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Objective Modified surgical lip repositioning (MLR) is a conservative method for correcting gummy smile (GS). However, its long-term evaluation in the prevention of relapse following lip repositioning surgeries remains questionable. This long-term study was therefore conducted to assess MLR with and without an adjunctive internal dual muscle traction approach (iMTA) in the treatment of GS. Methods This study was performed on 20 cases with GS. They were randomly and equally distributed to be treated either by MLR alone (Control) or augmented with iMTA (Test). Participants were assessed for GS reduction at 3, 6 and 12 months postoperatively. The patient's satisfaction scores were assessed at 12 months in both groups. Results The control participants revealed in a remarkable decrease in gingival exposure (2.7 mm ± 0.48) (P-value ≤ 0.05), while the test ones demonstrated a more significant reduction in GS (1.6 mm ± 0.52) (P-value ≤ 0.05). Satisfaction scores were significantly reported in the test group (9.3 ± 0.78 when compared to the control group (7.8 ± 1.3), (P-value ≤ 0.05). Conclusions Within the limits of this study, our long-term results revealed that MLR is an effective method for treating GS, while iMTA offered more stable results at 12 months when used as an adjunct to MLR.

PURPOSE The aim was to evaluate the effect of different preparation depths for inlay-retained fixed partial dentures on the accuracy of intraoral scanners. MATERIALS AND METHODS Tooth preparations for two inlay-retained fixed partial dentures were done and divided according to depth of the preparation. Group A: 2mm pulpal floor depth, 3mm gingival floor depth and Group B: 3mm pulpal floor depth, 4mm gingival floor depth. The CEREC Omnicam4.4.4, Omnicam4.6.2. Trios3 and Medit i500 intraoral scanners were used in this study. Tooth preparations were scanned by each scanner 10 times. The STL files obtained from the intraoral scanners were compared to the reference models (trueness) and within each test group (precision) using a 3D comparison software. Data were then statistically analyzed. RESULTS Regarding trueness, two-way ANOVA revealed significant differences between the different types of scanners (p

Periodontal disease is a chronic, infectious gum disease, which eventually leads to tooth loss, adversely affecting quality of life (QoL). Most of the research in this area focuses on evaluating clinical parameters rather than patient-based outcomes. Currently, these parameters are gaining importance along with treatment outcomes of chronic diseases and QoL. This study evaluates the impact of periodontal disease and its treatment on oral health-related quality of life (OHRQoL).We recruited 90 participants who were divided into two groups. One was the test group (n = 45) that underwent non-surgical periodontal therapy (NSPT) followed by periodontal flap surgery (SurgPT). Second was the control group (n = 45) that underwent only NSPT. Clinical parameters, plaque index, gingival index, periodontal/probing pocket depth (PPD), clinical attachment level (CAL), and mobility were recorded. An OHRQoL questionnaire was used to assess the functional, physical, social, and psychological domains at baseline, three, and six months.The mean PPD in the test group was 6.9 ± 0.38, 3.2 ± 0.36, 3.5 ± 0.5, and 5.8 ± 0.67, 3.13 ± 0.21, 3.73 ± 0.45 in the NSPT group at baseline, 3, and 6 months, respectively. The mean CAL in the SurgPT group was 7.07 ± 0.41, 3.56 ± 0.27, 3.74 ± 0.30, and 6.08 ± 0.16, 4.02 ± 0.17, 4.16 ± 0.19 in the NSPT group at baseline, 3, and 6 months, respectively. Both treatments resulted in reduction in all clinical parameters and were statistically significant in the SurgPT group (In this study, NSPT and SurgPT had a positive impact on OHRQoL by improving clinical parameters, but SurgPT had substantially better outcomes in terms of improved QoL.أمراض اللثة مرض معدي مزمن يصيب اللثة، يؤدي في النهاية إلى فقدان الأسنان مع تأثير سلبي على جودة الحياة. تركز معظم البحوث في هذا المجال على تقييم المعايير السريرية بدلا من النتائج المستندة على المريض. في الوقت الحالي، تكتسب هذه المعايير أهمية، وكذلك نتائج علاج الأمراض المزمنة على جودة الحياة. تهدف هذه الدراسة إلى تقييم تأثير أمراض اللثة وعلاجها على جودة الحياة المرتبطة بصحة الفم.قمنا بتوظيف ٩٠ مشاركا تم تقسيمهم إلى مجموعتين. مجموعة الاختبار (ن=٤٥) الذين تلقوا علاجا غير جراحي للثة متبوعا بجراحة السديلة اللثوية ومجموعة التحكم (ن=٤٥) الذين تلقوا علاجا غير جراحي للثة فقط. تم تسجيل العلامات السريرية، ومؤشر اللويحة، ومؤشر اللثة، وعمق جيب اللثة، ومستوى التعلق السريري والحركة. تم استخدام استبانة جودة الحياة المرتبطة بصحة الفم لتقييم المجالات الوظيفية والجسدية والاجتماعية والنفسية عند البداية، ٣ و٦ أشهر.كان متوسط عمق جيب اللثة في مجموعة الاختبار ٦.٩ ± ٠.٣٨، ٣.٢ ± ٠.٣٦ و٣.٥± ٠.٥وفي المجموعة الضابطة ٥.٨ ± .٠٦٧و ٣.١٣ ± ٠.٢١و ٣.٧٣ ± ٠.٤٥ عند البداية و٣ و٦ أشهر على التوالي. كان متوسط مستوى التعلق السريري في مجموعة الاختبار ٧.٠٧ ± ٠.٤١و ٣.٥٦± ٠.٢٧ و٣.٧٤± ٠.٣٠و ٦.٠٨± ٠.١٦. وفي المجموعة الضابطة ٤.٠٢± ٠.١٧و ٤.١٦± ٠.١٩عند البداية، ٣ و٦ أشهر على التوالي. أظهر كلا ذراعي العلاج انخفاضا في جميع المتغيرات السريرية وكانت ذات دلالة إحصائية في المجموعة الجراحية. لوحظ انخفاض أكثر جوهرية في درجات مظهر تأثير صحة الفم في المجموعة الجراحية (متوسط الفرق–٢٥.٠) مقارنة بالمجموعة غير الجراحية (متوسط الفرق–٥.٠).في هذه الدراسة، كان للعلاج غير الجراحي للثة وجراحة السديلة اللثوية تأثيرا إيجابيا على جودة الحياة المرتبطة بصحة الفم من خلال تحسين العلامات السريرية، لكن جراحة السديلة اللثوية كان لها نتائج أفضل بكثير من حيث تحسين جودة الحياة.

Laboratory and field experiment on use of the feed additive based on Bacillus subtilis endo- and exometabolites for the cows in different physiological periods are described in the paper. The feed additive impact on main body systems of the tested cows (n = 30), milk production parameters, growth rate of the calves (n = 18) born to the said cows were examined. The feed additive was added to the diets for the cows of test groups, 15 g per cow. The feed additive was found to have a positive effect on immunohematological and metabolic processes in postpartum cows. Neutrophils’ phagocytic activity increased by 12.5% and 14.6% in the animals of test group 1 and test group 2, respectively, as compared to that one in control animals (42.8 ± 1.9%). Neutrophil absorbency increased by 2.5 times, 3.2 times and 2.1 times in the animals of test group 1, test group 2 and control group, respectively. The proportion of T-lymphocytes in blood of animals in test group 1 and test group 2 was 44.5 and 48.9%, respectively, proportion of T-lymphocytes in blood of control animals equaled to 37.5%. Trend for increase in total protein concentration in cow sera owing to increase in albumin fraction was observed in postpartum period: it was 72.91 ± 3.45 g/l in test group 1; 75.54 ± 4.12 g/l in test group 2; 70.95 ± 4.25 g/l in control group. Average daily milk yield in cows of test group 1, test group 2 and control group for the 150 days of lactation was 24.50 ± 1.86 kg; 25.33 ± 1.45 kg and 22.75 ± 4.41 kg, respectively. Higher growth rate was reported for the calves born to the cows received the diet supplemented with the said feed additive. Heifers of test group 1 and test group 2 have reached body weight of 193.51 ± 5.76 and 195.33 ± 3.76 kg and in control group – of 187.33 ± 4.98 kg within 6 months. Feed additive based on endo- and exometabolites of Bacillus subtilis is recommended for cow diets for highly productive dairy herd creation and food-producing animal welfare maintenance.

Made available in DSpace on 2022-05-01T10:19:02Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: Xenogeneic matrices (XMs) have been increasingly used for root coverage procedures. This study compared the use of two types of XM (collagen matrix [CM] and xenogeneic acellular dermal matrix [XDM]) associated with the coronally advanced flap technique (CAF) to treat single gingival recessions. Methods: Seventy-five patients presenting single RT1 gingival recession were treated by CAF (control group, n = 25), CAF+CM (test group 1, n = 25), or CAF+XDM (test group 2, n = 25) and completed 6-month follow-up. Clinical, patient-centered, and esthetic assessments were performed and intra- and intergroup differences were analyzed. Results: At 6 months, the mean recession reduction for CAF, CAF+CM, and CAF+XDM was 2.4 ± 0.8 mm, 2.4 ± 0.9 mm and 2.1 ± 0.8 mm, respectively (P > 0.05). The corresponding mean percentage of root coverage was 78.9% ± 26.2% for CAF, 78.0% ± 28.5% for CAF+CM, and 65.6% ± 26.9% for CAF+XDM (P > 0.05). Dentin hypersensitivity and esthetic conditions showed significantly improvements in all groups. Test groups presented significant gains in gingival thickness (GT; CAF+CM: 0.4 ± 0.3 mm; CAF+XDM: 0.4 ± 0.2 mm) compared to the control group (CAF: 0.0 ± 0.1 mm; P

This study evaluated long-term clinical and patient satisfaction outcomes following a modified lip repositioning technique that utilized periosteal sutures in a twin population. Twin sisters diagnosed with maxillary lip hypermobility were randomly assigned to either the control group (original LipStaT technique) or test group (addition of periosteal sutures). The participants (n = 12; 6 per group) were evaluated at intervals for up to 3 years postoperative. Clinical measurements, digital images, and patient satisfaction surveys were collected. Descriptive statistics were used to assess outcome variables: average lip width at rest (ALW), vertical lip translation (VLT), and average gingival display (AGD). Student t test, one-way analysis of variance, and Spearman rank correlation tests were used to compare mean values of variables at five time points for both groups. The level of significance was α = .05. In the control group, mean VLT and AGD values showed statistically significant decreases from baseline (14.8 mm and 7.0 mm, respectively) to 2 years (5.7 mm and 2.4 mm, respectively), but a slight increase was seen at 3 years (7.5 mm and 5.0 mm, respectively; P < .0001). In the test group, mean VLT and AGD values showed statistically significant decreases from baseline (14.8 mm and 6.9 mm, respectively) to 3 years (5.5 mm and 3.5 mm, respectively; P < .0001). A higher participant satisfaction score at 3-year follow-up was observed in the test group. The modified lip repositioning technique in a population of twins resulted in more stable outcomes that lasted up to 3 years postoperatively.

Objective A radiology sign that references a resemblance to something which is not actually present within an image has been termed a 'metaphoric' sign. Metaphoric signs are widely described in the literature and commonly used in teaching as a form of pattern recognition, or ‘pareidolia’. However, the educational benefit of metaphoric signs has not been previously assessed. We aimed to assess the utility of metaphoric signs in medical student teaching. Materials and Methods Fifteen radiology cases were prepared into two lecture formats for medical student education. A 'test' lecture utilizing metaphoric radiology signs to describe the appearance of the cases and a 'control' lecture where pathology was compared to normal anatomical appearances without reference to metaphoric signs. Forty-nine volunteer medical students were randomized with cluster sampling to receive either the test or control lecture. Four days later, students were quizzed to determine retention of knowledge and to assess interest in the lecture on a visual analogue scale from 0 to 100. Results The median interest level of the test group (69.5) was higher than the control group (50) (p = 0.001). The mean quiz score was higher in the test group (34.5) than in the control group (29) (Difference 5.5, 95% confidence interval 0.08-10.92, p = 0.047). Conclusion The use of metaphoric signs in radiology education of medical students increased interest, descriptive ability and short-term knowledge retention, compared to the same material taught with normal anatomy correlation. Metaphoric signs should be considered as a useful radiology teaching tool.

Purpose: This experimental study was to evaluate and compare bone regeneration capacity of experimental bone defects filled with different autologous platelet concentrates (APCs) as a bone graft material in the rabbit’s tibiae. Material and methods: A total of forty-two adult rabbits were included in this study. After creation of bone defects, the animals were randomly assigned to three groups. In control group, no bone graft was used (Group A, n=14), in one test group Plasma Rich in Growth Factors (PRGF) was used as bone graft material (Group B, n=14), and in the other test group Injectable Platelet Rich Fibrin (i-PRF) was used as bone graft material (Group C, n=14). After implantation, each group was further divided into two subgroups, where rabbits were sacrificed 2 and 4 weeks postoperatively and the defects were evaluated with histologic and histomorphometric analysis. Results: Both test groups (Group B and Group C) treated with APCs (PRGF: 10.92±0.85 & 41.53±2.55and i-PRF: 13.13±0.68 &57.27±1.66 at 2 and 4 weeks respectively) demonstrated higher percentages of new bone formation than the control group (5.11±1.15 & 30.31±1.29 at 2 and 4 weeks respectively) (P < 0.001). Significant difference was found between the two test groups and control group (P < 0.001). On the other hand, significant difference was found between test groups (P < 0.001). Conclusions: Within the limitation of this animal study, the adjunct implication of either i-PRF or PRGF in endodontic surgery may be of great significance as it dramatically improves bone regeneration.

Introduction The Sniffin’ Sticks threshold test is widely used to assess olfactory threshold due to its high reliability and validity. Nevertheless, this test procedure is quite long with an average duration of 10 to 20 min. In study designs that require multiple olfactory threshold tests on short intervals, this could exhaust participants. To counteract this limitation, we developed the informed-four-reversal (INFOUR) short version of the Sniffin’ Sticks threshold test for repeated measurement designs and piloted it in a sample of normosmic participants. Methods Forty-two participants performed the original Sniffin’ Sticks version before being assigned either to the control group that repeated the original version or to the test group that conducted the INFOUR short version. Results The correlation between the original version at T1 and INFOUR at T2 was r = .75 and did not differ significantly from the retest reliability of the original version. Compared to the original version, the INFOUR took 42% less time to perform. Conclusion The INFOUR leads to a significant time saving, while maintaining good validity. Implications Therefore, this approach has the potential to be a useful tool for study protocols with repeated olfactory threshold measurements. In particular, when research protocols are time intensive or testing needs to the shortened, because the interventional effects are short or subtle.

Purpose: This study measured and compared shear bond strength (SBS) of a composite resin cement with that of PICN material after different surface cleaning methods. Materials and Methods: Forty Vita-Enamic plates (10x7x2 mm) were fabricated using of a low speed, water-cooled diamond saw. All plates were air-borne particle abraded using 50µm Al2O3 then contaminated with saliva, after that all plates were classified into four groups (n=10): control group (CG) in which conventional cleaning with air-water spry was used, and three test groups as follow: ultrasonic cleaning (UCG), steam cleaning (SCG), Ivoclean cleaning (ICG). Composite resin discs (Nexcomp) were cemented to ceramic plates using self-adhesive resin cement (Charm Supercem). All bonded specimens were stored in 37°C water for 1 month then, thermocycled 1000 times in water baths between 5˚C and 55˚C. Shear bond strength (SBS) test was performed using a universal testing machine. Scanning Electron Microscope (SEM) was used for failure mode examination. Results: Different cleaning methods significantly increased SBS values of tested groups compared to control one (p=0.000). The highest mean SBS (MPa) was reported for (SC) test group (18.41±1.5 MPa) followed by (UC) test group (11.52±.99MPa). While the lowest mean SBS was observed for (CG) (4.00 ±.59 MPa). There was statistically significant difference between (SCG) and other groups (CG, UCG, ICG) (p=0.0001). There was no statistically significant difference between IC and UC test groups (p=0.2941). Conclusion: Within the limitation of the present study, the bond strength of self-adhesive resin cement to hybrid ceramics increased by different surface cleaning protocols.

Echocardiographic evaluation of chronic aortic regurgitation (AR) severity can lead to diagnostic ambiguity due to few feasible parameters or incongruent findings. The aim of the present study was to improve the diagnostic usefulness of left ventricular (LV) enlargement and aortic end-diastolic flow velocity (EDFV) using cardiovascular magnetic resonance (CMR) as reference. Patients (n = 120) were recruited either prospectively (n = 45) or retrospectively (n = 75). Severe AR (CMR regurgitant fraction > 33%) was present in 51% and 93% of the patients had LV ejection fraction ≥ 50%. EDFV and LV end-diastolic volume index (EDVI) were assessed by echocardiography using the traditional (excluding trabeculae) and recommended approach (including trabeculae). The patients were randomised to a derivation (n = 60) or a test group (n = 60). EDVI (traditional/recommended) to rule in (>99/118 ml/m2) and rule out severe AR (≤75/87 ml/m2) were identified using ROC analyses in the derivation group. The corresponding thresholds for EDFV were >17 cm/s and ≤10 cm/s. In the test group, the positive/negative likelihood ratios to rule in/rule out severe AR using EDVI were 10.0/0.14 (traditional), 6.2/0.11 (recommended), and using EDFV were 10.2/0.08. To rule in and rule out severe AR using derived cut-off values instead of >2 SD reduced the false positives by 92%, whereas using EDFV ≤10 cm/s instead of ≤20 cm/s reduced the false negatives by 94%. In conclusion, EDVI and EDFV as quantitative parameters are useful to rule in or rule out severe chronic AR. Importantly, other causes of LV enlargement have to be considered.

Objectives Kalaf (Melasma) is an acquired facial hypermelanism. It has direct impact on patient’s quality of life and leads to development of various personality disorders. Lack of effective treatment and recurrences have drawn the attention of researcher to find alternative treatment. This study aimed to evaluate safety and efficacy of a topical Unani formulation in the management of melasma. Methods We conducted a prospective randomized controlled clinical study on the participants diagnosed with melasma. The participants (n=72) randomized into test (n=36) and control (n=36) groups. Sixty participants (n=30 in each group) completed the duration of therapy. The participants of the test group were treated with a classical Unani formulation and control group with hydroquinone 4%. The primary end point was change in mean MASI score and secondary end point was improvement in quality of life after eight weeks of treatment. Results The Unani formulation reduced 40.5% mean MASI score (17.31 ± 9.58 to 10.28 ± 5.92) in comparison to 32% reduction in mean MASI score (20.58 ± 9.49 to 13.92 ± 7.38) in the control group after eight weeks of treatment. When comparing with baseline the difference in MASI score was found statistically significant in both groups (p0.05). In addition, MQOL and DQLI also improved significantly in both groups. Conclusions This study concluded that the Unani formulation and the control drug were equally effective and safer in the management of melasma.

Objective: To determine the effect on intraocular pressure following primary Trabeculectomy with MMC 0.2% versus Trabeculectomy without MMC in Primary Open Angle Glaucoma. Study Design: This is a prospective and experimental Study. Setting: Study carried out at Ophthalmology Department, Shaheed Mohtarma Benazir Bhutto Medical University Larkana, from 01-03-2020 to 31-08-2020 (06 Months). Materials and Methods: The patients with primary open angle glaucoma were selected from glaucoma clinic after taking careful history and clinical examination. Patients selected for trabeculectomy into two groups. Group A includes 43 patients while Group B also includes 43 patients. Among Group A patients adjunctive MMC 0.2mg/ml for a period of 3 minutes was used during trabeculectomy as a primary procedure (Test Group) while Group B patients were operated without MMC 0.2% (Control Group). Follow-up period of 06 months was observed in both groups. The span of study was from 01-03-2020 to 31-08-2020. Results: The total of 86 Eyes of 86 patients of POAG were included in this study. Group A patients were operated for trabeculectomy with MMC while group B patients were operated for trabeculectomy without MMC. The mean IOP before surgery of Group-A was 25.39±2.42 mmHg while in Group-B it was 26.23±4.23mmHg. At day 1 of surgery in Group-A patients IOP was 13.20±3.05 mmHg while in Group-B patients IOP, was 14.09±4.04 mmHg. After 3 months in Group-A, IOP was 13.04±3.81 mmHg in Group-B IOP was 14.01±4.18 mmHg. Out of 43 patients in Group-A, 41(95.3%) were succeeded while in Group-B, 39(90.7%)were succeeded. Significant result was found for IOP reduction after 6 months of surgeryin group-A IOP was 13.48 + 2.86 mmHg while in group-B, IOP was 15.09 ±2.64 (P=0.754). Conclusion: Trabeculectomy with MMC as a primary procedure seems to be more effective than trabeculectomy without MMC.

This study aimed at assessing the value of heart rate variability (HRV) as a stress indicator before and after a final re-sit exam among healthy sixth grade medical students. Fifty participants were recruited for the study (test group, n = 30; control group, n = 20). Each participant was examined for 5 minutes pre and post exam periods using the Heartmath proprietary protocol. EmWave equipment was used to detect, record and analyze the HR and to plot out the variability in discrete percentages for low, medium and high coherences. Results indicated that mean percentage coherence score was significantly higher in the test group (p < 0.05) at low cardiac coherence domain, but lower (p < 0.05) at the high coherence domain, compared with the control. Coherence score was significantly higher (p < 0.05) after the exam indicating release from stress, as compared to before the examination when stress was observable among the exam candidates. There were no significant gender differences observed in cardiac coherence scores before and after examination. Our findings indicate that HRV is a reliable indicator of real-time exam stress and supports future clinical use of HRV as a non-invasive and simple stress test.

Objectives Minimally invasive flap designs have been introduced to enhance blood clot stability and support wound healing. Limited data appear to suggest, that in intrabony defects, better clinical outcomes can be achieved by means of minimally invasive flap compared to more extended flaps. The aim of this study was to evaluate the healing of intrabony defects treated with either minimally invasive surgical flaps or with modified or simplified papilla preservation techniques in conjunction with the application of an enamel matrix derivative (EMD). Materials and methods Forty-seven subjects were randomly assigned to either test (N = 23) or control (N = 24) procedures. In the test group, the intrabony defects were accessed by means of either minimally invasive surgical technique (MIST) or modified minimally invasive surgical technique (M-MIST) according to the defect localization while the defects in the control group were treated with either the modified or simplified papilla preservation (MPP) or the simplified papilla preservation technique (SPP). EMD was used as regenerative material in all defects. The following clinical parameters were recorded at baseline and after 12 months: full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depths (PD), clinical attachment level (CAL), and gingival recession (GR). Early healing index (EHI) score was assessed in both groups 1 week following the surgery. CAL gain was set as primary outcome. Results After 12 months follow-up, the CAL gain was 4.09 ± 1.68 mm in test group and 3.79 ± 1.67 mm in control group, while the PD reduction was 4.52 ± 1.34 mm and 4.04 ± 1.62 mm for test and control sites. In both groups, a minimal GR increase (0.35 ± 1.11 mm and 0.25 ± 1.03 mm) was noted. No residual PDs ≥ 6 mm were recorded in both groups. CAL gains of 4–5 mm were achieved in 30.4% and in 29.2% of test and control group, respectively. Moreover, CAL gains ≥ 6 mm were recorded in 21.7% of experimental sites and in 20.8% of control sites. No statistically significant differences in any of the evaluated parameters were found between the test and control procedures (P > 0.05). After 1 week post-surgery, a statistically significant difference (P Conclusions Within the limits of this pilot RCT, the results have failed to show any differences in the measured parameters following treatment of intrabony defects with EMD, irrespective of the employed surgical technique. Clinical relevance In intrabony defects, the application of EMD in conjunction with either MIST/M-MIST or M-PPT/SPPT resulted in substantial clinical improvements.

BACKGROUND: The long-term stability for both the patient and periodontist remains an important priority after connective tissue graft to manage the gingival recession cases. The goal of this analysis was to assess and compare the connective tissue graft with Pouch/Tunnel technique versus connective tissue graft with coronally advanced tunnel flap for the treatment of maxillary recession cases in severe periodontitis. METHODS: The total sample size was comprised of 200 subjects. The control group, coronally advanced flap along with connective tissue graft (CTG) was comprised of 100 samples and test group, pouch/tunnel technique with connective tissue graft (POT + CTG) was also comprised of 100 samples. The clinical findings included medium root coverage (MRC) and absolute root (CRC) coverage, gingival (GT) distribution and keratinized tissue (KT) gain. Esthetic findings were also evaluated. All findings analyzed initially after 6th months and have been expanded to 4 years. RESULTS: There were no major variations between the MRC and CRC patient classes with non significant values. In the POT + CTG category, GT and KT improvements were slightly greater at 4 years, with a substantial improvement in texture in control group. CONCLUSION: Pouch/Tunnel technique along with connective tissue graft allows for the clinical coverage of gingival recessions that is equivalent to Coronally advanced flap with CTG, however this may improves the gingival thickness, KT and esthetic performance.

Objectives The aim of the study was to examine the impact of the training program on directed physical fitness. Material and Methods The research involved 35 male cadets of the Polish Air Force Academy in Dęblin. The examined persons were on average 19 years old. All the examined persons were divided into 2 groups. Group I (N = 25, the test group) carried out a program on Special Aviation Gymnastic Instruments. Group II (N = 10, the control group) conducted the standard physical military education program. In both groups, the test was performed twice, before (examination I) and after (examination II) the preparatory process, using the following tests: pull-ups, a 16.5-meter race, a 10×10-meter shuttle race, forward bends, and the Aviation Synthetic Efficiency Test (ASET). The findings obtained in these tests were converted into points for the overall evaluation of physical fitness. The training lasted 70 days. Results In group I, in examination II, there was a statistically significant increase in the results of pull-ups (p < 0.01), the 16.5-meter race (p < 0.01), the 10×10-meter shuttle race (p < 0.05), forward bends for 2 min (p < 0.05) and the overall physical fitness (p < 0.05), compared to examination I. In group II, in examination II, the authors proved an insignificant increase in the findings when contrasted with examination I. The test results between groups I and II did not show any significant differences in the examined efficiency tests. In group I, in examination I, significant correlations were found between the overall physical fitness and pull-ups, the 10×10-meter shuttle race, the 16.5-meter race, forward bends and ASET. Examination II demonstrated significantly stronger correlations between the overall physical fitness and forward bends as well as ASET. In group II, in examination II, a significant correlation was shown between the overall physical fitness and the 16.5-meter race. Conclusions A significant correlation between the overall physical fitness and ASET in examination II indicates an impact of the training program on the targeted efficiency of the cadet pilots. Int J Occup Med Environ Health. 2021;34(5):647–58

Summary Objective This study aimed to assess the relationship of the anteroposterior position of maxillary central incisors with the forehead in an Iranian subpopulation residing in Kermanshah city. Materials and methods In this cross-sectional study, 12 orthodontists were requested to analyse full-smile profile photographs with complete maxillary incisor and forehead show in 70 patients with optimal facial harmony (35 males and 35 females) as the control group and 140 patients without optimal facial harmony (70 males and 70 females) as the test group. The inclusion criteria were (I) males and females between 18–60 years seeking orthodontic treatment and (II) willingness for participation in the study. The exclusion criteria were (I) presence of severe craniofacial anomalies, and (II) history of orthodontic treatment. The photographs were traced and analysed using Digimizer Image Analysis software 5.3.5. Data were analysed using STATA version 14.2 via independent t-test and linear regression. Results A significant difference existed in the anteroposterior position of maxillary incisors in males between the test and control groups (P = 0.002). However, this difference was not significant in females of the two groups (P = 0.77). A significant difference was noted in the anteroposterior position of maxillary incisors between males and females in the test group (P = 0.001) but not in the control group (P = 0.80). The frontal angle had a significant correlation with gender and anteroposterior position of maxillary incisors in both groups (P Conclusions According to the results, the anteroposterior position of maxillary incisors was significantly different in the test and control groups. The maxillary incisors in males were more retruded than in females. Also, the frontal angle had a significant correlation with the anteroposterior position of maxillary incisors, and by 1° increase in the frontal angle, the incisors were protruded by averagely 0.307 mm.

The purpose of the research is study of the animal's body clinical status and changes in hematological parameters before and after treatment against sarcoptoidosis of cattle. Materials and methods. The experiment was performed on bull calves and heifers aged 6–10 months, medium finish, of 100–120 kg of body weight. The test animals were divided into three groups: two test groups and one control group of 15 animals each. Before the experiment and at 7, 14 and 21 days after treatment with acaricides, scrapings from the affected skin and blood were taken from animals of all groups for research. The first test group animals were treated with ivermectin subcutaneously at a dose of 5 ml per animal, and the second test group was treated with cydectin subcutaneously at a dose of 5 ml per animal. The control animals were not treated. Results and discussion. The conducted hematological studies found a decrease in erythrocytes and hemoglobin in sarcoptoidosis, which indicated a decrease in oxygen supply to the body, and, consequently, organs and tissues. The white blood cell differential was observed to have a noticeable decrease in monocytes and lymphocytes.

To investigate the effectiveness of hydraulic pressure-assisted sinus augmentation (SA) in a rabbit sinus model in terms of radiographical and histological healing.Bilateral SA was performed in 12 rabbits. Each sinus was randomly assigned to either a hydraulic pressure-assisted SA (test) or a conventional SA (control) group. Healing periods of 2 and 4 weeks were applied (n = 6 for each week). Healing pattern including newly formed bone (NB) and residual bone substitute material (RM) was analyzed with microcomputed tomographically, histologically, and histomorphometrically.No sinus membrane perforation was detected in either group. In the microcomputed tomographic analysis, the test group exhibited higher apico-coronal spread of RM compared to the control group (p 0.05). Particularly, the test group exhibited several masses of NB out of the cluster of RM. Histologically, the test group showed an elongated shape of the augmented space, whereas the control group generally presented a dome shape. Histomorphometrically, the total augmented area and the area of NB (1.32 ± 0.56 vs. 0.84 ± 0.40 mmHydraulic pressure-assisted SA led to new bone formation in the distant areas from the bony access hole, but similar histological healing pattern to conventional SA.Hydraulic pressure-assisted SA is a promising option for treating pneumatized posterior maxilla.

To explore the performance of the improved DenseNet network in diagnosing pulmonary nodules (PNs) and differentiating benign and malignant PNs, improved DenseNet network was applied to segment MRI images of 60 PN patients, which were defined as the test group, while those segmented by the traditional one were undertaken as the control group. The MRI results were compared with the pathological diagnostic results, and the segmentation effects were evaluated factoring in precision, recall, Dice similarity coefficient, and intersection-over-union (IoU). The results showed that the improved DenseNet network algorithm showed higher accuracy, recall rate, Dice coefficient, and IoU versus the traditional one, and the difference was notable ( P < 0.05 ). The improved DenseNet network algorithm had higher diagnostic accuracy in terms of the PN volume, lobes, burrs, edges, and adhesion to surrounding tissue, with notable differences noted ( P < 0.05 ). The accuracy in differentiating benign and malignant PNs in the test group was higher (92.38 ± 8.74% vs. 75.56 ± 7.56%) versus the control group, and the difference was notable ( P < 0.05 ). In short, the MRI image segmentation algorithm based on the improved DenseNet network shows high accuracy in diagnosing PNs and differentiating benign and malignant PNs, and it is worthy of further promotion in the clinic.

Objectives Majoon-e-Seer Alvi Khan, a compound Unani formulation, has been indicated in disease conditions simulating dyslipidemia. The present study was done to substantiate the efficacy of Majoon-e-Seer Alvi Khan (MSAK) in dyslipidaemia on scientific parameters. Methods A randomized, single-blind, Standard controlled, clinical trial was carried out on 40 patients of dyslipidemia who were randomly allocated into test (n=30) and control (n=10) groups. The test drug, MSAK, and control drug, tablet Atorvastatin was given to the respective group for 60 days along with lifestyle modification. Results The test drug significantly alleviated the symptoms of subjective parameters (p Conclusions The study evidenced that Majoon-e-Seer Alvi Khan is potentially effective and safe in the treatment of dyslipidemia. However, a multicentre study with a robust study design is required to generalize the results.

The purpose of this 12-month randomized, controlled clinical trial was to evaluate the efficacy of a monotherapy protocol with the neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for treatment of peri-implantitis. Twenty patients with 36 implants exhibiting probing pocket depths (PPDs) > 4 mm and evidence of radiographic bone loss (RBL) were randomly divided into two groups. The test group was treated with the Nd:YAG laser, and the control group was managed with mechanical debridement only. Peri-implant clinical parameters were recorded at baseline and at 12 months after treatment. PPD, RBL, and bleeding on probing showed improvements after 12 months in the test and control groups. The laser therapy provided additional benefits of greater reduction in PPDs and increased bone level with no adverse outcomes. The results demonstrated that laser therapy could be a valuable modality for the treatment of peri-implantitis.

La Seguridad y Salud en el Trabajo es una disciplina cuya implementación en las organizaciones ha cobrado cada vez más importancia en los últimos años. Por esta razón, nace la necesidad de encontrar herramientas que soporten el proceso de enseñanza y la transmisión de conocimientos para la vida profesional. Partiendo de la metodología Design Thinking, se genera el proceso de ideación y creación de una herramienta gamificada de aprendizaje experiencial soportada en Realidad Virtual. Como resultado, se obtuvieron cuatro escenarios que simulan la operación de los trabajadores en diferentes sectores productivos. La validación de la herramienta se hizo mediante un instrumento de evaluación de cinco factores, diligenciado por un grupo de prueba que interactuó con el programa. Finalmente, la herramienta presentó aval por parte de los usuarios manifestando que esta es una experiencia educativa que les facilita aprender los conceptos colocándolos en práctica en un ambiente simulado.

Objectives: The objective of this study was to compare the placement of flapped vs. flapless dental implants utilizing clinical and immunological parameters. Subjects and methods: A total of 10 patients were received 20 dental implants. One quadrant in each patient was randomly assigned to control group while other to test group with the help of coin flip. Control group with 10 flapped implants and test group with 10 flapless implants. Follow-up examinations were carried out after 1 week, 1, and 3 months. All treatments were performed under local anesthesia. Peri-implant sulcular fluid samples were collected as well as clinical parameters recorded at the follow up periods. Results: Peri-implant sulcus depth was significantly greater in flapped implants at both 4 and 12 postsurgical weeks (P < 0.005). Matrix metalloproteinase-8 values were higher to a statistically significant level in the control group at 1 (P = 0.003) and 4 weeks (P = 0.007) after placement. Conclusions: Matrix metalloproteinase 8 levels of peri implant crevicular fluid as well as pocket depth were decreased in flapless implants than conventional flap implant surgery.

The use of virtual reality simulation (VRS) developed a new era in dentistry, where a pre-operative virtual planning in conjunction with a surgical guide could help the surgeon with a prosthetically-driven correct implant placement, especially in difficult clinical cases. Materials & methods: regarding this study, 14 patients were recruited with bounded partially edentulous spans in the maxilla. The patients were randomly assorted into 2 groups. The first group (control) is the static guide group (SG), while the second group (test group) is the dynamic navigation group (DN). After implant installation, a postoperative CBCT was obtained & the obtained image was superimposed over the original implant plan to determine the linear and angular deviation between the proposed plan and actual implant position. Results: Regarding the linear deviation between the planned and actual positions in both groups was measured at both the coronal apical areas. The independent sample t test showed a statistically insignificant difference between the two groups. On the other hand, regarding the angular deviation; The independent sample t test showed a statistically significant difference between the two groups. Conclusion: The Image Guided Implantology system provides highly accurate navigation with less than expected error acceptable in dental implantology. The accurate reporting of the exact position of the osteotomy drills should minimize the potential risk of damage to any critical anatomic structures. Furthermore, the accurate intraoperative navigation allows the surgeon to precisely transfer the presurgical plan to the patient in an accurate prosthetically-driven manner. Keywords: Navigation, Computer-guided, Implant placement, Accuracy.

With the development of artificial intelligence, technique improvement of the classification of skin disease is addressed. However, few study concerned on the current classification system of International Classification of Diseases, Tenth Revision (ICD)-10 on Diseases of the skin and subcutaneous tissue, which is now globally used for classification of skin disease. This study was aimed to develop a new taxonomy of skin disease based on cytology and pathology, and test its predictive effect on skin disease compared to ICD-10. A new taxonomy (Taxonomy 2) containing 6 levels (Project 2–4) was developed based on skin cytology and pathology, and represents individual diseases arranged in a tree structure with three root nodes representing: (1) Keratinogenic diseases, (2) Melanogenic diseases, and (3) Diseases related to non-keratinocytes and non-melanocytes. The predictive effects of the new taxonomy including accuracy, precision, recall, F1, and Kappa were compared with those of ICD-10 on Diseases of the skin and subcutaneous tissue (Taxonomy 1, Project 1) by Deep Residual Learning method. For each project, 2/3 of the images were included as training group, and the rest 1/3 of the images acted as test group according to the category (class) as the stratification variable. Both train and test groups in the Projects (2 and 3) from Taxonomy 2 had higher F1 and Kappa scores without statistical significance on the prediction of skin disease than the corresponding groups in the Project 1 from Taxonomy 1, however both train and test groups in Project 4 had a statistically significantly higher F1-score than the corresponding groups in Project 1 (P = 0.025 and 0.005, respectively). The results showed that the new taxonomy developed based on cytology and pathology has an overall better performance on predictive effect of skin disease than the ICD-10 on Diseases of the skin and subcutaneous tissue. The level 5 (Project 4) of Taxonomy 2 is better on extension to unknown data of diagnosis system assisted by AI compared to current used classification system from ICD-10, and may have the potential application value in clinic of dermatology.

Objectives The aim of this study was to evaluate clinically and radiographically alveolar Bone dimensional Changes after flapless immediate implant placement. Material and methods: Thirty-two Patients were divided into two groups; Group A (control group): received flapped immediate implants combined with xeno graft. Group B (Test group): received flapless immediate implants combined by xeno-graft. Evaluation includes Presence of infection.Wound dehiscence. Implant exposure. Graft exposure or loss. Soft tissue dehiscence. Implant stability. Buccal bone height and lingual bone height of the extracted socket. Ridge width. Results: buccal bone height, flapless group showed a significant lower (0.09 mm)Change than flap (1.13 mm).Ridge width, at 2, 4, 6 mm, flapless group showed a significant lower Change than flap. Flapless group showed significant higher implant stability than flap. Conclusion:the flapless group has shown a lower reduction in height and width after placing immediate implants and filling the residual gap with an organic bovine bone. More ridge reduction was observed for the flapless group.

Background: This research aims to evaluate the impact of acceptance and commitment therapy (ACT) on the occupational stress and the anxiety of nurses. Methods: This was an experimental study with pre-test post-test design with a control group. We included all nurses caring for patients with COVID-19 in governmental hospitals in Tehran during six months of 2020. Beck’s Anxiety Inventory (BAI) and Steinmetz Occupational Stress Questionnaire were used for data collection. Results: Box’s test (P=0.225) showed that the covariance-variance matrices were homogeneous. Levine’s test also indicated that the assumption of variance equality was observed. The amounts of ETA square root showed that 66.3% of the anxiety variance and 51.3% of the occupational stress variance could be predicted in the posttest through ACT. Conclusion: The rate of occupational stress and anxiety of the test group significantly decreased compared with the control group after the intervention. Therefore, ACT could decrease the occupational stress and anxiety of nurses and the therapists could use this approach for improving the mental health of nurses.

Bu çalışma, bilimsel tartışma odaklı eğitimin hemşirelik öğrencilerinde stigmayı anlama ve önleme düzeylerine etkisini belirlemek amacıyla yapılmıştır. Yarı deneysel ön test on test kontrol gruplu çalışmanın evrenini bir devlet üniversitesinde öğrenim gören Psikiyatri Hemşireliği dersini alan 104 öğrenci oluşturmuştur. Öğrenciler müdahale (n=21) ve kontrol (n=21) olmak üzere iki gruba ayrılmıştır. Araştırmada veriler, veri toplama aracı olarak araştırmacılar tarafından geliştirilen soru formu ve Damgalama Ölçeği ile toplanmıştır. Kontrol grubundaki öğrencilerin damgalama eğilimi son test puanında azalma olmasına rağmen ilk test ve son test puanları arasında istatistiksel olarak anlamlı bir farklılık olmadığı (p=0.765) saptanmıştır. Müdahale grubundaki öğrencilerin damgalama eğilimi son test puanında azalma olduğu ve bu azalmanın istatistiksel olarak anlamlı bir fark oluşturduğu bulunmuştur (p

Introduction: Ginger and honey have shown to be effective against pathogens routinely encountered in periodontal infection. However, none of literature has shown antibacterial effect of ginger and honey on the levels of dental plaque when used as a gel. Aim: To compare the effect of honey with ginger extract on the dental plaque levels and gingival health. Methodology: Fifteen systemically healthy patients were randomly allocated to either the test group [G1(ginger and honey gel = 15 sites)] or the control group [G2 (Chlorhexidine gel = 15 sites]. Full mouth Gingival Index (GI) Full mouth Plaque Index (PI) were evaluated at baseline and on 7th day. Results: The mean PI at baseline was 0.23 ± 0.02 (G1) and 0.29 ± 0.01 (G2) which was increased to 0.36 ± 0.01 (G1) and 0.37 ± 0.01 (G2) on 7th day. However, mean GI at baseline was 0.30 ± 0.04 (G1) and 0.34 ± 0.02 (G2) which was increased to 0.38 ± 0.03 (G1) and 0.43 ± 0.03 (G2) on 7th day. Conclusion: The results of this study suggest that the chlorhexidine gel and Natural gel containing Honey and Zingibar officinale both are effective in controlling plaque during the periodontal maintenance period.

BACKGROUND The long-term outcomes of demineralized porcine bone matrix (DPBM) in combination with enamel matrix protein derivative (EMD) for the treatment of one-wall intrabony defects have not yet been evaluated. Therefore, this study aimed to assess the clinical, radiographic, and patient-reported outcomes of regenerative therapy using DPBM with EMD (test group) in comparison with DPBM alone (control group) for the treatment of one-wall intrabony defects in the molar regions. METHODS Thirty-four patients (control group, n = 18, and test group, n = 16) were available at the 4-year follow-up assessment. Clinical (probing pocket depth and clinical attachment level [CAL]), radiographic (defect depth and width), and patient-reported (Oral Health Impact Profile [OHIP]-14) parameters were evaluated at baseline, 2 years, and 4 years after regenerative treatment. RESULTS Both treatment modalities, with and without adjunctive use of EMD, resulted in significant improvement of clinical (mean gain in CAL of 1.58 ± 1.34 mm), radiographic (mean defect width fill of 2.41 ± 0.90 mm), and oral health-related quality of life outcomes at 2 years after regenerative treatment of one-wall intrabony defects (P < 0.001), which has been sustained over a 4-year follow-up period. Particularly, OHIP-14 scores revealed a statistically significant reduction in physical pain, psychological discomfort, and physical disability (P < 0.05). CONCLUSIONS The clinical, radiographic, and patient-reported outcomes were significantly improved when DPBM was used in the regenerative treatment, but no additional benefits were observed with the adjunctive use of EMD.

Objectives To compare free‐hand to computer‐assisted implant planning and placement (CAIPP) regarding planned to achieved implant position. Material and methods Forty‐eight cast/bone models were mounted in mannequin heads. On each side, a tooth gap of different sizes was created. In the test group (T), study implants were placed using a CAD‐CAM guide based on virtual planning. In the control (C), free‐hand implant placement was performed. After CBCT scanning, the implant position was compared with the planned position. Descriptive statistics were applied, and ANOVA was used to identify differences between groups and gaps. (p

Background/Purpose Edentulous ridges with height discrepancies (RHDs) could jeopardize the outcome of implant placement. This study aimed at evaluating the outcomes of placing regular- and slope-configured implants in RHDs. Methods Patients with >1 mm RHDs requesting implant rehabilitation were recruited and randomly assigned to regular- (control) or slope-configured (test) implant treatment using a submerged installation protocol. Thread exposure (TE) and implant stability quotient (ISQ) were evaluated during implant installation (S1) and uncovered surgery (S2), and marginal bone level (MBL) was evaluated after implant installation (T1) and uncovery (T3), and one year after implant placement (T4). Periodontal status and gingival crevicular fluid (GCF) biomarkers of adjacent teeth were evaluated before implant installation (T0), before uncovery (T2), and at T4. Peri-implant clinical status and peri-implant crevicular fluid (PICF) biomarkers of examined implants were evaluated at T4. Results Nineteen patients with 17 control and 13 test implants were included. All of the implants survived with acceptable peri-implant health, and PICF biomarkers were at equivalent levels as GCF biomarkers of the adjacent teeth at T4. Compared with the control group, the test group showed reduced TE and equivalent ISQ at S1 and S2, and the loss of MBL was reduced at T4. Regarding the adjacent teeth, all periodontal parameters and GCF biomarkers were slightly decreased from T0 to T2, and the reductions in probing pocket depth and clinical attachment level were slightly greater at T4. Conclusion Slope-configured implants maintained the implant-supporting structures and minimally altered periodontal status of the adjacent teeth in RHDs.

To compare the outcomes of modified coronally advanced flap (mCAF) combined with either xenogeneic dermal matrix (XDM) or connective tissue graft (CTG) for the treatment of multiple adjacent gingival recessions (MAGRs). Forty-two patients, in whom 130 maxillary (MAGRs) of type (RT1) were found, were randomly allocated to the two groups. Clinical, esthetic, and patient-centered outcomes were evaluated at baseline, 6, and 12 months post-treatment. Group CAF+ CTG exhibited a higher mean root coverage value (mRC) (91.79%) (primary outcome variable) than group CAF+XDM (80.19%) without statistically significant difference at 12 months (p=0.06). The control group also had significantly higher percentage of teeth in which complete root coverage (CRC) and mean gain of gingival thickness (GT) were achieved, than the test group (p 0.05). Mean surgical time was lower in the test group (p

OBJECTIVES The use of local probiotics in the therapy of periodontitis is reflected in their ability to antagonize periodontopathogens and modulates the immune response of the host to the presence of pathogenic microorganisms. The aim of this study was to investigate the use of local probiotics in the treatment of periodontitis as an adjunctive therapy to scaling and root planning (SRP). METHODS The study involved 80 patients diagnosed with periodontitis. All participants underwent SRP therapy. Semi-solid probiotic was then locally applied to the periodontal pocket in randomly selected patients for the test group (40 of them). The other 40 patients were in the control group. Clinical parameters including periodontal pocket depth (PPD), bleeding on probing (BOP) and plaque index (PI) were measured at baseline, and at 7 and 30 days after treatment. RESULTS Seven days after the applied therapy in the test and control group, there was a significant decrease in the values or BOP (p

The process of aging and metabolism is intimately intertwined; thus, developing biomarkers related to metabolism is critical for delaying aging. However, few studies have identified reliable markers that reflect aging trajectories based on machine learning. We generated metabolomic profiles from rat urine using ultra-performance liquid chromatography/mass spectrometry. This was dynamically collected at four stages of the rat’s age (20, 50, 75, and 100 weeks) for both the training and test groups. Partial least squares-discriminant analysis score plots revealed a perfect separation trajectory in one direction with increasing age in the training and test groups. We further screened 25 aging-related biomarkers through the combination of four algorithms (VIP, time-series, LASSO, and SVM-RFE) in the training group. They were validated in the test group with an area under the curve of 1. Finally, six metabolites, known or novel aging-related markers, were identified, including epinephrine, glutarylcarnitine, L-kynurenine, taurine, 3-hydroxydodecanedioic acid, and N-acetylcitrulline. We also found that, except for N-acetylcitrulline (p < 0.05), the identified aging-related metabolites did not differ between tumor-free and tumor-bearing rats at 100 weeks (p > 0.05). Our findings reveal the metabolic trajectories of aging and provide novel biomarkers as potential therapeutic antiaging targets.

Background. The present randomized clinical trial aimed to determine the additive clinical and microbiological benefits of diode laser (DL) with modified Widman flap (MWF) to manage chronic periodontitis. Methods. Seventy-two sites in 36 healthy non-smoking patients diagnosed with chronic periodontitis were randomly assigned to the test group (MWF + active DL) or control group (MWF + sham DL). Clinical (probing pocket depth [PPD], clinical attachment level [CAL]) and microbiological (colony-forming units [CFUs]) measurements were recorded at baseline and 6- and 6-month postoperative intervals. Results. Compared to baseline, 6-month results showed significant changes in clinical and microbiological parameters in both groups. However, the intergroup comparison revealed significantly lower PPD (1.90±0.48 mm vs. 2.35±0.41 mm), CAL (4.43±0.57 mm vs. 4.93±0.58 mm), and CFUs for Porphyromonas gingivalis (6.32±0.18 vs. 8.88 ±1.88), Prevotella intermedia (7.62±1.86 vs. 8.12±1.78), and Aggregatibacter actinomycetemcomitans (6.43±1.44 vs. 7.24±1.22) in the test group after six months. Conclusion. Within the limitations, the present study confirmed the useful role of DL with MWF to manage chronic periodontitis.

Subcrestal placement of implants may have interproximal bone proximity issues that interfere with the submucosal contour of implant-supported zirconia restorations during delivery of the restorations. Modification of the mesial distal submucosal areas may be necessary to fully seat the restoration without impingement of the interproximal bone. Our aim was to determine if modification of submucosal cervical contour of implant supported zirconia-titanium base (Zi-Ti base) restorations resulted in a significant change in fracture strength compared with Zi-Ti base restorations without any modification near the cervical submucosal area. Implant Zi-Ti base restorations designed in the form of a maxillary premolar were made for the Straumann implant lab analog. Zirconia samples were cemented onto the Ti-base and the test group (N = 20) underwent recontouring and polishing at the junction of the Zi-Ti base cervical areas. The control group (N = 20) did not undergo any modifications. All 40 samples underwent fracture testing with an Instron machine. We assessed differences between modified and unmodified implants restorations using a 2-tailed t test for independent samples. Fracture strength values (N) ranged from 4354.68 to 6412.49 in the test group (N = 20) and from 5400.31 to 6953.22 in the control group (N = 20). The average fracture strength in the control group (6154.84 ± 320.50) was higher than in the modified group (5593.13 ± 486.51; P < .001). Modification of submucosal contour significantly decreased fracture strength. However, the average fracture strength exceeded the masticatory forces of humans.