PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item Can Hypotension Episodes that were not Identified in the Non-Invasive Blood Pressure be Detected during Cesarean Section? A Randomized Controlled Trial(2022) Ayhan, Asude; Akovali, Nukhet; Firat, Aynur Camkiran; 35997144Background: Neuraxial anesthesia is a commonly used technique for cesarean section (C/S) because of its simplicity, rapid onset of action, and the requirement of lower doses of anesthetic agents with the lack of uteroplacental transfer. However, this type of anesthesia often causes sudden onset of hypotension, and its pathogenesis is not yet clearly understood.Aims: To evaluate the efficacy and necessity of continuous non -invasive arterial pressure (CNAP) by comparing it with non-invasive blood pressure (NIBP) in order to understand whether it has advantages over oscillometric technique for detection of hypotensive episodes in healthy pregnant women who underwent C/S under neuraxial anesthesia.Study Design: A randomized controlled study.Methods: This prospective study evaluated healthy pregnant women at term who were scheduled for elective C/S under spinal anesthesia. Subjects were randomly assigned into two groups to receive either CNAP and NIBP, or only NIBP. A 30% decrease in systolic blood pressure from either baseline or the measured values in the first two minutes, or if the systolic blood pressure was less than 90 mmHg, is considered hypotension. Pre-, peri-, and postoperative specifications; newborn characteristics; and complications were recorded and compared.Results: A total of 106 individuals were enrolled in the study, with 53 parturients in each group. They were equally distributed in both groups (P > 0.05). The oscillometric method failed to detect hypotension in 8 out of 29 pregnant women who were noted to be hypotensive with CNAP. The number of hypotension events detected was higher, and the time to detection of the first episode of hypotension was shorter in the CNAP group (P > 0.05). A total of four newborns required intensive care unit treatment, one of whom needed mechanical ventilator support, all born to mothers in the CNAP group (P > 0.05).Conclusion: Continuous non-invasive arterial pressure in detecting hypotensive episodes does not provide an additional advantage to healthy pregnant women undergoing elective cesarean section.Item Marginal fit of CAD-CAM monolithic zirconia crowns fabricated by using cone beam computed tomography scans(2020) Kale, Ediz; Cilli, Mesutcan; Ozcelik, Tuncer Burak; Yilmaz, Burak; 31653403Statement of problem: Information regarding the precision of monolithic zirconia crowns fabricated by using a standard computer-aided design and computer-aided manufacturing (CAD-CAM) workflow is available. However, information on the effect of a modified workflow using 3D laboratory scanning and/or cone beam computed tomography (CBCT) for monolithic zirconia crown fabrication is lacking. Purpose: The purpose of this in vitro study was to evaluate the effect of different scans on the marginal fit of CAD-CAM monolithic zirconia crowns fabricated by 3D laboratory scanning and CBCT. Material and methods: An extracted maxillary left first molar was prepared and digitized by using a 3D laboratory scanner (D900; 3Shape A/S) (control group). The tooth was also scanned by CBCT (i-CAT; Imaging Sciences) to generate a second virtual 3D model (CBCTscan group). A tooth cast out of polyurethane (PU) (Zenotec Model; Wieland) was reproduced from the CBCT data by using a CAD software program (Dental System 2.6; 3Shape A/S) and milling machine (CORiTEC 550i; imes-icore) and further scanned by using the 3D laboratory scanner to generate a third virtual 3D model to represent a clinical scenario where a patient's cast is needed (PU3DLab group). A monolithic zirconia crown design (cement space: margin 40 mu m, 1 mm above 70 mu m) was used on the virtual models, and crowns were fabricated out of presintered zirconia blocks (ZenostarT4; Wieland) by using a 5-axis milling machine (CORiTEC 550i; imes-icore). The crowns were sintered (Sinterofen HT-S Speed; Mihm-Vogt), and the vertical marginal discrepancy (VMD) was measured by x100-magnification microscopy. Measurements were made at 384 points in 3 groups of 16 specimens. The measurements for each specimen were averaged, and VMD mean values were calculated. The Kruskal-Wallis test was used for the statistical analysis (alpha=.05). The Mann-Whitney U test and Bonferroni adjustment were further used to compare the pairs (alpha=.017). Results: The mean VMD value was 41 mu m (median: 38 mu m) for the control group, 44 mu m (median: 42 mu m) for the CBCTscan, and 60 mu m (median: 58 mu m) for the PU3DLab. No significant difference was found between control and CBCTscan groups (P=.274). However, there was a significant difference between control and PU3DLab and CBCTscan and PU3DLab groups (P<.001). Conclusions: Marginal fit of the crowns fabricated by using the 3D laboratory scanner and through the direct use of CBCT was better than that of the crowns fabricated by using the workflow that combined the use of CBCT, PU cast, and 3D laboratory scanner. All tested protocols enabled the fabrication of monolithic zirconia crowns with a marginal discrepancy smaller than 120 mu m.