Evaluating the accuracy of CAD/CAM optimized stones compared to conventional type IV stones

This study compared the accuracy (trueness and precision) of stone models fabricated using two brands of CAD/CAM optimized stones Cerec Stone (BC) and Elite Master (EM), and a conventional type IV stone Elite Rock Fast (ERF). 30 conventional Type IV and scannable stone complete-arch models were scanned with a blue LED extraoral scanner, and root mean square values were obtained. 6 abutments were used in complete-arch models. The digital models were compared with the master model to evaluate their trueness using model superimposition with Geomagic software. Precision was determined for each case by superimposing combinations of the 10 datasets in each group. The point cloud density of each model was calculated with MeshLab software. Kruskal-Wallis and Mann-Whitney nonparametric tests were used for the statistical analysis. The trueness of the stone models was 96 μm for the BC, 88.2 μm for the EM, and 87.6 μm for the ERF. There were no significant differences between the tested dental stones (p = .768). However, the EM models (35.6 μm) were more precise than the BC (46.9 μm) and ERF (56.4 μm) models (p = .001, p < .001). EM models also showed the highest point cloud density. There were significant differences in point cloud density (p = .003). The EM models showed significant differences in precision but no significant differences in terms of trueness. Although EM was more precise and had the highest point cloud density, all models were within the clinically acceptable limit

Evaluating the facial esthetic outcomes of digital smile designs generated by artificial intelligence and dental professionals

This study evaluates the preference rates for smile designs created by professionals or by Artificial Intelligence (AI) among dentists, dentistry students, and laypeople. Four cases with symmetrical and asymmetrical features were selected based on the Facial Flow (FF) concept from the database of the Smile Designer app regarding anatomical facial points. Two smile designs were created for each selected case: one using Artificial Intelligence (AI) and one created manually. An online survey assessed participants' preferences for the different smile designs. The chi-square test "Pearson's and Fisher's exact test (P)" was used to analyze the survey data. A total of 628 people completed the study. Dentists preferred the manually-created smile design for the first three cases. For Case 4, dentists who used the Smile Designer program preferred the manually-created design (55.88%), while those who did not use the program preferred the AI-generated design (55.84%). There was a significant difference in esthetic perception between dentists and dental students (p = 0.001) and between dentists and laypeople (p = 0.001) for Case 1, only between dentists and dental students (p = 0.003) for Case 2, and only between dentists and laypeople (p = 0.001) for Case 3. Furthermore, we found that females (p = 0.007) and orthodontists (p = 0.025) had a higher preference for the AI-generated design in this case compared to males and other dental specialties for Case 3. While age, education level, and clinical experience did not significantly impact dentists' preference for manually-created or AI-generated smile designs (p > 0.05), our results suggest that there were some differences in preference for Case 3. Overall, our findings suggest that the use of AI-generated smile designs for symmetric faces is acceptable to both dentists and laypeople and can offer time-saving benefits for clinicians

Analysis of differences of growth and phenology of provenances of Scots pine (Pinus sylvestris L.) in provenance experiment at Kupres (Bosnia and Herzegovina

U ovom radu analizirano je 15 europskih provenijencija običnog bora u međunarodnom pokusu kod Kupresa. Pokus je osnovan tijekom proljeća 2012. godine sa biljkama starosti dvije godine (2+0).Ukupno je posađeno 2700 sadnica običnog bora u pokusnom dizajnu slučajnog blok sustava koji je prilagođen terenu, 15 provenijencija u pet ponavljanja (5 x 36 sadnica).Pokus čine provenijencije iz deset europskih zemalja: Austrija (Traisen, Rein, Sistrans), Bosna i Heregovina (Bugojno), Ukrajina (Ivano Frankivsk), Slovačka (Hanusovce), Rumunjska (Sacueini), Norveška (Narvik, Arnes), Njemačka (Teisendorf, Trippstadt), Poljska (Raciane – Nida) i Italija (Ca del Lupo, Fenestrelle, Piani – Valda).Rezultati morfoloških i fizioloških istraživanja odnose se na razlike preživljivanja, visinama, promjer na vratu korijena i proljetnoj fenologiji otvaranja pupova.Analysis of differences of growth and phenology of provenances of Scots pine (Pinus sylvestris) in provenance experiment at Kupres (Bosnia and Herzegovina)In this paper, 15 European provenance of Scot pines have been analyzed in an international experiment at Kupres. The experiment was established during the spring of 2012 with plants of two years old (2 + 0). A total of 1,800 seedlings of ordinary Scot pine were planted in the experimental design of a casual block system adapted to the terrain, 15 provenances in five repetitions (5 x 36 seedlings). The experiment is made up of ten European countries: Austria (Traisen, Rein, Sistrans), Bosnia and Herzegovina (Bugojno), Ukraine (Ivano Frankivsk), Slovakia (Hanusovce), Romania (Sacueini), Norway (Narvik, Arnes), Germany (Teisendorf , Trippstadt), Poland (Raciane - Nida) and Italy (Ca del Lupo, Fenestrelle, Piani - Valda). The results of morphological and physiological researches relate to differences in survival, height, root neck diameter, and spring phenomenon of bud opening. The total number of seedlings measured is 1830, with the percentage of survival in the year 2017 being 67.70%, and ranging from 35.50% (Italy I1) to 87.70% (Austria A1). Descriptive analysis of the diameter of the root neck was found to have the highest mean diameter of Austria A1 (4.07 cm). The lowest value of the average diameter of the root neck has plants originating in Norway N1 (1.19 cm), root diameter values ranged from 0.30 cm to Norway N1, which is the minimum of 9.30 cm for Austria A1 which represents the maximum when it comes to the average diameter of the neck of the root.With an average height of 116.26 cm, the provenance of Poland P1 shows the highest average value for altitude, while the plants from Norway N1 have the lowest average value for a height of 40.52 cm.All studies have shown a variance analysis that statistically significant differences between investigated provenances are present, as confirmed by Duncan’s test.On the basis of the analysis carried out, it can be concluded that on the basis of the height of the only N1 and Italy I1 provenances, they are separated into separate groups because they have noticeable and far least average values of the seedlings height. On the other hand, as far as diameter on the root of the root can be seen only the N1 Norway proves itself into a separate group with by far the smallest mean diameter.Based on phenological observations, there is variability between all provenances. Differences in movement, duration and end of individual phenomena have been established. As a start of ordinary Scot pine tree vegetation in the international experiment on Kupres can be taken on April 26 because in the three provenances this day the opening of the buds began. In the other 12 provenances the opening of the buds began on May 3, and on 21 June it was noted that the plants in all fifteen investigated the origins have come to the final stage, that is, they have completely formed needles of green color.The first results of the phenological observations show that these studies should continue to determine the overall genetic diversity of ordinary wrinkles, to determine the success and genetic variability of provenances, as well as the behavior and success of different provenances at a given locality.Ordinary pine is genetically differentiated into ecological and vegetation areas, and shows different morphological and physiological characteristics from different areas. This indicates the separation of northern provenances.The research results obtained at the early juvenile stage are incomplete, often burdened with various disadvantages, and very often different from those obtained at later stages, and such research has to be carried out in continuity

Portrayal and management of a rarely seen alveolar bone resorption pattern mimicking the Combination Syndrome: a clinical report

Treatment of severely resorbed edentulous alveolar ridges is still a challenging topic of prosthodontics. Combination Syndrome is one of the most remarkable intraoral manifestations of excessive alveolar bone resorption which may be observed at the denture wearing patients with complete edentulous maxilla and bilateral partial edentulous mandibula. Since its first recognition in 1972, the major symptoms and morphological features of the Combination Syndrome such as enlarged maxillary tuberosities and resorbed edentulous ridges were often portrayed as being bilaterally located in either sides of the midsagittal plane. The aim of the present study was to describe a rarely seen alveolar bone resorption pattern mimicking the Combination Syndrome and to report the prosthetic treatment approach applied for its rehabilitation

A free terminal ileal perforation as the presenting sign of crohn’s disease in an adolescent female

The authors present a rare case of Aa free terminal ileal perforation as the presenting sign of Crohn's disease in an adolescent female

Methods for identification of animal protein origin

Identifikacija vrste mesa odnosno vrste animalnih bjelančevina vrši se u mnogim zemljama iz različitih razloga, kako ekonomskih tako i religijskih i zdravstvenih. Cilj te identifikacije je sprečavanje zamjene odgovarajućeg mesa, namijenjenog za ljudsku upotrebu, s neodgovarajućim ili manje vrijednim. Identifikaciju vrste mesa često otežava termička obrada mesa i proizvoda od mesa jer tijekom ovih procesa dolazi do promjene svojstava i sastava mesa, što se naročito odnosi na bjelančevine i masti. Kvalitativna identifikacija vrste mesa je uvijek na prvom mjestu. Analitička identifikacija vrste je zasnovana na izdvajanju njenih specifičnih dijelova i svojstava, koje su genetski određene. Na osnovi primijenjenog principa detekcije moguće je razlikovati određene skupine metoda kao što su fizikalno-kemijske,serološke i molekularno-biološke metode.Identification of meat species or proteins of animal origin is being used in many countries from different reasons, like economic as well as religious and health reasons. The aim is to prevent replacement of the appropriate meat, assigned for human nutrition, with unsuitable or less valuable types. The actual identification of animal species is very often made difficult in heat treated meat products because during this process, characteristics and content of components of meat parts change. This is especially true with proteins and fat. Qualitative identification of meat species is always a primary issue. Analytical identification of one species rests on separation of specific components and their characteristics, which have been genetically determined. According to the applied principles of detection, it is possible to differentiate various groups of methods such as physical-chemical, serological and molecular-biological methods

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

In vitro accuracies of 3D printed models manufactured by two different printing technologies

Purpose This study aims to compare the accuracies of full-arch models printed by two different 3D printing technologies. Materials and Methods A mandibular horseshoe-shaped master model was designed with RapidForm XOR2 softwareThe master model was printed 10 times with 3D printers using direct light processing (DLP) and PolyJet technology (n=20). The printed models were then scanned with an industrial scanner and saved in STL file. All digital models superimposed with the master model STL file and comparison of the trueness was performed using Geomagic Control 3D analysis software. The precision was calculated by superimposing combinations of the 10 data sets in each group. Results The trueness of printed models was 46 pm for the DLP printer and 51 pm for PolyJet printer; however, this difference was not statistically significant (p=0.155). The precision of printed models was 43 pm for the DLP printer and 54 pm for PolyJet printer. DLP printed models were more precise than the PolyJet printed models (p<0.001). Conclusion The 3D printing technologies showed significant differences in the trueness of full-arch measurements. Although DLP printed models had better trueness than PolyJet printed models, all of the 3D printed models were clinically acceptable and might be used for the production of fixed restorations

Evaluation of the effect of long-term N95 (FFP2) mask usage on blood oxygen saturation and dentist comfort

AMAÇ: Bu çalışmanın amacı, COVID-19 pandemisi boyunca yapılan dental işlemlerde uzun süre N95 maske kullanımının, diş hekimlerinin oksijen satürasyon değerleri ve nabız atım hızları üzerindeki etkisini değerlendirmek ve kullanım boyunca oluşan subjektif şikayetleri belirlemekti. GEREÇ VE YÖNTEM: Çalışmaya N95 maskesi kullanan 21-65 yaş (ortalama 31.43±9.44) arası toplam 60 (24 erkek ve 36 kadın) gönüllü diş hekimi dahil edildi. Satürasyon ve nabız kayıtları, N95 maskesi kullanılmadan önce ve 6 saat sürekli kullanımdan sonra parmak tipi puls oksimetre kullanılarak kaydedildi. Katılımcılara mide bulantısı, baş ağrısı, baş dönmesi, görme bozukluğu, nefes darlığı, çarpıntı, bilinç bulanıklığı, iletişim zorluğu, yorgunluk, nefes kokusu, maske-nem, sıcaklık ve kaşıntı ile ilgili soruları içeren subjektif semptomları 1-10 arasında puanlandırdıkları ölçme testi yapıldı. BULGULAR: Kullanım öncesi ve 6 saat boyunca N95 takılması sonrasında, başlangıç ve sonuç oksijen satürasyon değerleri arasında istatistiksel olarak anlamlı bir değişiklik görüldü (1. gün: p=0.012 ve 3. gün: p=0.02). Ancak bu farklılık klinik olarak anlamlı değildi. Katılımcıların N95 kullanımı sonrasında nabız değerlerine bakıldı ve istatistiksel olarak anlamlı farklılık görülmedi (p=0.455, p=0.479, p=0.053). Erkeklerde maske içinde oluşan nem, sıcaklık ve karşılıklı iletişim zorluğu şikayetleri, kadınlarda ise nem, sıcaklık ve kaşıntı şikayetleri nispeten yüksek skorlar aldı. Kadın grubunun mide bulantısı, görme bozukluğu, sıcaklık ve kaşıntı skorları erkeklere göre istatistiksel olarak anlamlı şekilde yüksekti (p=0.001). SONUÇ: N95 maskesinin 6 saat sürekli kullanımı diş hekimlerinin oksijen satürasyon ve nabız atım değerlerinde klinik olarak anlamlı bir etki göstermedi. Kadınlarda mide bulantısı, görme bozukluğu, sıcaklık ve kaşıntı şikayeti değerleri erkeklere göre daha yüksek görüldü.OBJECTIVE: This study aimed to evaluate the effect of longterm use of N95 masks on dentists’ oxygen saturation values and pulse rates due to dental procedures performed during the COVID-19 pandemic, and to determine the subjective complaints that occur during use. MATERIALS AND METHOD: A total of 60 volunteer dentists (24 males and 36 females) between the ages of 21-65 (mean 31.43±9.44) were included. Saturation and pulse rate records before and after 6 hours of continuous use of the N95 mask were recorded using a pulse oximeter. Participants scored subjective symptoms ranging from 1 to 10, including questions about nausea, headache, dizziness, visual impairment, shortness of breath, tachycardia, confusion, communication difficulties, fatigue, breath odor, mask moisture, temperature, and itching. RESULTS: There were significant changes between pre- and post-values of oxygen saturation after 6 hours continuous use of N95 mask (day 1: p=0.012 and day 3: p=0.02), but this difference was not clinically significant. Pulse rates of the participants were checked before and after the N95 use, and no significant difference was found (p=0.455, p=0.479, p=0.053). Among the subjective complaints, itching and temperature were found to be higher in women than in men. Complaints of moisture, temperature, and communication difficulties in the male group, and complaints of moisture, temperature, and itching in the female group received relatively high scores within each group. Nausea, visual impairment, temperature, and itching scores in the female group were significantly higher than the male group (p=0.001). CONCLUSION: According to the results of this study, 6 hours of continuous use of the N95 mask might not clinically affect the oxygen saturation and pulse rates of dental professions. Subjective complaints of nausea, visual impairment, temperature, and itching were observed higher in women than in men