Evaluation of trabecular bone changes according to the type of prosthesis in patients using bisphosphonates: a retrospective study

Abstract The objective of the study was to retrospectively compare the fractal size values calculated in the trabecular bone according to the type of complete removable denture, removable partial denture, and partial fixed prosthesis between patients using bisphosphonates and healthy patients, retrospectively. Panoramic radiographs of a total of 200 patients, (100 using bisphosphonates,100 control group), were taken from the right and left molar regions before and after treatment with 72 × 72 pixels. The fractal dimension (FD) was computed by using ImageJ Software using the box-counting method on the images obtained. There was an interaction effect between the trabecular bone change-patient group-the type of prosthesis used and the parameters of the area (p < 0.05). In patients using complete removable dentures and removable partial dentures in the maxilla and mandibula in the molar region, a greater decrease in FD values was observed in the control group than in the patient group using bisphosphonates. An increase in FD values over time was observed in the patient group using bisphosphonates with partial fixed maxillary and mandibular prostheses compared to the control group. Partial fixed prostheses should be preferred primarily instead of complete removable or removable partial dentures in patients using bisphosphonates to prevent osteonecrosis due to dental trauma

Farklı KOAH evrelerinde solunum fonksiyonları ve periferal kas kuvvetinin hastalık süresi ve prognoz ile ilişkisi

Farklı KOAH Evrelerinde Solunum Fonksiyonları ve Periferal Kas Kuvvetinin Hastalık Süresi ve Prognoz ile İlişkisi Öğrencinin Adı: Fzt. Begüm ÜNLÜ Danışmanı: Prof. Dr. S. Ufuk YURDALAN Anabilim Dalı: Fizyoterapi ve Rehabilitasyon Anabilim Dalı ÖZET Amaç: Çalışmamızda, farklı KOAH evrelerinde olan hastaların solunum fonksiyonları, solunum kas ve periferal kas kuvvetinin değerlendirilmesi, bunların hastalık süresi ve prognozu ile ilişkisinin belirlenmesi amaçlandı. Gereç ve Yöntem: Olguların demografik bilgileri, klinik (tanı süresi) ve medikal durumları, CAT skoru, son 3 aydaki acil başvuru ve hastane yatış sayıları ile son 1 yıldaki alevlenme ve hastane yatış sayıları kaydedildi. Solunum kas kuvveti ağız içi basınç ölçümleri, periferal kas kuvveti üst ekstremitede el kavrama kuvveti ve alt ekstremitede dinamometre ile değerlendirildi. Hastaların rutin kontrolleri kapsamındaki SFT sonuçları alındı. Hastalar GOLD birleşik değerlendirmesine göre gruplara ayrıldı. Bulgular: Çalışmamızda B Grubu 9, C Grubu 5 ve D Grubu 17 olmak üzere toplam 31 KOAH olgusu (26 erkek, 5 kadın; 45-80 yaş aralığında X̄= 64,80±7,71 yıl) değerlendirildi. Gruplar arasında solunum fonksiyonları ve solunum kas kuvveti karşılaştırılmasında istatistiki anlamlı fark bulunmadı (p>0,05). El kavrama kuvveti için gruplar arasında istatistiksel olarak anlamlı fark saptandı (p<0,05). Tüm olguların solunum fonksiyonları ve hastalık süresi arasında negatif yönlü, orta dereceli ilişki belirlendi (p<0,05). Son 1 yıl alevlenme ve hastane yatış sayısı ile diz ekstansiyon kuvveti arasında negatif yönlü, orta dereceli ilişki bulundu (p<0,05). Sonuçlar: Çalışmamızda el kavrama kuvveti KOAH evrelerine göre farklı bulunurken; hastalık süresi ile solunum fonksiyonları; alevlenme öyküsü ile diz ekstansiyon kuvveti arasında ilişki olduğu görüldü. -------------------- Pulmonary Functions and Peripheral Muscle Strength and Relationship Between Disease Duration and Prognosis in Different COPD Groups Student’s Name: Begüm ÜNLÜ, PT Supervisor: Prof. Dr. S. Ufuk YURDALAN Department: Department of Physiotherapy and Rehabilitation ABSTRACT Purpose: The aim of this study was to evaluate pulmonary function, respiratory muscle and peripheral muscle strength of patients with different stages of COPD and to determine their relationship with disease duration and prognosis. Methods: Demographic information, clinical and medical status, CAT score and number of emergency admissions and hospitalizations in the last 3 months and exacerbations and hospitalizations in the last 1 year were recorded. Respiratory muscle strength was assessed maximal mouth pressures. Peripheral muscle strength was measured by hand grip strength in upper extremity and dynamometer in lower extremity. PFT results were obtained within the scope of routine controls. The patients were divided into groups according to the combined GOLD assessment. Results: In this study, 31 COPD patients (26 males, 5 females; 45̄-80 years of age, X̄ = 64,80 ± 7,71 years) were evaluated. No statistically significant difference was found between the groups in the comparison of respiratory function and respiratory muscle strength (p>0,05). There was a statistically significant difference between the groups for hand grip strength (p<0,05). There was a negative and moderate correlation between respiratory function and duration of disease in all patients (p<0,05). There was a negative, moderate correlation between exacerbation and number of hospitalizations in the last one year and knee extension force (p<0,05). Conclusion: Hand grip strength was found to be different according to COPD groups. In addition, a correlation was found between disease duration and respiratory functions also between exacerbation history and knee extension force

The Effect of Posture and Breathing Exercises on Pain and Quality of Life in Home-Office Workers

Amaç: Araştırmamızda ev-ofis çalışan bireylerde uygulanan postür ve solunum egzersizlerinin ağrı ve yaşam kalitesine etkisinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Araştırma Ocak-Mart 2021 tarihleri arasında ev-ofis çalışan, 20-50 yaş arası 61 gönüllü katılımcı ile gerçekleştirildi. Katılımcıların demografik bilgileri kaydedildi. Ağrı değerlendirmesi Cornell Kas İskelet Sistemi Rahatsızlıkları Anketi (CMDQ) ile yapılırken, yaşam kalitesinin değerlendirilmesinde SF-36 Yaşam Kalitesi Anketi kullanıldı. Katılımcılar randomize olarak egzersiz grubu (n: 31) ve kontrol grubuna (n: 30) ayrıldı. Egzersiz grubuna “dört hafta süreli günde dört kez, haftada beş gün” sıklıkta postür ve solunum egzersizleri ile bir dakika ambulasyondan oluşan program verildi. Programdaki egzersizler fotoğraf ve videolar kullanılarak anlatıldı. Katılımcıların programlarını kontrol etmelerine yönelik egzersiz izlem çizelgesi hazırlandı. Kontrol grubuna ise dört hafta süre ile herhangi bir uygulama yapılmadı. Bulgular: Egzersiz grubuna 13 erkek, 18 kadın (yaş ort: 30,290±9,427 yıl); kontrol grubuna ise 5 erkek, 25 kadın gönüllü katılımcı (yaş ort: 28,800±7,644 yıl) dahil edildi. Program sonrası CMDQ için yapılan karşılaştırmada boyun, bel, sol alt kol skorları için gruplar arasında anlamlı bir fark gözlenirken (p0,050). Egzersiz grubunun öncesi-sonrası karşılaştırmasında CMDQ’da sol üst kol, kalça, sol diz, sağ ve sol alt bacak dışında kalan bölgelerde istatistiksel açıdan anlamlı fark olduğu belirlendi (p<0,050). SF-36 alt skorlarından ağrı, fiziksel rol güçlüğü, emosyonel rol güçlüğü ve genel sağlık algısındaki farklar istatistiksel olarak anlamlı idi (p<0,050). Sonuç: Araştırmamızda ev-ofis çalışanlarında egzersiz odaklı fizyoterapi yaklaşımları sonrası muskuloskeletal ağrı semptomlarının azaldığı ve yaşam kalitelerinin arttığı belirlendi. Anahtar Kelimeler: Egzersiz, ağrı, postür, yaşam kalitesi.Objective: In our study, it was aimed to evaluate the effects of posture and breathing exercises applied by individuals working at home-office on pain and quality of life. Material and Method: The research was carried out with 61 volunteer participants aged 20- 50 years, working at home-office between January and March 2021. Demographic information of the participants was collected. Pain was evaluated using the Turkish version of the Cornell Musculoskeletal Disorders Questionnaire (CMDQ), while the SF-36 Quality of Life Questionnaire was used to evaluate the quality of life. Participants were randomly divided into exercise (n: 31) and control groups (n: 30). The exercise group was given a program consisting of posture and breathing exercises for 4 weeks (4 times a day, 5 days a week) and ambulation for 1 minute. The exercises in the program were explained using photos and videos. An exercise monitoring chart was prepared for the participants to control their programs. Control group did not have any exercises for four weeks. Results: There were 13 males and 18 females in the exercise group (mean age: 30.290±9.427 years), and 5 males and 25 females in the control group (mean age: 28.800±7.644 years). While there was a statistically significant difference between the groups for neck, waist, and left lower arm scores of CMDQ (p<0.050) after the program, there was no significant difference between the groups in SF-36 (p>0.050). The pre-post program analysis for the exercise group shows that there was a statistically significant difference in CMDQ scores for all the regions (p<0.050) except for the left upper arm, hip, left knee, right and left lower leg. In the SF-36, the differences in pain, role limitations due to physical health, role limitations due to emotional problems and perception of general health were statistically significant (p<0.050). Conclusion: In our study, it was determined that after the exercise-focused physiotherapy approaches, musculoskeletal pain symptoms decreased, and the quality of life of the home-office workers increased. Keywords: Exercise, pain, posture, quality of life

ENDOCROWN RESTORATION OF THE ENDODONTICALLY TREATED TEETH BY USING CAD/CAM: CASE SERIES

Aim: As a result of large coronal destruction in endodontically treated teeth, significant losses occur in the dentin tissue around the pulp and the need for prosthetic treatment occurs. In this case series, endocrown applications produced in a single session with CAD/CAM system are presented as an alternative to crown restoration traditionally applied to premolar and molar teeth with excessive crown destruction. Case Series: In first case, 38-years-old male patient number 25, 46-years-old female patient number 36 in our second case, 21-years-old female patient number 46 in our third case, 26-years-old male patient number 46 in our fourth case, and in the last case 52-years-old male patient tooth number 15 has been applied to root canal treatment. As a result of the clinical and radiological examinations of the patients, it was observed that there were no systemic diseases. Endocrown restoration was considered appropriate and recommended to patients with less dentin tissue. Firstly, teeth are prepared for endocrown restoration. Afterwards, the impressions were digitalized by scanning the jaws with an intraoral optical scanner (Cerec Omnicam, Dentsply Sirona, USA). The restorations were designed with the help of the CEREC 4.3 software (Dentsply Sirona, USA) and the milling process was carried out using the feldspathic ceramic block (Vita Mark II, Vita Zahnfabrik, Germany) in the same session by CEREC inLab MC XL (Dentsply Sirona, USA). Later, the restorations were glazed and cemented with dual polymerized resin cement (RelyX Ultimate, 3M ESPE, USA). Conclusion: Endocrown restorations are a minimally invasive, conservative treatment approach that provides mechanical adhesion to the pulp chamber and cavity walls with adhesive resin cement and allows the preservation of the remaining tooth structure. For this reason, it is a treatment option that can be preferred instead of post-core and crown application in teeth with root canal treatment

Effects of structured home-based exercise program on depression status and quality of life in burn patients

Background: Burns can cause life-threatening injuries and severe limitations. This study aimed to evaluate the effects of the structured home-based exercise program on depression status and quality of life in burn patients. Materials and methods: This study was carried out in the Wound and Burn Treatment Department of University of Health Sciences, Dr. Lutfi Kirdar Kartal Education and Research Hospital, Istanbul. Thirty burn patients voluntarily participated in this study. Patients' demographic data such as burn area and grade, percentage, type, number of grafts, and duration of hospitalization were recorded. The quality of life was evaluated using the Short Form-36(SF-36), and depression status was evaluated using Beck Depression Inventory (BDI). The home-based exercise program was defined by the clinical physiotherapist on the day when the patient was discharged. The home-based exercise program was applied for 3 weeks. Evaluations were performed at discharge and repeated after 3 weeks at the end of the exercise program. Results: Of the 30 patients who completed the study (age range, 21-61 years; mean,34.9 +/- 12.99 years), 96.7% (n=29) were male and 3.3% (n=l) were female. A statistically significant difference was observed between BDI and SF-36 scores before and after the home-based exercise program (p<0.05). BDI scores decreased after the home-based exercise program, whereas SF-36 scores increased. Conclusion: Our study concludes that burn patients who underwent the structured home-based exercise programs attained acceleration of their physical, social, and psychological integrity. Thus, establishing a structured home-based exercise program according to the burn type and clinical course should be continued. (C) 2018 Elsevier Ltd and ISBI. All rights reserved

Lumbal di̇sk herni̇li̇ bi̇reylerde hi̇bri̇t telerehabi̇li̇tasyon programinin etki̇si̇

Giriş: Lumbal disk hernisi (LDH) ağrı ve duyusal kayıplara neden olan, kas kuvvetinde kayıplar ve buna bağlı olarak gelişen fonksiyon kaybı ile yaşam kalitesinin azalması ile karakterize muskuloskeletal bir problemdir. Bu çalışmanın amacı LDH tanılı bireylerde hibrit telerehabilitasyon programının etkinliğinin araştırılmasıdır. Gereç-Yöntem: Bu çalışma Ocak-Haziran 2022 tarihleri arasında Marmara Üniversitesi Fizyoterapi ve Rehabilitasyon Bölümü’nde yapıldı. Çalışmaya dahil edilme kriterlerine uyan ve çalışmaya gönüllü olarak katılan 51 LDH tanılı birey alındı. Bireylerin ağrı durumu Vizüel Analog Skala (VAS); kinezyofobi durumu Tampa Kinezyofobi Ölçeği (TKÖ), yaşam kaliteleri SF-12 Yaşam Kalitesi Ölçeği (SF-12); alt ekstremite kuvveti 30 Saniye Otur Kalk Testi (30 STS) ve fonksiyonelliği Zamanlı Kalk Yürü Testi (TUG) ve Oswestry Bel Ağrısı Engellilik Anketi (OBAEA) ile değerlendirildi. Bireyler 8 haftalık hibrit telerehabilitasyon programına dahil edildi. Değerlendirmeler dört defa (D0: program öncesi, D1: 4. haftanın sonu, D2: 8. haftanın sonu, D3: 16. haftanın sonu) yapıldı ve değişimler karşılaştırıldı. Bulgular: Programa alınan 51 hastanın 44’ü kadın 7’si erkekti (yaş ortalaması: 47,13±11,73 yıl). 22 hasta aktif olarak çalışıyordu. 25 hasta daha önce LDH nedeni ile fizik tedavi ve rehabilitasyon programına katılmıştı ve 16 hasta düzenli olarak fiziksel aktivite yaptığını bildirdi. Program öncesi sonrası değerlendirmeler karşılaştırıldığında VAS, SF-12 Fiziksel ve Mental skorları, 30 STS, TUG ve OBAEA için istatistiksel olarak anlamlı fark bulundu (p<0,01). Sonuç: Çalışmanın sonunda hibrit telerehabilitasyon programının LDH tanılı bireylerde ağrı, kas kuvveti, fonksiyonellik ve yaşam kalitesi üzerinde etkili olduğunu bulundu.Introduction: Lumbar disc herniation (LDH) is a musculoskeletal problem that causes pain and sensory loss, and is characterized by loss of muscle strength, loss of function and decreased quality of life. The aim of this study is to investigate the effectiveness of the hybrid telerehabilitation program in individuals diagnosed with LDH. Material-Method: This study was carried out between January and June 2022 at Marmara University, Department of Physiotherapy and Rehabilitation. 51 individuals diagnosed with LDH who met the inclusion criteria and voluntarily participated in the study were included. Pain status of individuals was assessed with the Visual Analogue Scale (VAS); kinesiophobia status was evaluated with Tampa Scale for Kinesiophobia (TSK), quality of life was assessed with the 12-Item Short Form Health Survey (SF-12); lower extremity strength was evaluated with the 30 Second Sit to Stand Test (30 STS) and functionality was assessed with the Timed Up and Go Test (TUG) and the Oswestry Low Back Pain Disability Questionnaire (OLBPDQ). Individuals were included in an 8-week hybrid telerehabilitation program. Evaluations were made four times (D0: pre-program, D1: end of week 4, D2: end of week 8, D3: end of week 16) and changes were compared. Results: Of the 51 patients included in the program, 44 were female and 7 were male (mean age: 47.13±11.73 years). 22 patients were actively working. 5 patients had previously participated in a physical therapy and 134 rehabilitation program due to LDH, and 16 reported regularly engaging in physical activity. When the evaluations before and after the program were compared, a statistically significant difference was found for VAS, SF-12 Physical and Mental scores, 30 STS, TUG and OLBPDQ (p<0.01). Conclusion: At the end of the study, it was found that the hybrid telerehabilitation program was effective on pain, muscle strength, functionality and quality of life in individuals with LDH

Serebral palsi̇li̇ çocuklarda denge egzersi̇zleri̇ni̇n fonksi̇yonel kapasi̇te üzeri̇ne etki̇si̇

Giriş: Serebral Palsi (SP), aktivite kısıtlılıkları, duyu, algı, kognisyon, iletişim ve davranışları etkileyen bir gelişim bozukluğudur. Ayrıca kas iskelet sistemindeki bozukluklar ve günlük yaşam aktivitelerindeki kısıtlamalar çocukların fonksiyonel kapasitelerin etkilemektedir. Erişkin dönemde yetersiz ambulasyon düzeyi de çocukların fonksiyonel kapasitelerini olumsuz etkileyerek kardiyopulmoner hastalık gelişme riskini arttırabilmektedir. Bu çalışmanın amacı SP’li çocukların rehabilitasyon programlarına ek olarak uygulanan denge egzersizlerinin fonksiyonel kapasite üzerindeki etkisini araştırmaktır. Gereç-Yöntem: Çalışma kapsamında dahil edilme kriterlerine uyan ve çalışmaya katılmaya aileleri tarafından onay verilen 6-12 yaş arasında 44 SP’li çocuk değerlendirildi. Çocukların demografik bilgileri, klinik durumları, özgeçmiş ve soygeçmiş bilgileri kaydedildi. Denge değerlendirmesi Berg Denge Ölçeği (BDÖ); fonksiyonel kapasite değerlendirmesi On Metre Yürüme Testi ile yapıldı. Çocuklar denge egzersizlerinin dahil edildiği rehabilitasyon programına alındı. Altı hafta sonra değerlendirmeler tekrarlandı. Veri analizinde SPSS 16.0 paket istatistik programı kullanıldı. Analizler %95 güven aralığında, p<0.05 anlamlılık düzeyinde değerlendirildi. Bulgular: Değerlendirilen çocukların 17’si kız 27’si erkekti (yaş ortalaması: 9,56±1,74 yıl). Rehabilitasyon öncesi sonrası BDÖ skorları karşılaştırıldığında istatistiksel olarak anlamlı fark bulundu (p<0,05). Ayrıca rehabilitasyon sonrası on metre yürüme test sonuçları rehabilitasyon öncesi sonuçlarla karşılaştırıldığında istatistiksel olarak anlamlı artış saptandı (p<0,05). Rehabilitasyon sonrası BDÖ ve yürüme hızlarının artış yüzdeleri arasında pozitif yönlü, orta şiddette, istatistiksel olarak anlamlı korelasyon bulundu (r: 0,425; p<0,05). Sonuç: Çalışmamızın sonuçlarına göre rehabilitasyon programı sonrasında SP’li çocukların BDÖ skorlarının ve on metre yürüme testine göre yürüme hızlarının arttığı görüldü. Ayrıca program sonrası dengedeki iyileşme ve fonksiyonel kapasitedeki gelişme yüzdelerin birbiri ile ilişkili olduğu saptandı. SP’li çocuklarda uygulanan rehabilitasyon programlarına eklenen denge egzersizleri, ambulasyona olan olumlu etkileri ile fonksiyonel kapasitelerinin gelişmesine yardımcı olabilir. Bu nedenle programlara denge egzersizlerinin eklenmesi ve tedavide çocukların fonksiyonel kapasitelerinin gelişimine yönelik uygulamalara yer verilmesi pediatrik ve erişkin dönem kardiyopulmoner hastalık riskinin azaltılması açısından önem taşımaktadır.Introduction: Cerebral Palsy (CP) is a developmental disorder that affects activity limitations, sensation, perception, cognition, communication and behavior. In addition, disorders in the musculoskeletal system and restrictions in activities of daily living affect the functional capacities of children. Insufficient ambulation level in adulthood may also negatively affect children's functional capacities and increase the risk of developing cardiopulmonary disease. The aim of this study is to investigate the effect of balance exercises applied in addition to rehabilitation programs of children with CP on functional capacity. Material-Method: Within the scope of the study, 44 children with CP between the ages of 6 and 12 who met the inclusion criteria and were approved by their families to participate in the study were evaluated. Demographic information, clinical status, and family history of the children were recorded. Balance assessment was done with Berg Balance Scale (BBS); functional capacity assessment was done with the Ten Meter Walk Test. Children were included in a rehabilitation program that included balance exercises. Evaluations were repeated six weeks later. SPSS 16.0 package statistics program was used for data analysis. The analyzes were evaluated at the 95% confidence interval, at the p<0.05 significance level. Results: Of the children evaluated, 17 were girls and 27 were boys (mean age: 9.56±1.74 years). When the BBS scores before and after rehabilitation were compared, a statistically significant difference was found (p<0.05). In addition, when the ten-meter walking test results after rehabilitation were compared with the results before rehabilitation, a statistically significant increase was found (p<0.05). A positive, moderate, statistically significant correlation was found between the percentages of increase in BBS and walking speed after rehabilitation (r: 0.425; p<0.05). Conclusion: According to the results of our study, it was observed that the BBS scores of the children with CP and their walking speed according to the Ten Meter Walk Test increased after the rehabilitation program. In addition, it was determined that the percentages of improvement in balance and functional capacity were correlated with each other after the program. Balance exercises added to rehabilitation programs in children with CP can help improve their functional capacities with their positive effects on ambulation. For this reason, it is important to add balance exercises to the programs and to include applications for the development of children's functional capacities in the treatment, in terms of reducing the risk of pediatric and adult cardiopulmonary diseases