RESUMEN
Introduction: Use of autopolymerising resin for directprovisionalization is one of the commonest methodsemployed by clinicians. However, these materials exhibit anexothermic reaction and are prone to cause pulpal damage.Thus, a combination of cooling technique and matrix materialto reduce the quantum of heat transferred to a healthy vitalpulpal tissue may be employed for minimal tissue damage.An ex-vivo study was thus envisaged to compare the efficacyof various matrix materials and cooling techniques on timerelated temperature changes in the pulp chamber duringthe fabrication of provisional FPD restorations using directtechnique.Material and Methods: A total of 100 provisionalrestorations were fabricated and were grouped on the basisof three different matrices: Vacuum template, Putty index andAlginate index and further subgrouped on the basis of variouscooling techniques employed. Thermal changes in the pulpchamber was evaluated using Cr/ Al thermocouple placedin the pulp chamber of a prepared tooth and connected to adigital thermometer. Intrapulpal temperature variations wererecorded, tabulated and statistically analysed.Results: The inter-group and intra-group statisticalcomparisons of continuous variables were done using analysisof variance with Bonferroni’s correction for multiple groupcomparisons considering the independent study groups. Theunderlying normality assumption was tested before subjectingeach variable to t test and ANOVA. In the entire study, thep-values less than 0.05 were considered to be statisticallysignificant. All the hypotheses were formulated using twotailed alternatives against each null hypothesis (hypothesis ofno difference). The entire data was statistically analysed usingStatistical Package for Social Sciences (SPSS ver 21.0, IBMCorporation, USA) for MS Windows.Conclusion: The order of heat dissipation for the differentmatrices used is as follows: Irreversible hydrocolloid matrix >PVS putty matrix > vacuum form template. It was concludedthat intrapulpal temperature rise during the direct fabricationof provisional restorations can be limited by employingdifferent cooling techniques. “Cooling” of PVS putty andalginate impression index for 2 minutes in refrigerator(Ambient temperature 10-120C) was found to be most effective“cooling” method for preventing temperature rise in pulp.
RESUMEN
Resumen: Objetivo: Presentar la experiencia relacionada a hipotermia terapéutica controlada en pacientes graves que presentaron lesión neurológica aguda. Material y métodos: Estudio clínico, retrospectivo, observacional y descriptivo, en el Departamento de Medicina Crítica de Adultos de un Hospital de Tercer Nivel en un periodo comprendido del 01 de enero de 2016 al 31 de julio de 2017. Pacientes llevados a hipotermia terapéutica. Resultados: Cinco pacientes incluidos en el estudio, con una media de edad de 52.4 años, 80% con padecimientos neurocríticos. El promedio de estancia en la UCI fue de 15.2 días, y de hospitalización 63 días. La media de días de ventilación mecánica fue de 13.8 días. Sesenta porciento de los pacientes desarrolló neumonía asociada a la ventilación mecánica. Cuarenta porciento de los pacientes presentó una discapacidad grave. Conclusiones: La hipotermia terapéutica en el grupo estudiado no impactó de manera positiva en los desenlaces neurológicos. La complicación más frecuente fue la neumonía asociada a la ventilación mecánica.
Abstract: Objective: To present the experience related to controlled therapeutic hypothermia in severe patients who presented acute neurological injury. Material and methods: Clinical, retrospective, observational and descriptive study in the Department of Critical Care of Adults of a Hospital of Third Level in a period between January 1, 2016 and July 31, 2017. Patients taken to therapeutic hypothermia. Results: Five patients included in the study, with a mean age of 52.4 years, 80% with neurocritical conditions. The average stay in the ICU was 15.2 days, and hospitalization was 63 days. The mean number of days of mechanical ventilation was 13.8 days. Sixty percent of patients developed ventilator-associated pneumonia. Forty percent of the patients had a severe disability. Conclusions: Therapeutic hypothermia in the study group did not positively impact neurological outcomes. The most frequent complication was ventilator-associated pneumonia.
Resumo: Objetivo: Apresentar a experiência relacionada à hipotermia terapêutica controlada em pacientes graves que apresentaram lesão neurológica aguda. Material e métodos: Estudo clínico, retrospectivo, observacional e descritivo, no Departamento de Medicina Crítica de adultos, no período de 1 de janeiro de 2016 a 31 de julho de 2017. Pacientes submetidos à Hipotermia Terapêutica. Resultados: Foram incluídos no estudo 5 pacientes com idade média de 52.4 anos, 80% com alterações neurológicas. A permanência média na UTI foi de 15.2 dias e de hospitalização 63 dias. A média de dias de ventilação mecânica foi de 13.8. 60% dos pacientes desenvolveram pneumonia associada à ventilação mecânica. 40% dos pacientes tinham um incapacidade grave. Conclusões: A hipotermia terapêutica no grupo estudado não teve impacto positivo nos desfechos neurológicos. A complicação mais frequente foi pneumonia associada à ventilação mecânica.