Digital Commons Network^™

Decoding The Silent Damage: Clinical And Electrophysiological Features Associated With Occupational N-Hexane Exposure ​, Mehli̇ka Panpalli Ateş, Umur Poyraz, Mustafa Yurtdaş, Emi̇n Gemci̇oğlu

Turkish Journal of Medical Sciences

Background/aim: This study aimed to investigate early findings in patients exposed to n-hexane while working in a shoe factory.

Materials and methods: Twenty-four patients exposed to n-hexane were evaluated by physical examination and electroneuromyography 2–5 weeks after the onset of paresthesia symptoms. The examination and electrophysiological results of these patients were assessed by different physicians who were blinded to both examinations.

Results: Among patients who had weakness, it was particularly obvious in the proximal muscles of the lower extremities. Nerve conduction studies showed decreased motor nerve conduction velocity, conduction block, prolonged distal latency, and prolonged F-wave latency in 20 patients. …

Endovascular Management Of Vascular Complications In Hemodialysis Patients: A Single-Center Experience ​, Ati̇ye Cenay Karabörk Kiliç, Burak Mert Akhan, Nemat Ibrahi̇mkhanli, Esra Kulaksiz Turan, Fati̇h Öncü, Mehmet Koray Akkan, Ahmet Baran Onal, Erhan Turgut Ilgit

Turkish Journal of Medical Sciences

Background/aim: Vascular access failure remains a major cause of morbidity in patients undergoing hemodialysis. This study aimed to evaluate the types of endovascular interventions performed for hemodialysis-related vascular complications, as well as their technical success and patency outcomes, at a single center.

Materials and methods: A total of 103 lesions in 89 patients treated between 2001 and 2023 were retrospectively analyzed. Catheterrelated complications, central venous stenosis or occlusion, and arteriovenous fistula- or graft-related complications were managed using endovascular techniques. Endovascular interventions included catheter repositioning, thrombolysis, percutaneous transluminal angioplasty (PTA), stent placement for central venous lesions, PTA of the fistula vein …

Is The 2d:4d Ratio Different In Patients With Dupuytren’S Disease Compared With The Normal Population? ​, Mustafa Yasi̇n Hati̇poğlu, Tevfi̇k Onur Özdemi̇r

Turkish Journal of Medical Sciences

Background/aim: The second-to-fourth digit (2D:4D) ratio is commonly used as an indirect marker of prenatal androgen exposure, although its biological validity is limited. Evidence of its relationship with Dupuytren disease is scarce. This study compared the radiographic 2D:4D ratios of patients with Dupuytren disease with those of a control group and examined whether the association differed by sex.

Materials and methods: Included in this retrospective observational study were 81 patients with Dupuytren disease and 82 age-comparable controls who contributed 101 and 122 hand measurements, respectively. The phalangeal lengths of the second and fourth digits were measured from hand radiographs and …

Subclinical Trigeminal Involvement In Bell’S Palsy: Insights From Cranial Somatosensory Evoked Potentials ​, Ahmet Hakan Ekmekci̇, Burcu Sümeyye Çağar, Nadi̇re Ünver Doğan

Turkish Journal of Medical Sciences

Background/aim: Bell’s palsy (BP) has traditionally been considered an isolated peripheral facial nerve mononeuropathy; however, subclinical trigeminal involvement has been suggested. We evaluated whether cranial somatosensory evoked potentials (cSEP) demonstrate electrophysiological alterations in the trigeminal system in patients with BP.

Materials and methods: The records of 32 patients with BP who underwent cSEP between March 2010 and April 2023 were retrospectively reviewed. For the six patients without explicit chart documentation, the affected side was determined using acute-phase facial electromyography records. During routine clinical assessment, cSEP recordings were obtained using inferior alveolar nerve stimulation according to a standardized protocol. Latencies (N1, …

Association Between Acetabular Morphology Parameters And Hip Osteoarthritis: A Multivariable And Diagnostic Performance Analysis ​, Ni̇hat Yi̇ği̇t, Nuri̇ Koray Ulgen, Hayretti̇n Unal, Ali̇ Sai̇d Nazligul, Mehmet Orçun Akkurt, Arslan Kağan Arslan

Turkish Journal of Medical Sciences

Background/aim: Acetabular morphology plays a fundamental role in hip biomechanics by influencing load distribution and maintaining cartilage integrity. Although the Sharp angle, lateral center–edge angle (LCEA), Tönnis angle, and acetabular depth are commonly used radiographic parameters, their independent associations with hip osteoarthritis (OA) and their relative diagnostic performance remain uncertain. This study evaluated these associations and compared their diagnostic utility.

Materials and methods: This retrospective study included standardized anteroposterior pelvis radiographs obtained between January 2021 and December 2024. Hips were classified according to the Kellgren–Lawrence (KL) grading system, with grade 0 hips assigned to the control group and grade ≥2 …

Posture And Musculoskeletal Symptom Burden, But Not Daily Step Count, Are Independently Associated With Physical Quality Of Life In Office Workers: A Cross-Sectional Study ​, Gülsemi̇n Ertürk Çeli̇k, Abdurrahman İskender, Ahmet Usta, Alper Doğanci

Turkish Journal of Medical Sciences

Background/aim: Office work is characterized by prolonged sitting and may be accompanied by musculoskeletal symptoms and reduced well-being. This study examined associations of step-based and self-reported physical activity, clinical posture, attitudes toward sports, smartphone addiction, and musculoskeletal symptom burden in office workers with the four domains of the World Health Organization Quality of Life Scale-Brief Version (WHOQOL-BREF).

Materials and methods: This cross-sectional analysis included 44 desk-based office workers at a public institution. WHOQOL-BREF domain scores were transformed to a 0–100 scale. Physical activity was assessed via 7-day average daily step counts and the International Physical Activity Questionnaire-Short Form (IPAQ-SF); posture …

Reliability And Validity Of The Turkish Version Of The Nose-Perf Scale ​, Aykut Özdoğan, Zülküf Küçüktağ, Gökçe Saygi Uysal, Enes Ahmet Subay, Serdar Özer

Turkish Journal of Medical Sciences

Background/aim: The objective of this study was to evaluate the validity and reliability of the Turkish version of the NOSE-Perf scale, developed to assess symptom severity and quality of life in patients with nasal septal perforation (NSP), and to compare the symptom profile of patients with NSP with those of the nasal obstruction and healthy control groups.

Materials and methods: To evaluate the temporal stability of the NOSE-Perf scale, a test–retest assessment was performed in the NSP group at a 1-month interval. Internal consistency was assessed using Cronbach’s alpha coefficient, while discriminative validity was evaluated using receiver operating characteristic (ROC) …

Methylphenidate-Related Cardiac And Cardiovascular Safety: A Bibliometric And Network Analysis ​, Ömer Çağlar Yilmaz, Sadetti̇n Burak Açikel

Turkish Journal of Medical Sciences

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Background/aim: Methylphenidate is widely used for the treatment of attention-deficit/hyperactivity disorder (ADHD); however, concerns regarding its cardiac and cardiovascular safety remain clinically relevant. This study aimed to delineate the scientific landscape of methylphenidate-related cardiac and cardiovascular safety using bibliometric methods.

Materials and methods: The Science Citation Index Expanded, Social Sciences Citation Index, and Emerging Sources Citation Index were used to search the Web of Science Core Collection. A proximity-based search that combined terms related to methylphenidate, cardiovascular health, and safety/adverse events retrieved 263 records. There were 244 publications in the dataset after only including articles and reviews. VOSviewer was …

Effects Of Topical And Systemic Pirfenidone On Postlaminectomy Epidural Fibrosis In A Rat Model ​, Özgür Öcal, Zuhal Yildirim, Ayşe Çakir Gündoğdu, Abdurrahi̇m Taş, Betül Yaman, Abdurrahman Çeti̇n, Gökhan Gürkan, Abdurrahman Aycan

Turkish Journal of Medical Sciences

Background/aim: To investigate the effect of topical and systemic administration of pirfenidone (PFD) on the development of postlaminectomy epidural fibrosis in a rat model.

Materials and methods: A total of 32 male Wistar albino rats were randomly assigned to four equal groups (n = 8 per group). A bilateral total L1–L2 laminectomy was performed using a posterior midline microsurgical approach. The control group received only laminectomy; the sterile saline (SF) group received laminectomy followed by irrigation with sterile saline; the topical pirfenidone (PFDTpc) group received laminectomy followed by topical PFD application at the laminectomy site; and the systemic pirfenidone (PFD-Sys) …

Effects Of Topical Glycerin And Hydrogen Peroxide On Auditory Brainstem Response Thresholds In A Rat Model Of Tympanic Membrane Perforation ​, Özlem Akkoca, Emi̇ne Aydin, Şule Demi̇rci̇, Ridvan Hali̇t Pamuk, Emi̇ne Ceren Ersöz Ünlü, Harun Çoban, Yüce İslamoğlu

Turkish Journal of Medical Sciences

Background/aim: Cerumenolytic agents containing glycerin and hydrogen peroxide are widely used in clinical practice and are generally considered safe; however, their potential effects on hearing function in cases of tympanic membrane (TM) perforation have not been adequately investigated. This experimental study evaluated the potential ototoxic effects of glycerin and hydrogen peroxide in rats with TM perforations using auditory brainstem response (ABR) testing.

Materials and methods: Twenty healthy male Wistar albino rats with bilaterally induced near-total TM perforations were divided into four groups (n = 4–6 animals/group) and received topical saline, amikacin, glycerin, or hydrogen peroxide applications twice daily for 10 …

Psychological Distress Among Dental Students: A Comparative Study Of Preclinical And Clinical Stages ​, Ömer Faruk Sari, Eli̇f Albayrak, Muhammed Hi̇lmi̇ Büyükçavuş

Turkish Journal of Medical Sciences

Background/aim: Understanding the degree of psychological stress experienced by dental students, together with the contributing factors, is important for reducing the adverse effects of stress and improving student well-being. Accordingly, the present study examined psychological distress levels among dental students and compared psychological distress across different academic years.

Materials and methods: This cross-sectional study included all undergraduate students enrolled in a single 5-year dental faculty in Türkiye during the 2024–2025 academic year. The Kessler Psychological Distress Scale (K10) survey was administered to the students and 399 dentistry students filled out the survey completely.

Results: Statistically significant differences in K10 scores …

Comments On “Pregnancy Outcomes In Systemic Sclerosis Before And After Diagnosis: A Retrospective Nationwide Cohort Study” ​, Muhammad Faisal Shabbir, Muksh Maheshwari, Chand Raj, Maria Baloch

Turkish Journal of Medical Sciences

No abstract provided.

Trustworthiness In The Future: The Enduring Principles, Values, And Virtues Of Professionalism In Medicine, Thomas J. Nasca, Charles W. Thomas

Department of Medicine Faculty Papers

No abstract provided.

Lactulose Hydrogen Breath Test Findings In Children And Adolescents With Duodenogastric Reflux And Suspected Small Intestinal Bacterial Overgrowth: A Pilot Study ​, Hati̇ce Yilmaz Dağli, Zafer Şahi̇n, Dudu Duygu Ci̇van, Reha Artan, Aygen Yilmaz

Turkish Journal of Medical Sciences

Background/aim: This study aimed to identify small intestinal bacterial overgrowth (SIBO) in children and adolescents with persistent symptoms of duodenogastric reflux disease (DGRD).

Materials and methods: Patients aged 5–18 years who were diagnosed with DGRD between 2021 and 2023 were identified. Patients with two or more of 10 symptoms suggestive of SIBO (nausea, vomiting, weight loss, diarrhea, fatigue, joint pain, bloating, depression, acne rosacea, malnutrition) underwent lactulose hydrogen breath testing (LHBT).

Results: A total of 112 patients with DGRD were identified. Seven patients who could not be reached via the telemedicine method were excluded from the study. LHBT was not …

Delta Lactate-To-Albumin Ratio Predicts Major Complications In Patients With Cytoreductive Surgery And Hyperthermic Intraperitoneal Chemotherapy ​, Aytaç Polat, Selcuk Gulmez, Deni̇z Avan, Azi̇z Serkan Senger, Orhan Uzun, Mursi̇t Di̇ncer, Nuri̇ Havan, Erdal Polat, Mustafa Duman

Turkish Journal of Medical Sciences

Background/aim: Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) imposes substantial physiological stress and carries a high risk of major postoperative complications. This study aimed to evaluate the predictive value of the delta lactate-to-albumin ratio (ΔLAR) for major complications following CRS/HIPEC.

Materials and methods: This retrospective cohort study evaluated 150 consecutive adult patients undergoing CRS/HIPEC. Δ-Lactate was calculated as the difference between arterial lactate levels measured before general anesthesia induction and at the end of surgery. ΔLAR was calculated by dividing Δ-lactate by serum albumin measured at 6–9 h postoperatively. Major postoperative complications were defined as Clavien–Dindo grade ≥III complications within …

Reporting Consistency And Functional Interpretation In Comprehensive Geriatric Assessment Of Older Adults With Heart Failure ​, Ahmet Aykut

Turkish Journal of Medical Sciences

No abstract provided.

Intrafamilial Variability In Autosomal Dominant Polycystic Kidney Disease Due To A Shared Pkd1 Mutation: A Potential Signal Of Sodium-Glucose Cotransporter-2 (Sglt2) Inhibitor Benefit ​, Sai̇de Eli̇f Güllülü Boz, Hande Aypek, Gökhan Öngen, Gülşah Çeçener, Alparslan Ersoy, Abdulmeci̇t Yildiz

Turkish Journal of Medical Sciences

No abstract provided.

Effect Of Multiple Uses And Sterilization Of Abutment-Level Peek Implant Scan Bodies On Complete-Arch Intraoral Digital Scans Trueness: An In Vitro Study, Georgio Zeidan, Maryse Nassif, Ghida Lawand, Hani Tohme

International Arab Journal of Dentistry

Introduction: Polyetheretherketone (PEEK) implant scanbodies (ISBs) offer favorable optical properties for digital impressions but may be susceptible to wear and dimensional changes with repeated clinical use and sterilization. While previous studies have examined these variables separately, no investigation has simultaneously evaluated their combined effects on abutment-level PEEK ISBs in complete-arch implant situations.

Aim: To evaluate the effect of multiple uses and autoclave sterilization of abutment-level PEEK implants can bodies on the trueness of complete-arch intraoral digital scans in an in vitro setting.

Methods: A maxillary edentulous reference cast with four implants in an All-on-4 configuration was fabricated …

Efficacy Of Diode Laser As An Adjunct To Non-Surgical Periodontal Therapy In The Treatment Of Stage Ii And Iii Periodontitis: A Randomized Clinical Trial, Heba Samir, Ayat Gamal-Abdelnaser, Marwa Elsayed

International Arab Journal of Dentistry

Objectives: The goal of periodontal therapy is to reduce the bacterial deposits in the pockets; which is mainly achieved by non surgical periodontal therapy (NSPT). Despite effective, it may sometimes be insufficient. Laser offered several advantages as bactericidal, disinfectant and healing accelerator. The aim of the study was to evaluate the efficacy of the use of adjunctive diode laser to NSPT compared to NSPT alone in the treatment of periodontitis.

Methods: In this randomized controlled study with parallel groups, 12 periodontitis patients were randomly assigned to either control group (NSPT only, n=6) or intervention group (laser + NSPT, …

Influence Of Head Posture In Sitting And Standing Positions On The Vertical Dimension Of Rest Value In Dentate Patients: A Comparative Clinical Study, Mia Bardawil, Carole Abi Ghosn, Jihad Fakhouri

International Arab Journal of Dentistry

Introduction: This study investigates the value of the vertical dimension of rest (VDR) in dentate patients in different head postures, supported and unsupported by the headrest of the dental chair, as well as in standing position.

Methods: The VDR was measured and compared in 60 dentate individuals aged 20–25 in different positions (sitting with and without head support, and standing) three times per position. The head was aligned according to the Frankfurt plane when unsupported or standing. Data were analyzed using the Shapiro-Wilk test for normality and ANOVA to assess the effects of posture, gender, and their interaction. …

The Immediate Impact Of Fixed Appliances And Aligners On Perioral Soft Tissues And Speech: A Comparative Approach, Nissi Gurindapalli, Lakshmi Mani Kumari Nachu, Divya Bhavani Vasamsetti, Ramesh Kumar Budumuru, Lakshmi Manojna Nachu, Mohan Kumar Pasupuleti

International Arab Journal of Dentistry

Background and Objective: Facial aesthetics and self-presentation assume significant importance in modern society and augmenting interest in orthodontic treatment practices. Fixed labial, or regular, appliances, namely braces, and clear aligners are the most common orthodontic modalities, and these two vary in their effects on perioral soft tissues and speech. The objective of this study was to compare the immediate effects of fixed labial appliances and clear aligners on perioral soft tissues and speech.

Methods: Anin-vivo comparative study was conducted at Vishnu Dental College. The samples included an equal number of orthodontic patients who were randomly allocated into two …

Comparative Evaluation Of The Effect Of Different Desensitising Methods On The Retention Of Crowns Cemented With Resin Modified Gic: An In-Vitro Study, Zainab Inayatullah, Kartika N. Kumar, Punit Rs Khurana, Anju Aggarwal, Aditya Chaudhary, Naila Perween

International Arab Journal of Dentistry

Introductions: This in vitro study aimed to evaluate and compare the effect of three different desensitizing methods— Admira Protect, dentin bonding agent (Tetric N Bond), and diode laser—on the retention of porcelain-fused-to-metal (PFM) crowns cemented with resin-modified glass ionomer cement (RMGIC).

Methods: Forty extracted, non-carious human premolars were prepared for full-coverage crowns and divided into four groups (n = 10): Group I (Control, no desensitizer), Group II (Admira Protect), Group III (Dentin bonding agent), and Group IV (Diode laser). Standardized tooth preparations were performed and PFM crowns were fabricated and cemented using RMGIC (RelyX Luting 2, 3M ESPE). …

Collateral Circulation As A Predictor Of Reperfusion Injury: Insights From Mechanical Thrombectomy In Stroke Patients ​, Eli̇f Uzun Ata, Asi̇ye Sözeri̇, Gürdal Orhan

Turkish Journal of Medical Sciences

Background/aim: The purpose of this study was to evaluate the association between collateral circulation (CC) status on preprocedural brain CT angiography (BCTA) and the development of postthrombectomy hemorrhagic transformation (HeT) and contrast extravasation (CE) in patients with acute ischemic stroke.

Materials and methods: This retrospective, single-center study included 185 patients with middle cerebral artery occlusion who underwent mechanical thrombectomy (MT) between February 2019 and October 2022 and achieved complete angiographic reperfusion with a final Thrombolysis in Cerebral Infarction grade of 3. Preprocedural CC was assessed on biphasic BCTA using a modified threecategory grading approach and classified as good, moderate, or …

Clinical And Prognostic Significance Of Glomerulonephritis In Clinically Indicated Kidney Allograft Biopsies ​, Hati̇ce Şahi̇n, Fatma Ayerden Ebi̇nç, Gülay Ulusal Okyay, Emre Yaşar, Ebru Gök Oğuz, Fevzi̇ Coşkun Sökmen, Kadi̇r Gökhan Atilgan, Ebru Şebnem Ayva, Mehmet Deni̇z Ayli

Turkish Journal of Medical Sciences

Background/aim: Posttransplant glomerulonephritis (GN) is an underrecognized but clinically important cause of allograft dysfunction. It remains uncertain whether GN detected in a clinically indicated kidney allograft biopsy provides prognostic information beyond graft function and chronic histological injury. The present study evaluates the association between biopsy-detected GN and death-censored graft loss.

Materials and methods: Included in this retrospective single-center study were kidney transplant recipients (KTRs) who underwent clinically indicated allograft biopsy between May 2012 and October 2025. The primary outcome was death-censored graft loss, defined as a return to kidney replacement therapy. Postbiopsy graft survival was assessed using Kaplan–Meier analysis and …

Patterns And Clinical Outcomes Of Necrotizing Soft Tissue Infections: A 5-Year Single-Center Cohort Study ​, Mert Can Rador, Ahmet Can Tuzluklu, Gaye Fi̇li̇nte, Kaan Gi̇deroğlu, Alperen Kahraman, Bi̇lal Eryildirim, Hasan Fehmi̇ Küçük

Turkish Journal of Medical Sciences

Background/aim: Necrotizing soft tissue infections are uncommon but rapidly lethal, and their perineal form, Fournier’s gangrene, is most often referred for reconstruction. Whether routine admission findings identify the highest-risk patients more accurately than severity scores remains uncertain, and whether sodium-glucose cotransporter-2 (SGLT-2) inhibitors, which are widely used in patients with diabetes, influence clinical outcomes also remains unclear.

Materials and methods: We retrospectively studied consecutive adults with necrotizing soft tissue infection at a tertiary referral center over 5 years. A subcohort of 70 patients who underwent plastic and reconstructive surgery was identified within the full institutional cohort of 137. Admission findings …

Microbiota Awareness And Glycaemic Status In Primary Care Patients: A Cross-Sectional Observational Study ​, Cansu Sepetçi̇, Erhan Şi̇mşek

Turkish Journal of Medical Sciences

Background/aim: The aim in this study was to assess microbiota awareness in adults across different glycaemic groups and to investigate the association between microbiota awareness and HbA1c levels in a primary care population.

Materials and methods: This cross-sectional observational study included 330 adults aged 18–65 years: 110 participants with type 2 diabetes, 110 with prediabetes, and 110 without diabetes or prediabetes. Microbiota awareness was assessed using the Microbiota Awareness Scale (MAS), which was administered through face-to-face interviews. HbA1c values and relevant clinical data were obtained from medical records. Group differences in MAS scores were evaluated using both unadjusted analyses and …

Effects Of A Virtual Reality-Based Nature Video Intervention On Sleep Quality And Mental Well-Being In Patients With Multiple Sclerosis: A Randomized Controlled Trial ​, Hati̇ce Yağci Karamanli, Nuray Bi̇ngöl

Turkish Journal of Medical Sciences

Background/aim: Sleep quality and mental health are negatively affected in many patients with multiple sclerosis (MS). The study was conducted to evaluate the effects of virtual reality (VR) on sleep quality and mental well-being.

Materials and methods: The study was designed as a randomized controlled trial. Data were collected from patients with MS who presented to a hospital in Türkiye. The study was completed by 21 participants in the experimental group and 22 participants in the control group. Participants in the experimental group watched nature videos using VR headsets for 6 weeks. Participants completed the Pittsburgh Sleep Quality Index (PSQI) …

Lipopolysaccharide-Induced Acute Systemic Inflammation Is Associated With Depression-Like Behavior And Increased Hippocampal Epha4 Expression ​, Senem Esi̇n Yavaş, Özkan Yavaş, Ayşe Akbaş, Seda Işiklar, Semi̇ha Ersoy

Turkish Journal of Medical Sciences

Background/aim: Depression is a prevalent neuropsychiatric disorder with a complex etiology and a higher burden in women. The inflammation hypothesis, initially proposed based on parallels between depression and sickness behavior, has gained increasing support from accumulating evidence. EphA4, a regulator of synaptic plasticity, is highly expressed in the hippocampus and functions as a negative modulator of neuroplasticity.

Materials and methods: Hippocampal EphA4 expression was investigated in female Wistar rats subjected to lipopolysaccharide-induced acute systemic inflammation. Acute systemic inflammation was induced by intraperitoneal administration of lipopolysaccharide (5 mg/ kg). Depression-like behaviors were assessed using the open-field test and tail-suspension test, while …

Effect Of Beverages With Varying Acidity On The Surface Microhardness Of Resin Composites: An In Vitro Study, Vishnu S, Shweta Purohit, Yashas Dm, Mangala G K, Chinnu Mary Jose, Athira Bs

International Arab Journal of Dentistry

Introductions: The increasing consumption of acidic beverages has raised concerns regarding their impact on the longevity of composite resin restorations. Surface microhardness is a critical parameter for evaluating the mechanical performance and durability of restorative materials.

Aim: To evaluate and compare the effect of beverages with varying acidity on the surface microhardness of different composite resin materials and to assess the relationship between beverage pH and microhardness reduction.

Materials and Methods: This in vitro experimental study included 140 disc-shaped specimens of four composite resins: Filtek Z350 XT, Tetric N-Ceram, Beautifil II, and Charisma Smart (n = 35 …

Evaluation Of Enamel Demineralization Around Bonded Lingual Retainers Cured Using The Transillumination Technique: An In Vitro Sem Study, Monis Raza, Achint Juneja, Udit Chaudhary, Anju Treesa Jacob, Vikas Thakur, Aayush Sudan

International Arab Journal of Dentistry

Introduction: Polymerization technique may influence enamel demineralization around bonded lingual retainers by affecting adhesive integrity.

Methods: Eighty-four mandibular incisors were randomly allocated to conventional curing (30 s), transillumination (30 s), or combined curing (15 s each). Specimens underwent pH cycling and were evaluated using scanning electron microscopy. Demineralization was scored (0–3), and linear lesion depth was measured. Data were analyzed using Kruskal–Wallis, Bonferroni, and Mann–Whitney tests (p ≤ 0.05).

Results: Combined curing significantly reduced demineralization compared with conventional and transillumination protocols (p < 0.001). Gingival regions showed significantly greater demineralization than occlusal regions across all groups.

Conclusions: Combined curing improved enamel preservation and may be an effective strategy for bonded …