Restauraciones indirectas para el manejo de la Hipomineralización de Molares e Incisivos: un abordaje conservador / Restaurações indiretas para o tratamento da hipomineralização de molares e incisivos: uma abordagem conservadora / Indirect restorations for the management of hypomineralization of molars and incisors: a conservative approach

Introducción: Técnicas adhesivas contemporáneas permiten la rehabilitación conservadora y estética de dientes afectados por caries dental, trauma dentoalveolar y defectos del desarrollo del esmalte. Para el tratamiento restaurador de la hipomineralización de molares e incisivos (HMI) se ha recomendado el uso de restauraciones indirectas. Reporte de caso: Paciente sintomático de sexo femenino, 8 años, portadora de HMI severa y comportamiento levemente negativo. Los dientes 16, 36 y 46 presentaban opacidades demarcadas asociadas a dolor provocado. El tratamiento se enfocó en educar a la familia con respecto a la HMI, orientar el comportamiento, controlar la sintomatología y restaurar la función y estética de los dientes afectados por la HMI. Debido a la extensión, severidad y localización de los defectos en los dientes 16, 36 y 46, se optó por realizar restauraciones indirectas con resina compuesta. Luego de 12 meses la paciente presentaba comportamiento definitivamente positivo, no relataba sintomatología dolorosa, las restauraciones estaban sin cambio de color, bien adaptadas, con buena salud gingival y con adecuada anatomía oclusal, lisas y sin signos de lesiones de caries dental. Conclusión: En este caso de HMI severa, la restauración con resina indirecta fue una estrategia estética, conservadora, viable y efectiva durante un periodo de seguimiento de 12 meses.

Introdução: As técnicas adesivas atuais permitem a reabilitação conservadora e estética de dentes acometidos por cáries, traumas dentoalveolares e defeitos de desenvolvimento do esmalte. Para o tratamento restaurador da hipomineralização de molares e incisivos (HMI), o uso de restaurações indiretas tem sido recomendado. Relato de caso: Paciente do sexo feminino, sintomática, 8 anos, com HMI severa e comportamento levemente negativo. Os dentes 16, 36 e 46 apresentaram opacidades acentuadas associadas à dor provocada. O tratamento teve como foco a educação da família sobre a HMI, orientando o comportamento, controlando os sintomas e restaurando a função e a estética dos dentes afetados pela HMI. Devido à extensão, severidade e localização dos defeitos nos dentes 16, 36 e 46, optou-se pela realização de restaurações indiretas com resina composta. Após 12 meses, a paciente apresentou um comportamento definitivamente positivo, não relatou sintomatologia dolorosa, as restaurações estavam sem alteração de cor, bem adaptadas, com boa saúde gengival e anatomia oclusal adequada, lisas e sem sinais de lesões de cárie. Conclusão: Neste caso de MHI severa, a restauração indireta em resina foi uma estratégia estética, conservadora, viável e eficaz com um período de acompanhamento de 12 meses.

Introduction: Contemporary adhesive techniques allow the conservative and aesthetic rehabilitation of teeth affected by dental caries, dentoalveolar trauma, and enamel development defects. For the restorative treatment of hypomineralization of molars and incisors (HMI), indirect restorations have been recommended. Case report: Symptomatic female patient, 8 years old, with severe HMI and slightly negative behavior. Teeth 16, 36, and 46 presented marked opacities associated with provoked pain. The treatment focused on educating the family regarding the HMI, guiding behavior, controlling the symptoms, and restoring the function and aesthetics of the teeth affected by the HMI. Due to the extension, severity, and location of the defects in teeth 16, 36, and 46, it was decided to perform indirect restorations with composite resin. After 12 months, the patient presented definitively positive behavior, and did not report painful symptoms, the restorations were without color change, well adapted, with good gingival health and adequate occlusal anatomy, smooth and without signs of dental caries lesions. Conclusion: In this case of severe MHI, indirect resin restoration was an esthetic, conservative, viable, and effective strategy during a 12-month follow-up period

Short-term effect of adhesive system on clinical performance of bulk fill composite: randomized clinical trial

Aim: Although bulk fill composites have been widely used as restorative material, there is no consensus regarding the best clinical protocol in terms of composite technique and adhesive system. Therefore, this clinical trial evaluated the clinical performance of bulk fill composites for class I restorations under different protocols. Methods: A randomized clinical trial including 155 class I restorations was conducted using different adhesive systems: conventional technique (phosphoric acid + conventional three-step adhesive system) (Group 1, 2 and 3); or self-etching adhesive system (Groups 4, 5 and 6). Control groups 1 and 4 were restored with conventional composite; groups 2 and 5 with low viscosity bulk fill and conventional composite as occlusal coverage; groups 3 and 6 with high viscosity bulk fill. The FDI criteria was used for clinical evaluation at baseline and after 6 months. Results: All groups showed good clinical performance. At baseline, the adhesive system did not affect postoperative hypersensitivity. After 6 months, group 5 showed a significant reduction in color and translucency; group 6 a reduction in terms of anatomical form and for postoperative sensitivity and an improvement in patient satisfaction (p<0.05). Considering the same restorative technique, the use of the self-etching adhesive system showed a significant decrease in color and translucency (p<0.05). Conclusion: All groups showed favorable clinical performance, and promising results were found for the conventional adhesive system and high viscosity bulk fill protocol

Effects of dentinary contamination by endodontic irrigants on bonding strength of adhesive systems

This study aimed to evaluate if 2.5% sodium hypochlorite compromises the adhesion of bonding materials. The factors in the study were the irrigation solutions in two levels: 2.5% sodium hypochlorite and saline solution; and the adhesive systems used in three levels: three-step adhesive, universal adhesive, and two-step self-etch adhesive systems. The answer variable used was the microshear bond strength obtained through a universal testing machine and fracture mode. Six groups were obtained (n=10) : Etch-and-rinse/Saline (saline solution + 3-step adhesive system - Scotchbond Multipurpose, 3M ESPE); Universal/saline (saline solution + universal adhesive system ­ Prime&Bond,); Self-etch/saline (saline solution + 2-step self-etch adhesive systems - Clearfil SE Bond); Etch-and-rinse/Hypo (sodium hypochlorite 2,5% + 3-step adhesive system - Scotchbond Multiuso); Universal/Hypo (sodium hypochlorite 2,5% + universal adhesive system ­ Prime&Bond); Self-etch/Hypo (sodium hypochlorite 2,5% + 2-step self-etch adhesive system - Clearfil Se Bond). The specimens were obtained from 60 healthy bovine incisors. The crowns were separated from the roots, and the regularization of the buccal surface was performed. The groups received saline solution and 2.5% sodium hypochlorite for 30 minutes, respectively. A matrix of 1mm and 3mm oh height was stabilized by Scotch tape to obtain the resin sticks. Afterward, the bond strength test was performed in a universal testing machine at 1mm/min speed. The data were analyzed with normality Shapiro-Wilk, two-way ANOVA, and Tukey's tests (p<0.001). Etch-and-rinse and Self-etch adhesives presented the highest bond strength values after irrigation with saline solution and 2.5% sodium hypochlorite, respectively (P < 0.01). The irrigation with 2.5% sodium hypochlorite decreased the bond strength values of Etch-and-rinse and Universal (P < 0.01). On the other hand, 2.5% sodium hypochlorite improved the bond strength values of Self-etch (P < 0.01). In conclusion, 2.5% sodium hypochlorite negatively impacted the bond strength of Etch-and-rinse and Universal but improved the adhesion of Self-etch.

The adhesion mechanism of barnacle and its cement proteins: a review / 生物工程学报

The adhesive protein secreted by marine sessile animals can resist the resistance of water and exert stickiness under the humid environment. It has become a candidate for the development of high-performance materials in the field of biomedicine and bionics. Barnacles are as one of the marine macrofoulers that can be firmly attached to the underwater substrate materials with different surface characteristics through its cement proteins. To date, the adhesion process of barnacle has been understood in-depth, but the specific underwater adhesion mechanism has not been elucidated and needs further exploration. This review first presented an overview of barnacle and its adhesion process, followed by summarizing the advances of barnacle adhesive protein, its production methods, and applications. Moreover, challenges and future perspectives were prospected.

Lesiones cutáneas asociadas al uso de bombas de insulina y sistemas de monitoreo: un problema desafiante / Insulin pumps and glucose monitors related cutaneous lesions: a challenging problem

Los cuidados actuales de la diabetes incluyen altos niveles de tecnología y los pacientes utilizan diferentes dispositivos que pueden ayudar en su control metabólico, pero pueden impactar negativamente en su piel. Sensores de glucosa como el Freestyle, Dexcom, el Enlite de Medtronic y los sistemas de infusión continua de insulina contienen diferentes productos químicos que están en contacto directo con la piel del paciente y pueden causar una dermatitis irritativa o de contacto alérgica. Las lesiones incluyen eczema, prurito, heridas, cicatrices y cambios en la pigmentación de la piel. Los productos químicos involucrados que pueden ocasionarlas son el isobornil acrilato, N, N- dimetilacrilamida, etil cianoacrilato y colophonium, forzando a los pacientes a cambiar los sitios de infusión, el set de infusión o el sensor mismo más pronto de lo esperado, para reducir el nivel de daño en la piel. Existe gran número de productos que permiten proteger la piel y reducir el contacto de la piel con la cánula de la bomba o el sensor. Para reducir o prevenir el daño existen productos como cremas o spray y parches de hidrocoloide que actúan como barrera y existen técnicas para aplicar y retirar cuidadosamente los parches y adhesivos de los dispositivos. Una vez que las lesiones se han producido, el tratamiento incluye pomadas y a veces corticoides tópicos y/o antibióticos. Para prevenir o reducir el daño de la piel asociado al sensor y uso de la bomba de insulina, la industria que los produce debería incluir la información en relación a los productos químicos incluidos en cada dispositivo.

Diabetes care nowadays includes a high level of technology and patients use different devices which can help them in their glycemic control, but can have a negative impact on their skin. Glucose sensors such as Freestyle, Dexcom, Medtronic Enlite and also continuous subcutaneous insulin infusion systems contain different chemical products which are in direct contact with the patient's skin and can cause irritative or allergic contact dermatitis. Lesions include eczema, pruritus, wounds, scars and changes in skin pigmentation. The chemical products which can induce them are isobornyl acrylate, N, N- dimethylacrylamide, ethyl cyanoacrylate and colophonium, forcing patients to change the infusion site, set or the sensor itself, earlier than expected, in order to reduce the level of skin damage. There are a number of products which can protect the skin and reduce it's contact with the pump cannula or the sensor. To reduce or prevent damage, we have products such as barrier cream or spray films and hydrocolloid blister plasters and actions such as careful application and removal of device's patches and adhesives. Once lesions are established, treatment includes ointments and sometimes topical steroids and/ or antibiotics. In order to prevent or reduce skin damage related to sensor and insulin pump use, the manufacturers should include the information related to the chemicals included in each device.

Sellado de lesiones de caries: reporte de caso / Selamento de lesões de cárie: relato de caso / Sealing of caries lesions: case report

El objetivo de este estudio fue informar un caso clínico de sellado de lesiones activas de caries, puntuación 5 del Sistema Internacional de Detección y Evaluación de Caries - ICDAS, en los primeros molares permanentes de un chico de 9 años. En el examen clínico, se identificaron lesiones activas, código 5 y 3 en los dientes 16 y 26, respectivamente. Sin embargo, en el examen radiográfico se observó que la lesión del diente 26 también se encontraba en la mitad externa de la dentina. Por lo tanto, ambas lesiones fueron consideradas como código 5. Así, para el sellado de las lesiones, se realizó un tratamiento de intervención mínima, usando sellante resinoso con capa intermedia de adhesivo. Después de 6 meses de acompañamiento, se observó la pérdida de la integridad del sellado del diente 16 realizándose la reparación del mismo; después de un año ambas lesiones estaban inactivas. Por lo tanto, el sellado de las lesiones de caries parece ser adecuado para las lesiones del esmalte que alcanzan la mitad exterior de la dentina

O objetivo deste estudo foi relatar um caso clínico de selamento de lesões de cárie ativas, escore 5 do International Caries Detection and Assessment System- ICDAS, em primeiros molares permanentes de um menino de 9 anos. Ao exame clínico, foram identificadas lesões ativas, escore 5 e 3 nos elementos 16 e 26, respectivamente. Entretanto, no exame radiográfico observou-se que a lesão do dente 26 também estava em metade externa de dentina. Dessa forma, ambas as lesões eram escore 5. O tratamento de mínima intervenção com o selamento das lesões de cárie foi realizado, usando selante resinoso com camada intermediária de adesivo. Em 6 meses de acompanhamento, observou-se perda de integridade do selante no dente 16, sendo realizado o reparo; após um ano, as lesões estavam paralisadas. Portanto, o selamento de lesão de cárie parece ser adequado para lesões em esmalte atingindo metade externa de dentina

The aim of this study was to report a clinical case of sealing active caries lesions, score 5 of the International Caries Detection and Assessment System- ICDAS, in the first permanent molars of a 9-year-old boy. On clinical examination, active lesions were identified, score 5 and 3 in molars 16 and 26, respectively. However, radiographic examination determined that the lesion of tooth 26 was also in the external half of dentin. Thus, both lesions were score 5. The minimal intervention treatment with the sealing of the carious lesions was performed, using resinous sealant with an intermediate layer of adhesive. In 6 months of follow-up, loss of integrity of the sealant was observed on tooth 16, and the repair was carried out; after one year, the lesions were paralyzed. Therefore, the sealing of caries lesions seems to be suitable for enamel lesions reaching the external half of dentin

Effect of hydroxyapatite based agents on the bonding properties of universal adhesives / 中华口腔医学杂志

Objective: To study the effect of hydroxyapatite (HA) based agents on the bonding properties of universal adhesive with different application modes, and to provide evidence for the use of adhesives after desensitization treatment. Methods: Sixty impacted third molars were extracted and selected (acquired from Department of Oral and Maxillofacial Surgery, College of Stomatology, Xi'an Jiaotong University). Four third molars were used to prepare 1 mm thick dentin disks and treated with 1% citric acid to simulate sensitive tooth models. The dentin surfaces were observed by scanning electron microscope (SEM) after treating with no desensitization (control group), desensitized by HA based toothpaste Biorepair and Dontodent Sensitive respectively (desensitizing toothpaste A group and B group), or HA paste treatment (desensitizing paste group ) (n=2 per group). The remaining teeth were selected to expose the mid-coronal dentin and establish dentin sensitivity models. Then, the specimens were divided into 4 former groups and received corresponding treatment. Each group was randomly divided into 2 subgroups, and intermediately strong universal adhesive (G-Premio Bond) was applied on the desensitized dentin by either etch-and-rinse mode or self-etch mode. Resin-dentin slice specimens (n=4 per subgroup), microtensile specimens (n=20 per subgroup) and slice specimens (n=6 per subgroup) were prepared. The microstructure and nanoleakage of the adhesive interfaces were observed by scanning electron microscopy (SEM). The microtensile strength (bond strength) and fracture mode were tested and recorded. The water permeability of the adhesive interface was observed by laser scanning confocal microscopy (LSCM). Results: SEM showed that desensitizing toothpaste and desensitizing paste could partially or entirely occlude most of the dentin tubules. For the etch-and-rinse mode, the bond strength of specimens treated with toothpaste A [(40.98±4.60) MPa], toothpaste B [(40.89±4.64) MPa] and HA paste [(41.48±3.65) MPa] was significantly higher than that of the control group [(38.58±4.28) MPa] (F=3.89,P<0.05). There was no statistically significant difference in bond strength among the 4 subgroups for self-etch modes (F=0.48,P>0.05). After desensitization, the bond strength of the control group and desensitizing groups in the self-etch mode was significantly higher than that in the etch-and-rinse mode (P<0.05). The overall fracture modes were mixed failure and interfacial failure in the control group and desensitizing groups. SEM showed speckled silver-stained particles deposited along the bottom of the hybrid layer on the bond interface of etch-and-rinse mode, and there were few silver-stained particles deposited on the bond interface of self-etch mode. LSCM showed continuous linear penetration in the hybrid layer of etch-and-rinse mode subgroups and discontinuous linear penetration in the hybrid layer of self-etch mode subgroups. Conclusions: HA based desensitizers have no adverse effect on the bond strength of intermediately strong universal adhesive and show good bonding performance accompanied with the self-etch mode.

Clinical effectiveness of pre-treatment with chlorhexidine in adhesive dental restorations: systematic review and meta-analysis / Eficacia clínica del pretratamiento con clorhexidina en restauraciones dentales adhesivas: revisión sistemática y metanálisis

Objective: To determine, by means of a systematic review and meta-analysis, the clinical effectiveness of pre-treatment with chlorhexidine (CHX) in adhesive dental restorations. Material and Methods: A literature search was conducted until February 2020, in the biomedical databases: Pubmed, Embase, Scielo, Science Direct, Scopus, SIGLE, LILACS, Google Scholar and the Cochrane Central Registry of Clinical Trials. The selection criteria of the studies were defined, which were: randomized and controlled clinical trials, without language and time restrictions, and reporting the clinical effects (retention, marginal discoloration, marginal adaptation, postoperative sensitivity and secondary caries) of pre-CHX treatment in adhesive dental restorations. Study risk of bias was analyzed using the Cochrane Handbook of Systematic Reviews of Interventions. Results:The search strategy resulted in six articles of which five entered a meta-analysis. The studies reported that there was no difference in retention, marginal discoloration, marginal adaptation, postoperative sensitivity, and secondary caries from pre-treatment with CHX in adhesive dental restorations. Conclusion: The reviewed literature suggests that pretreatment with CHX does not influence the clinical effectiveness in adhesive dental restorations.

Resumen: Antecedentes: la pandemia de COVID-19 ha desatado un ataque sin precedentes contra la humanidad en todo el mundo. El escenario en Bangladesh empeora día a día, y todos los aspectos de la sociedad están observando su impacto. Los profesionales de la salud corren un mayor riesgo de contraer la enfermedad mientras atienden a los pacientes. Objetivo: El objetivo de la investigación es explorar el conocimiento, la conciencia y las prácticas de los dentistas registrados con respecto a la epidemiología y transmisión de COVID-19 durante el rápido brote de este virus altamente contagioso en Bangladesh. Material y Métodos: Se realizó una encuesta transversal basada en la web entre los dentistas inscritos con su número de registro único válido del Consejo Médico y Dental de Bangladesh (BMDC). Se distribuyó un cuestionario estructurado entre los dentistas a través de diferentes plataformas de redes sociales. Un total de 184 dentistas participaron en la encuesta entre marzo y abril de 2020. Se realizó tanto análisis descriptivo como análisis de regresión logística multivariable. Resultados: La edad media de los odontólogos fue de 31,75 años, con una desviación estándar de 6,5 años. Aproximadamente el 29,3% de los dentistas habían completado su título de posgrado y el 76% de ellos se dedicaba a la práctica privada en el momento de la recopilación de datos. En comparación con los dentistas con educación universitaria, los dentistas con educación de posgrado tienen tres veces (OR = 3,1, IC del 95%: 1,2 - 7,9 y más de 5 veces (OR = 5,3, IC del 95%: 1,2 - 23,3) más probabilidades de tener) mejores conocimientos y prácticas hacia COVID-19 respectivamente. Los dentistas de 26 a 30 años tienen menos probabilidades de tener buenas prácticas que los dentistas más jóvenes (OR: .1; IC del 95%: .01 - .5). Sin embargo, los dentistas con menos de cinco años de experiencia tienen 10,3 (1,6 - 68,9) veces más probabilidades de tener buenas prácticas en comparación con los dentistas con más experiencia. Conclusión: La mayoría de los dentistas de Bangladesh han demostrado un buen conocimiento, conciencia y práctica con respecto a COVID-19. Recomendamos que las autoridades sanitarias, las organizaciones profesionales y los hospitales coordinen y lleven a cabo una formación avanzada obligatoria sobre enfermedades infecciosas para todos los dentistas en ejercicio del país.

Resina Filtek Z250 XT precalentada como agente cementante de restauraciones indirectas / Preheated Filtek Z250 XT resin as a luting agent in indirect restorations

Introducción: Las restauraciones indirectas de resina son ampliamente empleadas para realizar tratamientos estéticos en dientes posteriores. Recientemente se ha propuesto el uso de resinas precalentadas como agentes de unión. Objetivo: Evaluar la resistencia a la tracción de restauraciones indirectas cementadas con una resina precalentada comparándola con un cemento de resina autoadhesivo y un cemento resinoso. Métodos: Las preparaciones dentarias se realizaron en 45 premolares con piedras diamantadas calibradas. Las muestras se dividieron aleatoriamente en tres conjuntos (n = 15) según los grupos experimentales: grupo 1 (resina precalentada), grupo 2 (resina autoadhesiva) y grupo 3 (cemento de resinoso adhesivo). Las muestras fueron incluidas en acrílico autopolimerizable. Se realizaron restauraciones indirectas para cada muestra, las superficies internas fueron microarenadas y se aplicó silano antes de la cementación con los agentes de unión. La resistencia a la tracción se realizó utilizando una máquina universal de ensayos con una velocidad de cruceta de 5 mm/min. El análisis estadístico se llevó a cabo con ANOVA de un factor y la prueba post hoc de Tukey. Se adoptó un nivel de significancia de p < 0,05. Resultados: La resina Filtek Z250 XT precalentada a 60 °C durante 15 minutos tuvo una fuerza de resistencia a la tracción de 5,775 MPa, similar a RelyX Ultimate con 5,442 MPa (p > 0,05), ambos grupos poseen una fuerza de resistencia a la tracción significativamente mayor que RelyX U200 (3,430 MPa). Conclusiones: La resina precalentada (Filtek, Z250 XT) y el cemento resinoso (RelyX Ultimate) muestran las mismas propiedades de resistencia a la tracción cuando se usan como agentes adhesivos en restauraciones indirectas de resina(AU)

Introduction: Indirect resin restorations are widely used in the esthetic treatment of posterior teeth. Preheated resins have been recently proposed as luting agents. Objective: Evaluate the tensile bond strength of indirect restorations cemented with a preheated resin versus a self-adhesive resin cement and a resinous cement. Methods: Tooth preparation was conducted of 45 premolars using calibrated diamond-coated stones. The samples were randomly divided into three sets (n = 15) according to the following experimental groups: Group 1 (preheated resin), Group 2 (self-adhesive resin) and Group 3 (adhesive resinous cement), and soaked in self-polimerizable acrylic. Indirect restorations were performed for each sample. The inner surfaces were microsanded, and silane was applied before cementation with the luting agents. Tensile bond strength was verified with a universal testing machine at a crosshead speed of 5 mm/min. Statistical analysis was based on one-factor ANOVA and Tukey's post hoc test. A significance level of p < 0.05 was established. Results: The Filtek Z250 XT resin preheated at 60°C for 15 minutes displayed a tensile bond strength of 5.775 MPa, similar to RelyX Ultimate with 5.442 MPa (p > 0.05). Both groups displayed a significantly greater tensile bond strength than RelyX U200 (3.430 MPa). Conclusions: The preheated resin (Filtek Z250 XT) and the resinous cement (RelyX Ultimate) exhibit the same tensile bond strength properties when used as luting agents in indirect resin restorations(AU)

Evaluation of adhesive bone conduction hearing aid in pediatric patients with unilateral congenital aural atresia / 中华耳鼻咽喉头颈外科杂志

Objective: To evaluate the auditory efficacy and subjective satisfaction of adhesive bone conduction hearing aid in children with unilateral congenital aural atresia (UCAA). Methods: Ten subjects (5 males and 5 females) diagnosed with UCAA with an average age of 8.3 years old (ranged from 5 to 15) were included in Beijing Tongren Hospital, Capital Medical University from January to August 2019. The free sound field hearing threshold, word recognition score in quiet, speech reception threshold in noise and sound localization ability (results were measured by RMS error) tests were performed in unaided and aided situation, respectively. Subjective satisfaction questionnaires were also distributed to subjects. Paired t test and Wilcoxon signed rank test were used as statistical analysis methods. Results: The average hearing threshold in aided condition was improved by (21.9±4.4) dB (t=15.8，P<0.05). Speech recognition abilities were generally improved both under quiet and noise (P<0.05);however, when the binaural summation, squelch and head shadow effects were analyzed respectively, the binaural squelch effect was not statistically improved (P>0.05), while the other effects were improved in aided condition (P<0.05). In sound localization test, there was no significant difference of the RMS error value between the unaided and aided situation (P>0.05). The subjects got high satisfaction rates in three subjective questionnaires. Conclusion: The adhesive bone conduction hearing aid can provide significant audiological benefit for children with UCAA as well as raising the quality of their life.

Medical adhesive-related skin injury in cancer patients: A prospective cohort study / Lesión cutánea relacionada con adhesivos médicos en pacientes con cáncer: cohorte prospectiva / Lesão de pele relacionada a adesivo médico em paciente com câncer: coorte prospectiva

Objective: to estimate the incidence of medical adhesive-related skin injury in the peripheral venous catheter fixation region in critical cancer patients, to identify risk factors, and to establish a risk prediction model for its development. Method: a prospective cohort study with a sample of 100 adult and aged patients hospitalized in an intensive care unit. The data were analyzed using descriptive, bivariate and multivariate statistics with Cox regression. Results: the incidence of medical adhesive-related skin injury was 31.0% and the incidence density was 3.4 cases per 100 people-days. The risk factors were as follows: alcoholism, smoking habit, hospitalization due to deep vein thrombosis, acute respiratory failure, immediate postoperative period, heart disease, dyslipidemia, use of antiarrhythmics, blood transfusion, friction injury, pressure injury, turgor, edema, hematoma, petechiae, low values in the Braden scale, clinical severity of the patient, elasticity, moisture, texture and color. The predictive model consisted in the following: decreased skin turgor, presence of hematoma and edema. Conclusion: medical adhesive-related skin injury at the peripheral venous catheter insertion site has a high incidence in critical cancer patients and is associated with decreased turgor, presence of hematoma and edema, evidence that can support the clinical practice.

Objetivo: estimar la incidencia de lesión cutánea relacionada con adhesivos médicos en la región de fijación del catéter venoso periférico en pacientes oncológicos críticos, identificar factores de riesgo y establecer un modelo de predicción de riesgo para su desarrollo. Método: cohorte prospectiva con una muestra de 100 pacientes adultos y adultos mayores ingresados en una unidad de terapia intensiva. Los datos se analizaron mediante estadística descriptiva, bivariada y multivariada con regresión de Cox. Resultados: la incidencia de lesión cutánea relacionada con adhesivos médicos fue del 31,0% y la densidad de incidencia fue de 3,4 casos por 100 personas-día. Los factores de riesgo fueron: alcoholismo, tabaquismo, hospitalización por trombosis venosa profunda, insuficiencia respiratoria aguda, postoperatorio inmediato, cardiopatía, dislipidemia, uso de antiarrítmicos, transfusión de sangre, lesión por fricción, lesión por presión, turgencia, edema, hematoma, petequias, bajos valores en la escala de Braden, gravedad clínica del paciente, elasticidad, humedad, textura y coloración. El modelo predictivo estuvo compuesto por: disminución de la turgencia cutánea, presencia de hematomas y edema. Conclusión: la lesión cutánea relacionada con adhesivos médicos en el sitio de inserción del catéter venoso periférico tiene una alta incidencia en pacientes oncológicos críticos y se asocia a disminución de la turgencia, presencia de hematoma y edema, dicha evidencia puede servir de base para la práctica clínica.

Objetivo: estimar a incidência de lesão de pele relacionada a adesivo médico em região de fixação de cateter venoso periférico em pacientes oncológicos críticos, identificar fatores de risco e estabelecer modelo de predição de risco para o seu desenvolvimento. Método: coorte prospectiva com amostra de 100 pacientes adultos e idosos internados em unidade de terapia intensiva. Os dados foram analisados por estatística descritiva, bivariada e multivariada com regressão de Cox. Resultados: a incidência da lesão de pele relacionada a adesivo médico foi de 31,0% e a densidade de incidência foi de 3,4 casos por 100 pessoas-dia. Os fatores de risco foram: etilismo, tabagismo, internação por trombose venosa profunda, insuficiência respiratória aguda, pós-operatório imediato, cardiopatia, dislipidemia, uso de antiarrítmico, hemotransfusão, lesão por fricção, lesão por pressão, turgor, edema, hematoma, petéquias, valores baixos na escala de Braden, gravidade clínica do paciente, elasticidade, umidade, textura e coloração. Compuseram o modelo preditivo: turgor de pele diminuído, presença de hematomas e edema. Conclusão: a lesão de pele relacionada a adesivo médico em sítio de inserção de cateter venoso periférico tem elevada incidência em pacientes oncológicos críticos e está associada ao turgor diminuído, presença de hematoma e edema, evidências essas que podem embasar a prática clínica.

Removal of denture adhesives from PMMA and Polyamide denture base materials

Abstract Denture adhesives need complete removal due to their frequent replacement. Objective Our study investigates the removal of denture adhesives from denture base materials, using different methods. Methodology PMMA and Polyamide denture base materials were used to fabricate 120 samples (15×15×1.5mm). One side of the samples was left as processed and the other polished with a usual procedure, hydrated for 24 h, dried, and weighted. They received 0.2 g of three adhesive creams on their unpolished surface (Corega, Olivafix, Fittydent), pressed on polysulfide material, stored under 37°C and 95% rel. humidity for 1 h and 60 of them, following their separation from polysulfide base, brushed under running water, whereas the rest inserted in a cleanser bath (Fittydent Super) for 5 min. The samples were dried and inserted in the oven (37°C) for additional 10 min and weighted again. Roughness tests of denture materials and light microscopy of adhesives creams were also used to evaluate the materials. Time lapse images of spayed with water adhesives on PMMA base were also taken to evaluate the volumetric changes of adhesives. Weight data before and after adhesive removal, indicating the amount of remaining adhesive, were statistically analyzed using Welch's ANOVA and Games-Howell multiple comparisons tests at α=0.05 level of significance. Results Roughness of Polyamide was higher than PMMA and Fittydent showed greater volumetric changes than the others. Significant differences (p<0.05), were found between PMMA and Polyamide bases, between Olivafix and Fittydent adhesives, and between brushing and cleansing methods but only for PMMA-Olivafix combination. Conclusions Adhesives showed a stronger adherence to PMMA surface, and Fittydent was the most difficult to be removed. Removal methods were not effective for all adhesives or denture base materials. These indicate that removal methods, adhesive type and denture base material are all playing a significant role in the removal of adhesives from denture surfaces.

Safety of Alginate-based Gastric Mucosal Protective Adhesive and Feasibility Study of Its Use as Submucosal Injection / 中国医疗器械杂志

OBJECTIVE@#To study the safety of alginate based gastric mucosal protective adhesive and its feasibility as a submucosal injection.@*METHODS@#The feasibility of using alginate-based gastric mucosal protective gel as submucosal injection was evaluated by @*RESULTS@#After injection of different concentrations of alginate base mucosal protective adhesive solution, the uplift height was significantly higher than that of normal saline (@*CONCLUSIONS@#Gastric mucosa protector is a promising new medical device product with feasibility and good biocompatibility as submucosal uplift injection agent.

Improvement in compatibility of hot melt pressure-sensitive adhesive with cinnamon volatile oil and in vitro transdermal property by physical blending / 中国中药杂志

Hot melt pressure-sensitive adhesive(HMPSA) has broad application potential in the field of traditional Chinese medicine(TCM) plasters due to its high drug loading, weak skin irritation, satisfactory adhesion, etc. compared with rubber plasters.However, the structure of HMPSA is prone to suffer from the damage caused by volatile oils in TCM plasters. In view of this, a kind of HMPSA with a stable structure was prepared by physical blending of DINCH, polypropylene wax and liquid rubber(LIR) in the present study, which is denoted as DPL. The dosage of cinnamon volatile oil(CVO), the model drug, was selected with viscosity, softening point and cohesion as evaluation indexes. The interaction between DPL and HMPSA was investigated by Fourier transform infrared spectroscopy(FT-IR) and differential scanning calorimetry(DSC). The compatibility of HMPSA with CVO and its transdermal ability were studied by in vitro transdermal test, adhesion, scanning electron microscopy( SEM) and rheological evaluation. The results showed that 5% CVO began to damage the structure of HMPSA. The initial adhesion and holding adhesion of DPL-modified HMPSA(DPL-HMPSA) were not significantly changed compared with those of HMPSA, whereas the 180° peel strength was decreased. FI-IR unraveled that DPL formed the n-π conjugated system with styrene-isoprene-styrene block copolymer(SIS), and there was no significant difference in the glass transition temperature according to DSC results, which indicated the good compatibility of DPL with HMPSA. With 5% CVO loaded, the drug content of DPL-HMPSA was 1. 14 times higher than that of HMPSA, and the decrease rate of drug content in DPL-HMPSA was 16% lower than that in HMPSA after 3 months. SEM demonstrated that CVO did not cause obvious structural damage to DPL-HMPSA. Rheological evaluation revealed that the storage modulus and loss factor of DPL-HMPSA were higher than those of HMPSA, and the cohesion was also stronger. The percutaneous penetration rate of cinnamaldehyde in DPL-HMPSA was 2. 25 times that of HMPSA. In conclusion, DPL-HMPSA had more stable structure, better compatibility with CVO, and higher in vitro transdermal efficiency of cinnamaldehyde than before the modification. This study can provide reference for the mitigation of the matrix structure damage caused by volatile oil components in TCM plasters and the enhancement of the content and in vitro transdermal rate of drug.

Effect of captopril pretreatment on the dentin bonding durability of self-etch adhesive / 浙江大学学报·医学版

To investigate the effect of captopril on the dentin bonding durability of self-etch adhesive. Different concentrations of captopril ethanol solutions or captopril ethanol/water solutions were prepared to pretreat dentin as primer for the self-etch adhesives. The surface morphology of the dentin was observed with scanning electron microscopy (SEM). Based on the morphology analysis, the pretreatment condition was selected and two self-etch adhesives were employed to evaluate the improvement effect of the captopril pretreatment on the dentin bonding durability. : SEM showed that the pretreatment of captopril ethanol solutions and captopril ethanol/water solutions were able to remove the smear lay and partially expose collagen matrix. According to the SEM results, the pretreating condition of captopril ethanol/water solution with the pretreating time of was selected for further dentin bonding study. For Clearfil SEBOND system, the immediate bonding strength increased from to  (0.05]. For Clearfil S BOND system, there was no significant difference in the immediate bonding strength between the experimental group [(4.07) MPa] and the control group[(4.11) MPa]. But after one-year aging, the bonding strength of the experimental group was higher than that of the control group <0.05]. : The pretreatment with captopril ethanol/water solution increases the dentin bonding strength of the self-etch adhesive systems and also improves the bonding durability.

Effect of alternative solvent evaporation techniques on mechanical properties of primer-adhesive mixtures / Efeito de técnicas alternativas utilizando evaporação de solvente nas propriedades mecânicas da mistura primer-adesivo

ABSTRACT This study evaluated the influence of the mode and time of solvent evaporation on the tensile strength (TS), flexural strength (FS) and elastic modulus (EM) of two adhesive systems: Scotchbond Multipurpose (SBMP) and Clearfil SE (CSEB). For this purpose, rectangular samples (2x1x7 mm) were prepared with 10 μL of primer and the solvents were evaporated with air spray at (23±1) ºC, (40±1) ºC and negative control (without spray). For each temperature, the times of 5, 20, 30, and 60 seconds were investigated. The statistical results showed that evaporation at 40±1ºC resulted in better EM for the two adhesives tested and all the evaporation times evaluated. However, there were no significant differences between the times and modes of evaporation for TS. The results of this study indicate that evaporation at a temperature of (40±1) °C could improve the elastic modulus of both adhesives tested, regardless of the evaporating time.

RESUMO Este estudo avaliou a influência do modo e do tempo de evaporação do solvente na resistência à tração (RT), resistência à flexão (RF) e módulo de elasticidade (MR) de dois sistemas adesivos: Scotchbond Multipurpose (SBMP) e Clearfil SE (CSEB). Para isso, amostras retangulares (2x1x7 mm) foram preparadas com 10 μL de primer e os solventes foram evaporados com aerossol a (23±1) ºC, (40±1) ºC e controle negativo (sem aerossol). Para cada temperatura, foram avaliados os tempos de 5, 20, 30 e 60 segundos. Os resultados estatísticos mostraram que a evaporação a (40±1) ºC resultou em melhor MR para os dois adesivos testados e todos os tempos de evaporação avaliados. No entanto, não houve diferenças significativas entre os tempos e modos de evaporação na RT. Os resultados deste estudo indicam que a evaporação a uma temperatura de (40±1) °C poderia melhorar o módulo de elasticidade de ambos os adesivos testados, independentemente do tempo de evaporação.

Comparison of the retention of conventional dentures after the use of common adhesive brands on poor denture foundations: an in vitro study / Comparación de la retención de dentaduras convencionales con el uso de marcas comerciales de adhesivos en procesos alveolares deficientes: un estudio in vitro

There is no information about the possible impact in denture retention after the use of common denture adhesives (DAs) when poor denture foundations (PDF) are present. Moreover, there is a lack of information about which current formulation provides greater retention and for how long. Twelve models from edentulous patients with different ridge shape and border height were used and complete dentures were manufactured. Four different formulation brands of DAs were tested after 10 minutes and three, six, nine, and 12 hours of DA application using a universal testing machine. The Fittydent® and Fixodent® adhesives had the highest retention at 12 hours. The PDF group increased on average its retention by 400 %. However, the group presented lower retention compared to the good denture foundation group. In conclusion, DAs significantly increased denture retention. The PDF group were the most benefited with the application of DAs. The Fixodent® paste had the highest retention.

No existe información acerca del posible impacto en la retención de dentaduras después del uso de adhesivos dentales comunes (DAs) cuando existen rebordes alveolares deficientes (PDF). Más aun, existe una falta de información acerca de cuál formula actual provee mayor retención y por cuanto tiempo. Doce modelos de pacientes edentulos con diferentes formas y alturas en sus rebordes alveolares fueron usados, y dentaduras completas les fueron realizadas. Cuatro diferentes fórmulas y marcas de DAs fueron evaluadas después de 10 minutos, tres, seis, nueve y 12 horas de que se aplicó el DA usando una maquina universal de pruebas. Los adhesivos Fittydent® y Fixodent® presentaron la retención más alta a las 12 horas. El grupo con PDF incrementó su retención hasta en un 400 %. Sin embargo, el grupo presentó menor retención cuando se comparó con el grupo que posee adecuados procesos alveolares. Los DAs incrementaron significativamente la retención de las dentaduras. El grupo PDF fue el más beneficiado con la aplicación de DAs. La pasta Fixodent® provee la más alta retención.

Comparative Evaluation of Bond Strength of Self-Etching and Total Etch Dental Adhesive Systems to Dentin of Deciduous and Permanent Teeth / Evaluación Comparativa de la Fuerza de Unión de los Sistemas de Adhesivo Dental Autograbado y Grabado Total para la Dentina de Dientes Deciduos y Permanentes

ABSTRACT: The aim of this study was to analyze the bond strength of total-etch and self-etch adhesive systems to dentin of primary and permanent teeth. Methods: Thirty sound naturally exfoliated primary molars deciduous teeth (DT) and thirty sound permanent bicuspids permanent teeth (PT) were randomly divided into six groups (n=10 per group) according to two commercial adhesive systems: Adper Single Bond 2; 3M ESPE (Total-etch) and Adper Easy Bond; 3M ESPE (selfetch and total-etch). Specimens submitted to cyclic loading in a universal Instron testing machine. Bond strength values (MPa) were analyzed by ANOVA test and Duncan post hoc test (a=0.05). Results: Mean values were higher in PT compared to DT. In deciduous teeth, no significantly differences observed. Total etch AdperTM Single Bond 2 showed significantly higher bond strength than self-etch AdperTM with additional acid etching in PT (p=0.031). Conclusion: Our findings suggest that the highest bond strength was found in dentin tissue of PT with total etch AdperTM employing the adhesive the Single Bond 2 of one step self-etch.

RESUMEN: El objetivo de este estudio fue analizar la fuerza de unión de los sistemas adhesivos de grabado total y autograbado a la dentina de los dientes primarios y permanentes. Métodos: treinta sonidos exfoliaron naturalmente los molares primarios dientes caducifolios (DT) y treinta sonidos. Los dientes permanentes de los premolares permanentes (PT) se dividieron aleatoriamente en seis grupos (n = 10 por grupo) de acuerdo con dos sistemas adhesivos comerciales: Adper Single Bond 2; 3M ESPE (Grabado total) y Adper Easy Bond; 3M ESPE (autograbado y grabado total). Muestras sometidas a carga cíclica en una máquina universal de pruebas Instron. Los valores de resistencia de la unión (MPa) se analizaron mediante la prueba ANOVA y la prueba post hoc de Duncan (a = 0.05). Resultados: Los valores medios fueron mayores en PT en comparación con DT. En dientes deciduos, no se observaron diferencias significativas. Total etch AdperTM Single Bond 2 mostró una fuerza de unión significativamente mayor que la autograbado AdperTM con grabado ácido adicional en PT (p = 0.031). Conclusión: Nuestros hallazgos sugieren que la mayor fuerza de unión se encontró en el tejido de dentina de PT con grabado total AdperTM empleando el adhesivo Single Bond 2 de autograbado de un solo paso.

Agentes condicionantes alternativos no procedimento adesivo: revisão de literatura / Alternative conditioning agents in the adhesive procedure: literature review

Objetivos: revisar a literatura acerca do uso de ACA no procedimento adesivo. Métodos: Realizaram-se duas buscas distintas na literatura, na base de dados PubMed, na qual a primeira se utilizou das palavras-chave "Restorative dentistry" e "Alternativeconditioning", combinadas entre si pelo operador booleno "AND". Encontraram-se 28 estudos sem restrição de período em que, após a leitura crítica de títulos e resumos, selecionaram-se três. A segunda busca utilizou as palavras-chave "Alternativeconditioning", "Adhesives" e "Dentistry", combinadas pelo operador booleano "AND", encontrando 72 estudos sem restrição de período e, após a leitura de títulos e resumos, selecionaram-se três. Entre eles, o Ácido Fosfórico (AF) foi incapaz de remover a camada hipermineralizada de dentina das Lesões Cervicais Não Cariosas (LCNC). Resultados: Notou-se a eficácia do EDTA, como alternativa ao condicionamento convencional, nas superfícies tratadas com clorexidina. Já o ácido metafosfórico a 40% dispôs de precipitação do mineral bruxita. O condicionamento com Ácido Cítrico (AC) a 5% e Cloreto Férrico Anidro (CFA) a 0,6% e 1,8%, ambos exibiram ótima microtração. O condicionamento com Ácido Nítrico (AN) a 10% e Oxalato Férrico (OF) a 3% reduziu a resistência de união. Entretanto, o resultado pode variar conforme o adesivo utilizado. Conclusão: Os estudos comprovaram a eficácia da aplicação de ACA em procedimentos adesivos, contribuindo com o aumento da retenção das restaurações.

Objective: The Alternative Conditioning Agents (ACA) aim to reduce the biodegradation of adhesive interfaces in resinous restorations. Methods: The aim was to review the literature on the use of ACA in the adhesive procedure. Two different searches were performed in the literature, in the PubMed database, in which the first one used the keywords "Restorative dentistry" and "Alternative conditioning", combined with the Boolene operator "AND". There were 28 studies without period restrictions in which, after critical reading of titles and abstracts, 3 were selected. The second search used the keywords "Alternative conditioning", "Adhesives" and "Dentistry", combined by the Boolean operator "AND", finding 72 studies without period restriction and, after reading titles and abstracts, 3 were selected. Among these, phosphoric acid (PA) was unable to remove the hypermineralized dentin layer from non-carious cervical lesions (NCCL). Results: The efficacy of EDTA, as an alternative to conventional conditioning, was noted on surfaces treated with chlorhexidine. Metaphosphoric acid at 40% had precipitation of the "bruxita" bauxite/brucite mineral. The conditioning with 5% Citric Acid (CA) and 0.6% and 1.8% Anhydrous Ferric Chloride (AFC) both showed excellent microtraction. Citric Acid (CA) conditioning at 10% and Ferric Oxalate (FO) at 3% reduced the bond strength. However, the result may vary according to the adhesive used. Conclusion: Studies have proven the efficacy of ACA in adhesive procedures, contributing to increased retention of restorations.

Effects of three self-etch adhesives and mild salivary contamination on the bonding durability of deciduous teeth / 北京大学学报(医学版)

OBJECTIVE@#To compare the bonding durability of three different self-etch adhesives to primary enamel and dentin, and to investigate the effect of mild salivary contamination followed by air drying on the bonding durability.@*METHODS@#Two hundred and forty enamel specimens were divided randomly into 16 groups (n=15/group)according to the adhesive system [self-etch adhesives: Clearfil SE Bond(SE), AdperTM Easy One (EO), Scotchbond Universal (SBU); total-etch adhesive: AdperTM Single Bond Plus(SL)], contamination status (non-contaminated vs. salivary-contaminated) and storage condition (stored in distilled water for 24 h vs. aging mode 5 000 thermal cycles in 5 ℃ and 55 ℃). Two hundred and forty dentin specimens were assigned in the same way. Shear bond strength for 12 specimens in each group were measured. The adhesive interface for the residual specimens in each group was observed by scanning electron microscopy(SEM). Data were analyzed by three-way analysis of variance and Tukey test(P < 0.05).@*RESULTS@#For primary enamel, total-etch adhesive showed higher initial shear bond strength values (28.92±1.83) MPa and shear bond strength values (27.27±3.03) MPa after thermal cycles compared with the other groups, and the difference between the groups was statistically significant (P < 0.01). Shear bond strength values of EO decreased significantly in salivary-treated groups, regardless of storage conditions, and the difference was statistically significant (P < 0.01). For primary dentin, shear bond strength values of EO decreased significantly in salivary-treated groups after 24 h (P < 0.01). After 5 000 thermal cycles, total-etch adhesive showed significantly lower shear bond strength values (14.31±1.97) MPa compared with the other groups, and the difference between the groups was statistically significant (P < 0.01), and shear bond strength values of EO were significantly lower than those in SE and SBU groups (P < 0.01), regardless of contamination status.@*CONCLUSION@#Total-etch adhesive SL has better bonding durability to primary enamel. SE and SBU have better bonding durability to primary dentin and have a certain resistance to salivary contamination, while the bonding performance of EO is compromised greatly by mild salivary contamination followed by air drying.