One-year clinical evaluation of IPS Empress CAD versus polished Celtra Duo ceramic Laminate veneers (randomized controlled clinical trial) / Avaliação clínica de um ano de IPS Empress CAD versus laminados de cerâmica Celtra Duo polidos (ensaio clínico randomizado controlado)

Objective: To evaluate fracture resistance and survival rate of IPS Empress CAD versus Polished Celtra Duo ceramic laminate veneers. Material and Methods:Thirty-six ceramic laminate veneers were fabricated for maxillary anterior teeth. The patients were divided into two groups according to the material Group 1(control group) fabricated from IPS Empress CAD laminate veneers and group 2 (intervention group) fabricated from Polished Celtra Duo laminate veneers. Standardized the same preparation with butt joint design and chamfer finish line located supra gingival were performed for all the teeth. The fabrication of the veneers was performed using Cad\Cam (Ceramill motion) machine, with software (Exocad). The veneers surfaces were treated and silanated according to the manufacture instruction of each ceramic and enamel surfaces were etched where total etch adhesive protocol was obeyed using BISCO. Follow up sessions were done every two months up to one year for each patient using dental probe and operator vision to evaluate the fracture, survival rate, marginal adaptation, sensitivity and caries. according to USPHS criteria (United States Public Health Service). This was performed by an experienced, blinded investigator. Results: Fracture resistance, marginal adaptation, retention, caries and sensitivity were evaluated according to the criteria of USPHS and we found there is no significant difference as both groups scaled zero score. Conclusion: Both IPS Empress Cad and Polished Celtra Duo laminate veneers revealed successful clinical performance in terms of fracture resistance, marginal adaptation, retention, and sensitivity after one year follow up period (AU)

Objetivo: Avaliar a resistência à fratura e a taxa de sobrevivência de laminados de cerâmica IPS Empress CAD versus Celtra Duo polidos. Material e Métodos: Trinta e seis facetas cerâmicas laminadas foram confeccionadas para dentes anteriores superiores. Os pacientes foram divididos em dois grupos de acordo com o material Grupo 1 (grupo controle) confeccionado com laminados IPS Empress CAD e grupo 2 (grupo intervenção) confeccionado com laminados Celtra Duo polidos. A mesma forma de preparo e acabamento de chanfro localizado supra-gengival padronizados foram realizados para todos os dentes. A confecção das facetas foi realizada em máquina Cad \ Cam (Ceramill motion), com software (Exocad). As superfícies laminadas foram tratadas e silanizadas de acordo com as instruções do fabricante de cada cerâmica e as superfícies de esmalte foram condicionadas seguindo o protocolo adesivo de condicionamento ácido total com BISCO. Sessões de acompanhamento foram realizadas a cada dois meses durante um ano para cada paciente usando sonda exploradora e visão do operador para avaliar a fratura, taxa de sobrevivência, adaptação marginal, sensibilidade e cárie; de acordo com os critérios USPHS (Serviço de Saúde Pública dos Estados Unidos). Isso foi realizado por um investigador experiente e cego. Resultados: a resistência à fratura, adaptação marginal, retenção, cárie e sensibilidade foram avaliadas de acordo com os critérios da USPHS e não encontramos diferença significativa, pois ambos os grupos escalonaram pontuação zero. Conclusão: As facetas laminadas IPS Empress Cad e Celtra Duo polido revelaram desempenho clínico bem-sucedido em termos de resistência à fratura, adaptação marginal, retenção e sensibilidade após um período de acompanhamento de um ano. (AU)

Sources of Health Care Financing among Patients at the Ahmadu Bello University Teaching Hospital; Zaria; Nigeria

Introduction: Health care financing is the mobilization of funds for health care services. This study determined the various sources of health care financing among the patients on admission at the Ahmadu Bello University Teaching Hospital (ABUTH); Shika-Zaria in 2011 and the effects of the medical bills on the patients and their family members. Methodology: A multi-staged sampling technique was used to select 100 clients for the study. The clients were stratified into the four major wards of the ABUTH; the medical; surgical; obstetrical and gynecological and the pediatric wards. A total of 25 clients were equally allocated to each ward and these were then selected by balloting. Information was sought on their socio-demographic characteristics; sources of the health care financing and the adverse effects of the medical bills on the patients and their family members. Results: Majority of the clients were married; Hausa Muslim housewives who earned N5;000/month (less 1 $/day). Most were aged between 20 and 29 (34) with a mean age of 36.7 years. Patients' relatives paid for the medical bill in most of the cases (48); 37 paid through out of pocket; while 11 used the National Health Insurance Scheme (NHIS) respectively. The medical expenses affected family feeding (29.3); while 16 of the patients could not get full medical services due to lack of funds; 8.8 could not pay school fees of their children and 12.2 were indebted. There were no significant association between the age; sex; marital status; monthly income; occupational status and the clients' sources of health care financing. Majority of the clients (65) were not aware of the NHIS. Most (80) of the patients would want to use the health insurance scheme (NHIS) if they have access to the opportunity. Conclusions: The main source of health care financing in this tertiary center was through out of pocket expenditure by patients and their relatives. Recommendation: There is a need for the urgent implementation of the community health insurance scheme in Nigeria for the benefit of the less privileged

Comparison of frequency of recurrence following aspiration and injection of steroid versus surgical excision in the treatment of wrist ganglion

To compare the frequency of recurrence following aspiration and injection of steroid versus surgical excision in the treatment of wrist ganglion. Randomized controlled trial. General surgical department, Combined Military Hospital, Rawalpindi, Pakistan, from Jan 2010 to Dec 2010. Sixty patients of clinically diagnosed wrist ganglia were randomized into groups A and 'B' with 30 patients in each group. After approval by the hospital ethical committee, patients in group 'A' were subjected to aspiration and injection of methyl-prednisolone acetate 40 mg/ml and those in group 'B' underwent surgical excision of the ganglion. Patients were explained the procedure they were subjected to and they were also counselled about the risk of recurrence after a particular procedure and after that informed written consent was obtained from them. Patients were followed up at intervals of 2 weeks, 6 weeks, 3 months and 6 months after the procedure to look for recurrence in both groups. On follow up at 6 months, 12 [40%] patients in group A while only 2 [6.66%] patients in group B had recurrence of the ganglion. No complications were noted. This difference was found to be statistically significant [p = 0.0023]. Recurrence of wrist ganglion is considerably less in patients treated with surgical excision and should be preferred over aspiration and steroid injection