ObjectiveLocal anesthetic solutions with vasoconstrictors are not contraindicated in hypertensive patients, but due to their hemodynamic effects, local anesthetics without vasoconstrictors are mainly preferred by the clinicians. The aim of this study was to compare hemodynamic effects of three different local anesthetics without vasoconstrictors during tooth extraction in hypertensive patients.Material and MethodsSixty-five mandibular molars and premolars were extracted in 60 hypertensive patients (29 females and 31 males; mean age: 66.95 ± 10.87 years; range: 38 to 86 years old). Inferior alveolar and buccal nerve blocks were performed with 2% lidocaine hydrochloride (HCl), 2% prilocaine HCl or 3% mepivacaine HCl without vasoconstrictor. Hemodynamic parameters namely systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), saturation rate (SR), rate pressure product (RPP) and pressure rate quotient (PRQ) were investigated before and at different intervals after anesthetic injection.ResultsThe hemodynamic effects of the three agents were similar to each other, although some significance was observed for DBP, MAP, RPP and PRQ values in the lidocaine, prilocaine and mepivacaine groups.ConclusionLidocaine, prilocaine and mepivacaine solutions without vasoconstrictor can be safely used in hypertensive patients. It is advisable that dental practitioners select anesthetic solutions for hypertensive patients considering their cardiovascular effects in order to provide patient comfort and safety.

Aims: This study determined the effect of three different surface treatment methods [sandblasting (SB), tribochemical silica coating (TSC), and ytterbium fiber laser (YFL) roughening] on surface roughness and titanium-ceramic shear bond strength using specimens obtained using casting (CST), milling (ML) and selective laser melting (SLM). Methods:In this in vitro study, we obtained 32 cylindrical titanium specimens for each fabrication method and subjected them to each surface treatment method. Nine experiments (n=11) were conducted. One specimen was randomly selected from each group for scanning electron microscope analysis. Surface roughness was examined using a profilometer device (n=10). Ceramic was applied to titanium specimens. A universal testing machine was used to determine shear bond strength in megapascal (MPa).Results: Surface roughness of CST/YFL (1.254±0.058 µm), SLM/SB (1.294±0.054 µm), and SLM/ YFL (1.208±0.057 µm) groups were significantly higher than other groups (CST/SB, CST/TSC, ML/SB, ML/TSC, ML/YFL, and SLM/TSC, p<0.01). Shear bond strengths of CST/YFL (20.28±6.97 MPa), SLM/SB (21.9±8.06 MPa), and SLM/YFL (29.92±5.67 MPa) were significantly lower than other groups (p<0.01). Shear bond strength of the ML/SB group (42.40±7.52 MPa) was highest but there were no significant differences between ML/SB and CST/SB (33.04±7.62, p=0.101), CST/TSC (35.38±4.15, p=0.426), ML/TSC (40.03±6.42, p=0.998), ML/YFL (39.43±9.24, p=0.991) and SLM/TSC (37.05±7.84, p=0.766). Conclusions:This study showed that the production and surface treatment method impact shear bond strength. Excessive roughness affects the bonding strength. The highest shear bond strength was identified in the ML group.

PurposeTo compare the effects of fabricating methods of custom monoblock mandibular advancement devices (MADs) on usability and efficacy in patients with mild and moderate obstructive sleep apnea (OSA).Materials and MethodsDigitally fabricated custom MADs (dMADs) were produced for 11 OSA participants who had previously used conventionally fabricated custom MADs (cMADs). The participants answered a modified usability questionnaire for both MADs, and the average scores that were given to the questionnaire were evaluated by age, sex, and body mass index (BMI), and the scores of cMADs and dMADs were compared. After 6 months of usage of each MAD, the apnea‐hypopnea index (AHI), mean and lowest oxygen saturations, and total sleep time were measured for efficacy assessment. Data were analyzed with Cronbach's alpha, Mann‐Whitney U, Kruskal‐Wallis, Wilcoxon signed‐rank, one‐way repeated measures analyses of variance, and Bonferroni tests (α = 0.05).ResultsCronbach's alpha was found at 0.834 and 0.722 for the conventional and digital questionnaires, respectively. The usability scores of the dMADs were significantly higher than those of cMADs (p = 0.013). There was no difference in usability scores in terms of sex or BMI (p > 0.05). No statistically significant difference was found for cMAD (p = 0.113) among age groups; however, there was a significant difference for dMAD (p = 0.046). The AHI, mean, and lowest oxygen saturation values were significantly affected by MAD usage (p < 0.001). However, total sleep time values did not differ after the MAD treatments (p > 0.05). Significantly lower AHI and significantly higher lowest oxygen saturation values were observed with dMAD, while both appliances led to similar results for mean oxygen saturation and total sleep time values (p > 0.05).ConclusionsParticipant usability scores were higher for digitally manufactured MADs than conventionally manufactured MADs. However, both conventional and digital MADs were found effective in decreasing the AHI levels and increasing the mean and lowest oxygen saturation values of the participants.

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To evaluate the accuracy of complete arch scanning with multiple implant titanium scan bodies using laboratory scanners. A master model of an edentulous maxillary arch with 6 implants was fabricated. Titanium scan bodies were inserted into the model. Three laboratory scanners were used: D2000 (3Shape), Vinyl High Resolution (Smart Optics), and inEos X5 (Dentsply Sirona). The master model was consecutively scanned ten times using dental laboratory scanners (LS) without detaching and repositioning the scan bodies. Linear and angular accuracy between adjacent implants was measured using inspection software (Control X, Geomagic). The accuracy of the complete arch scans was calculated. Implant regions were defined as; parallel (R1: #24-26 and #16-14), angled (R2: #22-24 and #14-12), angled to occlusal plane (R3: #12-22), and cross-arch (R4: #16-26). The effect of LS and implant region on accuracy was compared using two-Way ANOVA (α=0.05). Significant greater linear distortion was noted in R4 (61.2±17.9µm) compared to R1 (23.4±15.5µm) and R2 (26±17.7µm) (p<0.01). Greater linear distortions were noted in R4 with D2000 (0.07±0.016 degrees) and Vinyl High Resolution (0.067±0.02 degrees) than inEos X5 (0.032±0.021 degrees) (p>0.05). Greater mean linear precisions were noted in R1 (9±8µm) and R3 (9.3±8.3µm) than R4 (12.6±10.3µm) (p<0.05). The highest linear precision was noted in D2000 (7.2±7.6µm) (p<0.05). The angular precision of D2000 (0.02±0.015 degrees) was the highest (p<0.01). The angular precision of R4 (0.036±0.018 degrees) was the lowest (p<0.01). This study revealed that the trueness was affected by the implant region and the precision was affected by both LS and implant region.