Esperanza de vida tras el reemplazo de válvula aórtica en pacientes jóvenes / Life expectancy after aortic valve replacement in young patients

Introducción y objetivos: Se desconoce si los pacientes jóvenes con estenosis aórtica grave tienen una esperanza de vida restaurada tras el reemplazo de la válvula aórtica (RVAo). Métodos: Se incluyó a todos los pacientes entre 50 y 65 años sometidos a RVAo en 27 centros españoles durante 18 años. Se comparó la supervivencia observada y la esperada a los 15 años de seguimiento. Se repitieron todos los análisis con los pacientes sin complicaciones durante el posoperatorio inmediato. Resultados: Se analizó a 5.084 pacientes. En la muestra total, la supervivencia observada a los 10 y los 15 años fue del 85,3% (IC95%, 84,1-86,4%) y el 73,7% (IC95%, 71,6-75,6%). Las supervivencias esperadas fueron del 90,1 y el 82,1%. La supervivencia relativa acumulada a 1, 5, 10 y 15 años de seguimiento fue del 97,4% (IC95%, 96,9-97,9%), el 96,5% (IC95%, 95,7-97,3%), el 94,7% (IC95%, 93,3-95,9%) y el 89,8% (IC95%, 87,3-92,1%). Para los pacientes sin complicaciones, la supervivencia relativa acumulada a 1, 5, 10 y 15 años fue del 100,3% (IC95%, 99,8-100,5%), el 98,9% (IC95% 97,6-99,9%), el 97,3% (IC95%, 94,9-99,4%) y el 91,9% (IC95%, 86,5-96,8%). Conclusiones:La esperanza de vida de los pacientes jóvenes con estenosis aórtica grave intervenidos para RVAo es menor que la de la población general. La esperanza de vida de los pacientes sin complicaciones durante el posoperatorio inmediato también está reducida. Por lo tanto, las características basales probablemente sean los principales factores que explican la reducción de la esperanza de vida (AU)

Introduction and objectives: In young patients with severe aortic stenosis, it is unknown whether their life expectancy restored after aortic valve replacement (AVR) is unknown. Methods: We analyzed all patients aged between 50 and 65 years who underwent isolated AVR in 27 Spanish centers during an 18-year period. We compared observed and expected survival at 15 years of follow-up. We repeated all analyses for patients without complications in the postoperative period. Results: A total of 5084 patients were analyzed. For the overall sample, observed survival at 10 and 15 years was 85.3% (95%CI, 84.1%-86.4%) and 73.7% (95%CI, 71.6%-75.6%), respectively. Expected survival was 90.1% and 82.1%. Cumulative relative survival for 1, 5, 10 and 15 years of follow-up was 97.4% (95%CI, 96.9%-97.9%), 96.5% (95%CI, 95.7%-97.3%), 94.7% (95%CI, 93.3%-95.9%), and 89.8% (95%CI, 87.3%-92.1%). For patients without complications, cumulative relative survival for 1, 5, 10 and 15 years was 100.3% (95%CI, 99.8%-100.5%), 98.9% (95%CI 97.6% -99.9%), 97.3% (95%CI, 94.9%-99.4%), and 91.9% (95%CI, 86.5%-96.8%). Conclusions: Life expectancy in young patients who have severe aortic stenosis and undergo AVR is lower than that of the general population. Life expectancy of individuals without complications during the postoperative period is also reduced. Therefore, baseline characteristics are likely the main factors that explain the reduction in life expectancy (AU)

In vitro comparison of apical microleakage by spectrophotometry in simulated apexification using White Mineral Trioxide Aggregate, TotalFill Bioceramic Root Repair material, and BioDentine.

AIM: The purpose of this study was to compare the sealing ability of various calcium silicate-based root-filling materials with a glucose leakage model after orthograde obturation using an open apex model. MATERIALS AND METHODS: Thirty-two recently extracted human maxillary anterior teeth with single, straight root canals were selected and divided into four groups: Group 1 (G1), White Mineral Trioxide Aggregate; the material was delivered into the canal using the MAP system and further compacted with a specific plugger. Group 2 (G2), TotalFill bioceramic Root Repair material: the material was injected directly into the middle half of the root canal. Group 3 (G3), BioDentine; the material was delivered into the canal using the Hawe composite gun and prefitted pluggers. STATISTICAL ANALYSIS: Statistical analysis was performed using the SPSS 23.0 statistical software package. The Kruskal-Wallis nonparametric test was applied to compare the differences in glucose microleakage. RESULTS: There were no significant differences among the three experimental groups. The results showed a tendency for leakage to increase from the 1st day to the end of experimental period. CONCLUSIONS: Within the parameters of this in vitro study, it may be concluded that the three materials evaluated present similar apical microleakage when treating teeth with open apices requiring orthograde delivery of an apical barrier.

Evaluación de la lima Proglider para crear una vía de deslizamiento en conductos curvos usando tomografía computerizada de haz cónico / Evaluation of proglider file for creating a glide path in root canal preparation of curved canals by using cone-beam computed tomography

Objetivo: El objetivo de este estudio fue evaluar la eficacia y la rapidez de la lima rotatoria ProGlider (Dentsply Maillefer, Ballaigues, Suiza) para crear una vía de deslizamiento en el conducto radicular versus PathFile (Dentsply Maillefer, Ballaigues, Suiza) y Race ISO 10 (FKG Dentaire, Le Chaux-de-Fonds, Suiza) mediante el uso del CBCT. Material y método: Se seleccionaron sesenta conductos mesiales de molares mandibulares humanos extraídos con ángulos de curvatura entre 25-60º. Éstos fueron distribuidos aleatoriamente en tres grupos (n = 20) de acuerdo con el sistema de instrumentación del conducto: PathFile 13/02; 16/02; 19/02 (grupo PF); RaCe ISO 10 10/02; 10/04; 10/06 (grupo RI), y ProGlider 16/02 (grupo PG). Se utilizó CBCT antes y después de la instrumentación y el software AutoCAD para determinar el transporte apical y los cambios en el ángulo de curvatura. También se midió el tiempo de trabajo de cada sistema. Resultados: No se encontraron diferencias significativas en los cambios en el ángulo de curvatura (p = 0,076) ni en el transporte apical (p = 0,42) entre los tres grupos. ProGlider requirió significativamente menos tiempo de trabajo. Conclusiones: ProGlider creó la vía de deslizamiento y el mantenimiento de la anatomía del conducto original en menos tiempo en comparación con PathFile y RaCe ISO 10. Los tres sistemas fueron igualmente efectivos en el mantenimiento de la anatomía del conducto radicular

Objective: The aim of this study was to evaluate the efficacy of three the rotary path file sistems by comparing maintenance of the original canal shape (using Cone-Beam Computed Tomography) and evaluating the working time. Methods: Sixty mandibular molar mesial root canals with curvature angles of 25-60º were selected and randomly assigned to three groups (n=20): Pathfile #13/02- 16/02-19/02 (Dentsply Maillefer, Ballaigues, Switzerland) (PF group); RaCe ISO 10 #10/02-10/04-10/06 (FKG Dentaire, Le Chaux-de-Fonds, Switzerland). (RI group); ProGlider #16/02 (Dentsply Maillefer, Ballaigues, Switzerland) (PG group). CBCT and AutoCAD software were used to determine apical transportation and changes to the curvature angle. The working time of each system was also measured. Results: No statistically significant differences in canal curvature angle (p = 0,076) and apical transportation (p = 0,42) were found between the groups. Canals instrumented with ProGlider file required significantly less working time. Conclusions: The ProGlider file created the glide path maintaining the original canal anatomy in less time. The original anatomy of canals was maintained by all three rotary techniques

Frequency and characteristics of occupational dental trauma.

BACKGROUND: Dental trauma at the workplace may have important clinical and occupational consequences, but little is known about its profile. AIMS: To describe the frequency and characteristics of work-related dental injuries. METHODS: For all patients with occupational dental trauma seen at the FREMAP Hospital of Barcelona (Spain) between January 2000 and December 2006, we recorded their characteristics, type of work and nature of the trauma, including cause of the accident, extent of trauma, reason for referral to a dentist, and days of sick leave. RESULTS: The frequency of dental trauma was 1.71 per 1000 occupational accidents attended and was related to the worker's occupation. In security services, it was 7.37 per 1000 and 2.01 in transport services. The frequency was similar in both genders. The most common causal mechanisms were direct impact (38%), traffic accidents (29%) and falls at the same level (16%). Causal mechanisms differed according to gender and type of job. Most injuries consisted of dental fracture (54%), and 67% of the patients required referral to a dental surgery. Injuries were limited to the mouth in 52% of cases, 8% of which required sick leave, with a mean duration of 23.0±21.8 days. CONCLUSIONS: The frequency of dental trauma in this working population was low and was related to the worker's occupation. Causal mechanisms differed according to gender and type of job. Most dental injuries were severe and required referral to a dental surgery. Frequency of sick leave was low.

Surface roughness of finished composite resins.

This study evaluated the results of polishing composite resin by using the following finishing and polishing techniques: Arkansas stone burs; eight-blade tungsten-carbide burs; diamond burs; aluminum-oxide disks; no polishing; and 12- and 30-blade tungsten-carbide burs. The results were compared to ascertain which technique delivers the smoothest surface. The study was done with 120 class V restorations on extracted human teeth distributed in two groups (I and II) of 60 restorations each. Group I teeth samples were filled with microfilled composite resin and Group II with a hybrid composite resin. Readings were made with a profilometer to evaluate the final polishing. The conclusions from the results of the study were that microfilled composite resins provided a better finish when treated with aluminum-oxide disks. These results were statistically significant (p < 0.001). When hybrid composites were used the control group recorded the lowest values.

Antimicrobial activity of seven root canal sealers. Results of agar diffusion and agar dilution tests.

A comparative study of the antimicrobial action of seven root canal sealers: Traitement Spad, Endométhasone, N2 Universal, Diaket-A, AH26 with silver, Tubli Seal, and Sealapex was done with 120 strains of Staphylococcus aureus. Two antimicrobial susceptibility tests were used: the agar dilution test and the agar diffusion test. The Diaket-A and Traitement Spad sealer cements showed the highest efficiency in the dilution test, whereas Diaket-A was in fourth place in the diffusion test, only better than the antimicrobial activity of the Tubli Seal and Sealapex sealers.

[Behavior of different strains of Staphylococcus aureus against root canal filling cements]. / Estudio del comportamiento de diferentes cepas de Staphylococcus aureus frente a los cementos de obturación de conductos radiculares.

The mean goal of this study is the determination of the conduct of 120 strains of Staphylococcus aureus against seven root canal sealers: Traitement Spad, Endométhasone, N2 Universal, AH26 with silver, Diaket-A, Tubli Seal and Sealapex. The agar diffusion test was employed in the determination of its bacterial growth inhibition. The results obtained have demonstrated values very different between the tested strains. Therefore we recommended to employ strains with reference in the investigation of the bacterial growth inhibition in order to repeat equal experimentation conditions.