Er:YAG laser treatments on the surface roughness of base metal alloys. A total of 36 specimens were prepared of two base metal alloys (Wiron 99, Bellabond plus). The surfaces of the specimens were standardized by gradual wet grinding with 320-, 600-, 800- and 1,000-grit silicon carbide paper for 10 s each on a grinding machine at 300 rpm. Specimens of each alloy were randomly divided into six groups (n = 6) comprising a control group (group C), a group sandblasted with Al(2)O(3) powder at 60 psi for 10 s through a nozzle at a distance of 10 mm (group S), and four Er:YAG laser (Fotona AT) treatment groups. The laser treatment groups were as follows: 500 mJ, 10 Hz, 100 μs (group 500MSP); 500 mJ, 10 Hz, 300 μs (group 500SP); 400 mJ, 10 Hz, 100 μs (group 400MSP); and 400 mJ, 10 Hz, 300 μs (group 400SP). Surface roughness measurements (Ra) were performed using a profilometer. The data were analysed by two-way ANOVA, and mean values were compared using Tukey's HSD test (α = 0.05). According to the two-way ANOVA results, the base metal alloys and interaction between base metal alloy and surface treatment were not statistically significant different (p > 0.05), the surface treatments were significantly different (p < 0.0001). For the two base metal alloy groups, no significant differences were observed among the control, 400MSP, and 400SP groups (p = 0.912), and these groups demonstrated the lowest Ra values. The highest Ra value was observed in group S (p < 0.05). Er:YAG laser treatment at 400 and 500 mJ/10 Hz is not an alternative method for surface roughening of base metal alloys.

Perforation of a mitral valve aneurysm is a rare cause of acute mitral regurgitation, and valvular aneurysm formation and its rupture without infectious involvement are unusual. An 80-year-old man was admitted with acute onset and progressive dyspnea. He had no history of chest pain, palpitation, or fever. Laboratory findings did not suggest any signs of infection. Transthoracic echocardiography revealed an aneurysm of the mitral septal leaflet protruding into the left atrium during systole and color-flow Doppler ultrasonography showed severe mitral regurgitation. There was no aortic regurgitation nor evidence for rheumatic involvement of the valvular structures. Pulmonary artery systolic pressure estimated from the tricuspid regurgitation jet was 50 mmHg. Transesophageal echocardiography showed a saccular, thin-walled, mitral valve aneurysm on the atrial surface, expanding during systole and a small tissue defect on the aneurysmatic segment of the mitral leaflet. There were no signs of connective tissue disease. The patient was submitted to surgery. The aneurysmatic and perforated parts on the septal leaflet were resected and an annuloplasty ring was placed. The histopathological examination of the mitral valve tissue showed nonspecific degenerative changes. The postoperative period was uneventful and the patient was discharged on the fifth postoperative day.

In a dilated heart with impaired systolic functions, functional mitral regurgitation could be seen even in the presence of structurally normal mitral apparatus. A number of mechanisms play role in the development of functional mitral regurgitation. These are increased mitral tethering forces, reduction in closing forces and mechanical and electrical dyssynchrony. Papillary muscle dyssynchrony has also been shown to be related with functional mitral regurgitation. Cardiac resynchronization therapy is known to reduce the amount of functional mitral regurgitation in patients with left ventricular systolic failure although some may not respond to treatment with cardiac resynchronization therapy. Papillary muscle dyssynchrony may predict the response of cardiac resynchronization therapy on the regression of functional mitral regurgitation and may suggest the suitable therapeutic options, such as cardiac resynchronization therapy, mitral valve repair, coronary revascularization separately or in combination. In this review, the mechanisms of functional mitral regurgitation, papillary muscle dyssynchrony and its relationship with functional mitral regurgitation and the relationship of papillary muscle dyssynchrony with the improvement of functional mitral regurgitation after cardiac resynchronization therapy are focused.

Unlabelled: In this case report, an alternative approach was presented for treatment of coronal fracture including pulp of maxillary central incisor, one of the abutments of an adhesive bridge, by using fiber post and tooth's own fractured component. The patient was referred to our clinic with the complaint of pain from the upper right central incisor and mobility of the adhesive bridge in maxillary anterior segment. It was realized that, the upper right central incisor, one of the abutments of the adhesive bridge, had been fractured at middle thirds of the crown including the pulp chamber. After dismounting the adhesive bridge and completion of the root canal treatment, a fiber post was placed into the fractured tooth. The fractured component, adherent to adhesive bridge retainer, was concorded to the fiber post. The whole structure was cemented with adhesive resin. A 1-mm-wide groove was made along the fracture line and restored with composite resin. The patient was evaluated clinically and radiographically at 12 and 30 months after the treatment., Clinical Significance: Adhesive cementation of fractured component by supporting the remaining tooth structure with a fiber post is an inexpensive and conservative treatment alternative when the fractured component is compatible with the remaining tooth structure in cases of tooth fractures including the pulp chamber at anterior segment., (© 2011, COPYRIGHT THE AUTHORS. JOURNAL COMPILATION © 2011, WILEY PERIODICALS, INC.)

Background: Atrial electromechanical delay (AEMD) calculated from tissue Doppler imaging (TDI) echocardiography can be an alternative to invasive electrophysiologic studies. We investigated whether the AEMD obtained from TDI is prolonged in patients with nonischemic dilated cardiomyopathy (DCM)., Methods: Fifty-five patients with nonischemic DCM (23 men/32 women; age, 43.9 +/- 14.8 years) and 55 controls (20 men/35 women; age, 41.3 +/- 13.4 years) were included in this study. Atrial electromechanical delay (the time interval from the onset of P wave on electrocardiogram to the beginning of late diastolic wave [Am wave] on TDI) was calculated from the lateral and septal mitral annulus, and lateral tricuspid annulus (PA lateral, PA septum, and PA tricuspid, respectively). P-wave dispersion was calculated from the 12-lead electrocardiogram., Results: PA lateral and PA septum duration were significantly longer in patients with nonischemic DCM than the controls (78.4 +/- 19.7 versus 53.8 +/- 6.6 and 55.2 +/- 16.3 versus 40.5 +/- 6.2, P < .0001 for both; respectively). However, PA tricuspid duration was statistically similar between the 2 groups (36.4 +/- 10.9 versus 37.2 +/- 5.7, P > or = .05). P-wave dispersion was significantly higher in nonischemic DCM patients than the controls (53.0 +/- 14.4 versus 37.5 +/- 5.5, P < .0001). PA lateral was correlated with the left atrial maximal volume (r = 0.64, P < .0001), P-wave dispersion (r = 0.65, P < .0001), and log B-type natriuretic peptide (NT proBNP) (r = 0.63, P < .0001). There was a statistically significant and negative correlation between the PA lateral and left ventricular ejection fraction (r = -0.63, P < .0001) and E-wave deceleration time (r = -0.34, P < .0001). Multivariate analysis revealed that left atrial maximal volume and log NT proBNP were the independent predictors of PA lateral (P < .0001 and P = .003, respectively)., Conclusion: The AEMD was significantly prolonged in patients with nonischemic DCM. Left atrial enlargement and log NT proBNP were the independent predictors of this prolongation., (Copyright 2010 Elsevier Inc. All rights reserved.)

This in vitro study evaluated the effect of six different adhesive systems on the shear bond strength of resin composite to feldspathic and low-fusing porcelains. Sixty porcelain blocks were prepared for each low-fusing (Matchmaker) and feldspathic (MVK95) porcelain specimen. After surface preparation, the porcelain specimens were divided into six groups (n = 10) for different adhesive systems (Adper Prompt L-Pop, QuadrantUnil Bond, Te-Econom, PQ1, One-StepPlus and Prime&Bond NT). After adhesive application, a universal resin composite (FiltekZ250) was condensed on the specimens. The prepared specimens were then stored in distilled water at 37 degrees C for 24 hours, then all the samples were thermal cycled 1000 times between 5 degrees C and 55 degrees C. Shear testing was performed on a universal test machine using a crosshead speed of 0.5 mm/minute. The statistical analysis of the bond strength data included two-way ANOVA. Then, the means were compared by Tukey HSD test (alpha = 0.05). The lowest bond strength was observed in Adper Prompt L-Pop. No statistically significant difference was observed between One-Step Plus and Prime&Bond NT. The highest bond strength was observed in PQ1. When low-fusing or feldspathic porcelain restorations are repaired with resin composite, self-etching adhesive systems may not be indicated. If maximum bond strength is the goal in porcelain resin bonding, adhesive systems that have a high filler ratio should be used.

Objective: Panoramic radiographs often are the first method used to screen edentulous patients before complete denture therapy. However, routine radiographic examination of edentulous patients is being questioned because of the cumulative effects and cost of radiation exposure. The purpose of this study was to determine the frequency and location of significant radiographic findings in edentulous jaws., Method and Materials: Panoramic radiographs from 338 patients were included in the survey (183 men, 155 women; 676 edentulous arches). The radiographs were evaluated by 1 oral radiology specialist for the following clinically significant radiographic findings: retained root fragments, impacted teeth, radiolucencies associated with cysts, radiopacities associated with localized sclerotic bone formation, location of the mental foramen on the crest, and location of the maxillary sinus close to the crest of the ridge. The data were analyzed using descriptive statistics., Results: Radiographic findings were found in 47.6% (56.5% women, 43.5% men) of the edentulous patients. Fifty-two subjects (29 women, 23 men) had 67 submucosal or intrabony root remains, 50 of which were located in the maxilla. The most frequent finding was retained root fragment, followed by radiopacities. Impacted teeth were found in 11 women and 10 men. In 15 patients the mental foramen was situated at the top of the residual ridge. Of these patients, 13 were women and 2 were men. In 29 patients (14 women, 15 men) the maxillary sinus was close to the crest of the ridge. Six patients (3 women, 3 men) had a bilateral maxillary sinus close to the crest of the ridge. The other 23 patients had a unilateral maxillary sinus close to the crest of the ridge, and except for in 2 men, all were in the left side of the maxilla., Conclusion: Routine panoramic examination of the jaws is necessary to detect impacted teeth, retained root fragments, and other radiographic findings that may require treatment before construction of complete dentures.

The aim of this study was to compare bacterial penetration after obturation with lateral compaction technique using four different root canal sealers. This study was performed on 100 teeth including negative control (n = 10), positive control (n = 10), and experimental groups (n = 80). 80 teeth were randomly divided into five groups of 20 teeth each and obturated with AH 26 (A), AH Plus (AP), Sealapex (S), Ketac-Endo (K) root canal sealers. Evaluation was carried out for 60 days. After 30 days of comparing the bacterial penetration values, total penetration was observed in 85% of the Group AP, and group K, 80% of the group S, and 75% of the group A. According to the results of chi(2) test, there was no statistically significant difference observed between any groups (p > 0.05). After 60 days of comparing the bacterial penetration values, total penetration was observed in 100% of the group AP, group K, and group S and 95% of the group A. It may be concluded that under the conditions of this study, there was no difference in the bacterial penetration of the four root canal sealers tested at 30 and 60 days.

Unlabelled: PURPOSE The purpose of this study was to evaluate the effect of different acid etching times with 9.6% hydrofluoric acid gel and two adhesive systems on shear bond strengths of resin composite to porcelain., Materials and Methods: Ninety-eight 7 x 7 x 2 mm feldspathic porcelain blocks (VMK 95, Vita) were prepared. The specimens were divided into 7 groups: 1 control (no surface treatment) and 6 groups acid etched with 9.6% hydrofluoric acid gel for different etching times, including 30 s, 30+30 s, 60 s, 60+60 s, 120 s, and 180 s. Each of the etching time groups was divided into two bonding agent (Single Bond, AdheSE) subgroups (n = 7). Microhybrid composite (Filtek Z250) was condensed using a teflon mold and light polymerized for 20 s on the porcelain specimens. The prepared specimens were then stored in distilled water at 37 degrees C for 24 h before mechanical testing. Shear testing of all groups was performed on a universal testing machine (Lloyd LRX) at a crosshead speed of 0.5 mm/min. The bond strength data were analyzed with two-way ANOVA. The means were compared using the Tukey HSD test (alpha = 0.05)., Results: Acid etching time and bonding agent statistically significantly influenced bond strength (p < 0.05). In the Single Bond group, the bond strengths between group 0 (10.48 MPa) and Group 30 (11.17 MPa) did not differ significantly, with these groups exhibiting the lowest bond strength values. The highest bond strength in Single Bond group was observed in group 120 (15.07 MPa) and group 60+60 (15.42 MPa), which did not differ significantly from each other. In the AdheSE group, the bond strengths of group 0 (9.33 MPa) and group 30 (9.49 MPa) did not differ significantly, and these groups exhibited the lowest bond strength values. The highest bond strengths in the AdheSE subgroup were observed in group 120 (14.84 MPa) and group 60+60 (14.96 MPa), which were not significantly different. Comparing the two different adhesive systems, Single Bond exhibited higher bond strength values than did the self-etching adhesive AdheSE., Conclusions: Acid etching of porcelain with 9.6% hydrofluoric acid gel for 120 s provided adequate bond strength for composite repair with a microhybrid composite. When a porcelain restoration is repaired with composite, Single Bond adhesive should be preferred to the AdheSE self-etching adhesive system.

Purpose: The purpose of the present in vitro study was to examine shear bond strengths of resin composite to porcelain according to surface treatment., Materials and Methods: One hundred eight feldspathic porcelain blocks were prepared. Specimens were divided into nine surface treatment groups: sandblasting with 50- or 110-microm Al2O3, acid etching with hydrofluoric acid, applying silane agent, and combinations of these treatments. Microhybrid resin composite was condensed and light cured for 40 seconds on the porcelain specimens, which were then stored in distilled water at 37 degrees C for 24 hours before mechanical testing., Results: The bond strengths were significantly different according to one-way ANOVA. The lowest bond strength was observed in the silane group (4.09 MPa); the highest bond strengths were observed with acid etching + silane (11.97 MPa) and sandblasting with 50-microm Al2O3 + acid etching + silane (12.34 MPa) (no significant difference between groups)., Conclusion: Acid etching with 9.6% hydrofluoric acid gel or sandblasting with 50- or 110-microm Al2O3 particles alone did not provide adequate bond strength. Silane agent was effective in increasing the shear bond strength of resin composite to porcelain after sandblasting or acid etching. Porcelain treatment with a combination of 50-microm Al2O3 air abrasion, 9.6% hydrofluoric acid, and silane agent provided higher bond strengths than treatment with any of these procedures alone.