Cuspal flexure, depth-of-cure, and bond integrity of bulk-fill composites.

PURPOSE: Evaluate cuspal flexure caused by polymerization shrinkage stress, bond integrity, and depth-of-cure of bulk-fill composites. METHODS: Twenty-eight extracted permanent molars were mounted in stainless steel rings. Slot-shaped Class II mesio-occlusal-distal preparations (four mm deep) were restored with Filtek Supreme Ultra (control; two two-mm increments) and bulk-fill composites (Tetric EvoCeram, Venus, Filtek Bulk Fill). The teeth were digitized using a 3D scanner before and after restoration. Before- and after-restoration scans were aligned, and cuspal flexure was calculated. Bond integrity along occlusal interfaces was assessed by dye penetration and measured after overnight immersion in basic fuchsin dye and cross-sectioning. Depth-of-cure was determined on the cross-sections using Vickers hardness. Statistical analysis was performed with one-way analysis of variance. RESULTS: All composites caused inward cuspal flexure (10.4 to 13.6 µm). No statistical difference in flexure was found among the composites (P=.07). No significant difference in microhardness at any restoration depths was found for any composite (.35

Low social support is associated with an increased risk of postoperative delirium.

STUDY OBJECTIVE: To examine the predictive value of social support in postoperative delirium. DESIGN: Prospective observational study. SETTING: Postoperative recovery room and orthopedic surgery department. PATIENTS: 106 consecutive patients undergoing a planned orthopedic surgery with general anesthesia. MEASUREMENTS: All patients completed questionnaires to assess depressive mood (the Beck Depression Inventory) and social support (Sarason's Social Support Questionnaire) during the preanesthesia visit. Postoperative delirium symptoms were assessed daily using the Memorial Delirium Assessment Scale. Demographic, clinical, and biological data, including anesthesia procedure, were recorded. MAIN RESULTS: Controlling for various potential confounders through multivariate binary logistic regression, postoperative delirium was independently predicted by satisfaction with social support, but neither by depressive mood nor the number of supportive persons. Other significant predictors were the preoperative use of benzodiazepines, age, and type of surgery. CONCLUSION: Patients who report low satisfaction with social support may present with a particular vulnerability to postoperative delirium, even after controlling for physical confounding variables and depressive mood.