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This study compared the efficacy of apicoectomy and apical curettage with and without leukocyte- and platelet-rich fibrin (L-PRF) in treating large periapical lesions. Sixty-four adults (30 male, 34 female) with a previously endodontically treated tooth and a large periapical lesion were randomized into four groups (n = 16): retrograde obturation (RG), orthograde obturation (OG), RG + L-PRF, and OG + L-PRF. All participants underwent root canal retreatment in two sessions. The RG group underwent root-end resection and retrograde MTA obturation, the RG + L-PRF group underwent L-PRF application to the bone defect following the RG protocol, the OG group underwent orthograde MTA obturation and periapical curettage without root-end resection, and the OG + L-PRF group underwent L-PRF application following the OG protocol. Clinical and radiographic assessments were performed preoperatively, and at 1 week and 1, 3, 6, 9, and 12 months postoperatively. At follow-up visits, pain scores, swelling, tooth mobility, tenderness to percussion (T-PER), tenderness to palpation (T-PAL), and the presence of fistula were clinically assessed. Periapical radiography determined the periapical index (PAI) score and measured the periapical lesion area (PALA). The Kruskal–Wallis test was performed to test the effect of a single independent variable (factor) on a dependent variable. No statistically significant differences were identified between the groups for preoperative PAI scores, pain scores, swelling, tooth mobility, fistula, T-PER, or T-PAL (p > 0.05). At postoperative week 1, the RG + L-PRF group showed a significantly lower T-PER. The RG + L-PRF group showed significantly lower PALA values and significantly higher PALA healing rates at postoperative 1, 6, and 9 months. Both L-PRF groups achieved PALA healing rates of over 90% at 9 months. It was concluded that a combination of apicoectomy and L-PRF effectively treats periapical lesions and promotes both short- and long-term healing and that a combination of periapical curettage and L-PRF offers a less invasive alternative, especially when the crown-to-root ratio is a concern. Trial registration: The protocol was registered at ClinicalTrials.gov (NCT05847647).

ObjectivesThe aim of this randomized clinical trial was to compare selective removal to soft dentin (SRSD) and selective removal to firm dentin (SRFD) in permanent teeth. The primary outcome of the study was to compare the success rates of the two caries removal techniques. The secondary outcome of the study was to investigate whether or not calcium silicate-based material (CS) had an effect on the success rate of the treatment.Materials and methodsBetween November 2018 and March 2020, patients with deep caries lesions were invited to participate in the study. Posterior teeth (N = 165) with primary caries lesion radiographically extending ¾ of dentin and positive response to cold test were randomly selected. A total of 134 participants meeting the inclusion criteria were randomized to SRSD and SRFD (control) groups. After the caries removal procedure, teeth with exposed pulps were assigned to the pulp exposure (PE) group, and the SRSD group was further divided into test 1 (with CS) and test 2 groups (without CS). Success was defined as a positive response to the cold test, a negative response to percussion, the absence of pain, an abscess, a fistula, and periapical alterations. Fisher–Freeman–Halton exact tests, Kaplan–Meier survival analysis, and the log-rank tests were performed for comparisons between groups.ResultsNo statistically significant difference was found between the success rates of test 1 (100%) and test 2 (93.5%) groups, whereas the proportion of success in control (82.4%) and PE (84%) groups were significantly lower when compared with test groups (p = 0.024; p < 0.05) at the end of 2-year follow-up.ConclusionsSRSD had a higher success rate when compared to SRFD to treat deep carious lesions after 2 years of follow-up. The use of CS material after SRSD as a liner had no effect on the treatment outcome.Clinical relevanceSRSD with good coronal sealing might be recommended without CS application for the treatment of deep caries lesions in permanent teeth.Trial registrationClinical trial registration number NCT04052685 (08/09/2019).

The prophylactic extraction of third molars is highly dependent on the surgeon’s experience as the common practices and guidelines contradict. The purpose of this study was to evaluate the eruption status of impacted third molars using deep learning-based artificial intelligence (AI) and to develop a model that predicts their final positions at an early stage to aid clinical decisions. In this retrospective study, 1102 panoramic radiographs (PANs) were annotated by three expert dentists to classify eruption status as either initial or definitive. A dataset was created and two deep learning architectures, InceptionV3 and ResNet50, were tested through a three-phase protocol: hyperparameter tuning, model evaluation, and assessment of preprocessing effects. Accuracy, recall, precision, and F1 score were used as performance metrics. Classical machine learning (ML) algorithms (SVM, KNN, and logistic regression) were also applied to features extracted from the deep models. ResNet50 with preprocessing achieved the best performance (F1 score: 0.829). Models performed better with definitive cases than with initial ones, where performance dropped (F1 score: 0.705). Clinically, the model predicted full eruption or impaction with 83% and 75% accuracy, respectively, but showed lower accuracy for partial impactions. These results suggest that AI can support early prediction of third molar eruption status and enhance clinical decision-making. Deep learning models (particularly ResNet50) demonstrated promising results in predicting third molar eruption outcomes. With larger datasets and improved optimization, AI tools may achieve greater accuracy and support routine clinical applications.

Background Third-dimensional binary localization, determining whether impacted maxillary canines (IMCs) requiring surgical exposure lie buccally or palatally, is among the key parameters influencing the choice of surgical approach. In 30–50% of cases, the tooth is non-palpable, necessitating further radiographic evaluation. This study investigated whether convolutional neural networks (CNNs) applied to panoramic radiographs (PRs) can accurately classify IMC position, enhancing their diagnostic value in preoperative assessment. Methods This retrospective study included 494 IMCs from 472 PRs. Surgical notes and CBCT findings served as reference standards. IMCs were annotated on PRs and classified using CNN architectures across multiple preprocessing pipelines. Deep feature embeddings were further evaluated using logistic regression (LR), support vector machines (SVM), and k-nearest neighbors (KNN). Model performance was assessed using accuracy, macro-averaged precision, recall, F1-score, and ROC-AUC. Results The ResNet50 + LR model yielded the highest performance (accuracy: 0.898, F1-score: 0.897, ROC-AUC: 0.945), outperforming InceptionV3 and all softmax-based models. Preprocessing had minimal effect on ResNet50 but improved InceptionV3 outcomes. Most misclassifications occurred in buccal cases. Feature-space analysis revealed favorable linear separability for LR. Conclusions CNN-based analysis of PRs enables accurate IMC localization, with ResNet50 + LR demonstrating consistent performance. These findings support the potential of AI-assisted PR interpretation as a viable step toward enhancing clinical utility of two-dimensional imaging.

ObjectivesThe purpose of this study is to assess the stages of skeletal maturity in cone beam computed tomography (CBCT), hand–wrist radiography (HWR) and cephalometric radiography (CR) techniques of orthodontic patients, and associate skeletal maturity stages with chronological age, in a Turkish subpopulation.MethodsHand–wrist radiographs, cephalometric radiographs and CBCT of 105 patients were evaluated. For evaluation of HWR, the “Hand Bone Age A Digital Atlas of Skeletal Maturity” of Vicente Gilsanz and Osman Ratib (2005) was used. Skeletal maturation in the cephalometric radiographs and sagittal sections of cervical vertebrae obtained by CBCT were evaluated with Hassel and Farman’s method (1995). All results were re-evaluated 3 weeks later to assess intra-observer reliability.ResultsIntra-observer reliability coefficients of the skeletal maturity stages in HWR, CR, and CBCT were 0.912, 0.595, 0.756 respectively (p < 0.05). Spearman’s correlation coefficient value between skeletal developmental stages in in HWR, CR, and CBCT was found to be 0.785, 0.875, and 0.791, respectively (p < 0.05).ConclusionResults of this study reveal that the determination of the skeletal development status with analysis of cervical vertebrae using cephalometric radiographs and CBCT is as reliable method as the evaluation of the hand–wrist radiographs and is compatible with chronological age in a subgroup of the Turkish population. When assessing the skeletal development stages of patients, both CBCT and CR can be used validly, so no extra hand–wrist radiography is required. This information is important for the prevention of increased radiation doses in patients.

OBJECTIVE The TiLOOP Bra mesh is a breast-implant-surrounding material that supports the pectoralis muscle and keeps the implant stable in the subpectoral area during breast reconstruction surgery. This study aimed to investigate the dosimetric effect of TiLOOP Bra mesh on dose distribution of radiotherapy in patients requiring postoperative treatment. METHODS The metal oxide semiconductor field effect transistor (MOSFET) and nanoDot optically stimulated luminescence dosimeter (OSLD) were used for dose measurements at different depths in solid phantoms. The measurements were performed above and below the mesh, and at 1 cm deep to the mesh for 6 MV photon energy. The relative dose differences were obtained by measuring doses using the dosimeters and comparing the results with calculated values in Eclipse TPS (Treatment Planning System). The relative dose differences between the cases where the mesh had been present and where the mesh had been removed were evaluated. RESULTS The results were found less than 1%. The findings showed that the TiLOOP Bra mesh used in breast surgery did not affect the dose calculations for radiotherapy. In addition, there were no metallic artifacts on computed tomography image. CONCLUSION Therefore, the quality of the computed tomography image was not affected by the TiLOOP Bra mesh, and it was not necessary to correct the artifact and change the HU (Hounsfield Unit) value in TPS.

Kripto para birimleri ile gelişim hâlinde bulunan eşler arası merkeziyetsiz para düzeni; ülkeler, kurumlar ve kuruluşlar güdümündeki fiat para düzenine bir tezat ve bir alternatif teşkil etmektedir. Çalışmanın ele aldığı sorun ise söz konusu iki para düzeni arasında yapılmış olan karşılaştırmaların ekseriyetle araçların nitelikleri ile kısıtlı kalmış olmaları ve bağlamlarını pek dikkate almamış bulunmalarıdır. Çalışmanın amacı, bu boşluğun doldurulabilmesi ve böylelikle de kripto para birimlerinin dayanıklılıkları hakkında daha net yorumların getirilebileceği bir atmosferin tesis edilebilmesi olmuştur.Türkiye’nin ihtiva ettiği azımsanamayacak kripto hacminin ışığında böylesi yorumların mevcut olmaları daha da önemli birer hâle gelmektedir. Konuyla ilgili olanların gerek yatırım, gerek akademik çalışma ve gerek ise yalnızca bilgi edinmenin hazzı çerçevelerinde çalışmadan istifade edebilmeleri arzulanmıştır. Çalışmaya ait yapı ise çalışmanın yöntemini meydana getirmiş konumdadır. Tümevarım yaklaşımı doğrultusunda bizzat para ile söz konusu bu kavrama ilişkin olan olgular ele alınmış, olası paralellerin tespitleri ışığında güncel fiat para düzeni ile öncülü konumundaki altın standartları dönemleri irdelenmiş, takriben ise bu düzenlerin niteliklerine yer verilmiştir.Bu bağlamda rezerv olarak kullanılan ve mevzubahis kapsam dahilinde en fazla hacmi arz eden para birimlerine sahip beş ülkenin ekonomileri incelemelere tabi tutulmuş, sonrasında da kısaca merkeziyetsiz para düzenine değinilmiştir. Bir yandan iki sistem arasında karşılaştırmalar meydana getirilmiş ve bir diğer yandan da devamlılıklarının veya bir başka deyişle finansal krizler karşısındaki dayanıklılıklarının temelleri saptanmaya çalışılmıştır. Bulgular söz konusu birimlerin devamlılıklarını muhafaza edeceklerine işaret etmekle birlikte alanda daha fazla çalışmanın yürütülmesi ise hiçbir araştırmacının zararına olacak türden birer faaliyet konumunda yer almamaktadır.

Objectives: Sinus lifting, a procedure to augment bone in the maxilla, may cause complications such as sinusitis due to impaired drainage. This study aimed to assess how sinus lifting impacts airflow in the sinus cavity, which is essential for patients undergoing dental implants. Using computational fluid dynamics (CFD), this research analyzed airflow changes after sinus floor elevation, offering insights into the aerodynamic consequences of the procedure. Methods: Digital modeling and CFD analysis were performed using patient cone-beam computed tomography data. Three different sinus elevation scenarios, each with varying implant heights, were simulated. Airflow simulations were conducted to assess how reshaping the sinus cavity affects aerodynamics and airflow dynamics. Nasal resistance, calculated through pressure drops and flow rates, and wall shear stress, indicating potential mucosal damage, were evaluated. Results: Although some airflow changes occurred post-surgery, the implants primarily affected the front and rear of the elevated area, with little impact being seen on air entry points. Conclusions: Maxillary sinus lifting for dental implant placement may impair sinus drainage, especially at higher elevations, increasing the risk of mucosal damage due to intensified airflows in the reduced sinus volume. A more uniform, simplified intra-sinus structure may enhance fluid dynamics and reduce complications.

Mehmet Emin Buyukbayram,1 Zekeriya Hannarici,2 Aykut Turhan,3 Alperen Akansel Çağlar,1 Pınar Çoban Eşdur,1 Mehmet Bilici,1 Salim Başol Tekin,1 Canan Dinar Ayman1 1Department of Medical Oncology, Atatürk University Faculty of Medicine, Erzurum, Turkey; 2Department of Medical Oncology, Health Sciences University Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey; 3Department of Medical Oncology, Republic of Turkey Ministry of Health Ordu Training and Research Hospital, Ordu, TurkeyCorrespondence: Mehmet Emin Buyukbayram, Department of Medical Oncology, Atatürk University Faculty of Medicine, Erzurum, Turkey, 25100, Tel +905392449362, Email m.eminbuyukbayram@hotmail.comObjective: Neoadjuvant chemotherapy (NAC) in hormone-positive operable breast cancer supports breast-conserving surgery, axillary dissection, and survival. However, the pathological complete response (pCR) rates to NAC in hormone-positive breast cancer remain low. Identifying the predictive parameters for pathological response prior to NAC is crucial. In this study, we investigated clinical, pathological, inflammatory, and metabolic parameters that could predict NAC response and survival.Material and Methods: A retrospective study was conducted on 120 patients with hormone-positive breast cancer. Clinical and pathological stages of patients who underwent surgery following NAC were used to calculate the CPS score (clinical stage score + pathological stage score). The Kruskal Wallis test was employed to compare clinical, pathological, and laboratory parameters with the CPS score. The Bonferroni test was applied for post-hoc analysis. Categorical variables were compared using the Pearson Chi-Square test or Fisher’s exact test.Results: There was no statistically significant association between the CPS score and age (p=0.106), estrogen receptor positivity (p=0.331), grade (p=0.100), Ki67 (p=0.247), and chemotherapy received (p=0.720). While pCR was statistically significant in univariate analysis (p=0.001), it did not reach statistical significance in the multivariate model (p=0.258). Axillary pathological response (ypN) had a statistically significant correlation with the CPS score (p=0.003). There was no statistically significant association between the CPS score and leukocyte, lymphocyte, neutrophil, or platelet counts, glucose levels, NLR, PNI, or SII values (p > 0.05).Conclusion: ypN was associated with the CPS score in predicting survival following NAC in hormone-positive breast cancer. No statistically significant association was observed between inflammatory or metabolic parameters and the CPS score. Further validation in larger studies is warranted.Keywords: breast neoplasms, neoadjuvant therapy, prognosis