ABSTRACT
Statement of the Problem: Refractory nocturnal enuresis possesses a heavy psychosocial burden for the affected child. Only a 15% spontaneous annual cure rate is reported
Purpose: This patient-level meta-analysis aimed to evaluate the efficacy of rapid palatal expansion to treat nocturnal enuresis among children
Materials and Method: A sensitive search of electronic databases of PubMed [since 1966], SCOPUS [containing EMBASE, since 1980], Cochrane Central Register of Controlled Trials, CINAHL and EBSCO till Jan 2014 was performed. A set of regular terms was used for searching in data banks except for PubMed, for which medical subject headings [MeSH] keywords were used. Children aged at least six years old at the time of recruitment of either gender who underwent rapid palatal expansion and had attempted any type of pharmacotherapy prior to orthodontic intervention were included
Results: Six non-randomized clinical trials were found relevant, of which five studies had no control group. Eighty children were investigated with the mean age of 118 [28.12] months ranged from 74 to 185 months. The median time to become completely dry was 2.87 months [confidence interval [CI] 95% 2.07-2.93 months]. After one year, the average rate of becoming complete dry was 31%. The presence of posterior cross bite [relative risk [RR]: 0.31, CI 95%: 0.12-0.79] and signs of upper respiratory obstruction during sleep [RR: 5.1, CI 95%: 1.44-18.04] significantly decreased and increased the chance of improvement, respectively. Meanwhile, the other predictors did not significantly predict the outcome after simultaneous adjustment in Cox regression model
Conclusion: Rapid palatal expansion may be considered when other treatment modalities have failed. The 31% rate of cure is promising when compared to the spontaneous cure rate. Though, high-level evidence from the rigorous randomized controlled trials is scarce [Level of evidence: C]
ABSTRACT
PURPOSE: ANSI/ADA has established standards for adequate radiopacity. This study was aimed to assess the changes in radiopacity of composite resins according to various tube-target distances and exposure times. MATERIALS AND METHODS: Five 1-mm thick samples of Filtek P60 and Clearfil composite resins were prepared and exposed with six tube-target distance/exposure time setups (i.e., 40 cm, 0.2 seconds; 30 cm, 0.2 seconds; 30 cm, 0.16 seconds, 30 cm, 0.12 seconds; 15 cm, 0.2 seconds; 15 cm, 0.12 seconds) performing at 70 kVp and 7 mA along with a 12-step aluminum stepwedge (1 mm incremental steps) using a PSP digital sensor. Thereafter, the radiopacities measured with Digora for Windows software 2.5 were converted to absorbencies (i.e., A=-log (1-G/255)), where A is the absorbency and G is the measured gray scale). Furthermore, the linear regression model of aluminum thickness and absorbency was developed and used to convert the radiopacity of dental materials to the equivalent aluminum thickness. In addition, all calculations were compared with those obtained from a modified 3-step stepwedge (i.e., using data for the 2nd, 5th, and 8th steps). RESULTS: The radiopacities of the composite resins differed significantly with various setups (p<0.001) and between the materials (p<0.001). The best predicted model was obtained for the 30 cm 0.2 seconds setup (R2=0.999). Data from the reduced modified stepwedge was remarkable and comparable with the 12-step stepwedge. CONCLUSION: Within the limits of the present study, our findings support that various setups might influence the radiopacity of dental materials on digital radiographs.
Subject(s)
Aluminum , Composite Resins , Dental Materials , Linear Models , Radiography, Dental, DigitalABSTRACT
PURPOSE: Clinicians commonly encounter cases in which it is difficult to determine whether adjacent radiopacities are normal or pathologic. The ideal radiopacity of composite resin is equal to or higher than that of the same thickness of aluminum. We aimed to investigate the possible effects of different curing times on the post-24-hour radiopacity of composite resins on digital radiographs. MATERIALS AND METHODS: One mm thick samples of Filtek P60 and Clearfil resin composites were prepared and cured with three regimens of continuous 400 mW/cm2 irradiance for 10, 20 and 30 seconds. Along with a 12-step aluminum step wedge, digital radiographs were captured and the radiopacities were transformed to the equivalent aluminum thicknesses. Data were compared by a general linear model and repeated-measures of ANOVA. RESULTS: Overall, the calculated equivalent aluminum thicknesses of composite resins were increased significantly by doubling and tripling the curing times (F(2,8)=8.94, p=0.002). Notably, Bonferroni post-hoc tests confirmed that the radiopacity of the cured Filtek P60 was significantly higher at 30 seconds compared with 10 seconds (p=0.04). Although the higher radiopacity was observed by increasing the time, other comparisons showed no statistical significance (p>0.05). CONCLUSION: These results supported the hypothesis that the radiopacity of resin composites might be related to the duration of light curing. In addition to the current standards for radiopacity of digital images, defining a standard protocol for curing of dental materials should be considered, and it is suggested that they should be added to the current requirements for dental material.