Evaluation of the pH, calcium ion release, and antibacterial effect of a premixed bioceramic endodontic sealer.

This study sought to compare a bioceramic sealer (TotalFill) and a calcium hydroxide (Ca[OH]2) sealer (Sealapex) in terms of their pH, calcium ion (Ca²âº) release, and antibacterial effect against Enterococcus faecalis bacteria. For the pH and Ca²âº release tests, 20 polyethylene tubes (10 mm in height and 1 mm in internal diameter) were filled with the appropriate sealer (n = 10 per sealer), immersed in glass flasks each containing 10 mL of deionized water, and stored in an incubator at 37°C. The water was changed after 1, 7, 28, and 90 days. At each water change, the eluates were measured with an advanced electrochemistry meter to determine the pH and with a flame atomic absorption spectrometer to determine the Ca²âº release. The antibacterial effect was measured using the turbidimetry-based direct contact test in which the wells of a microtiter plate were coated with a thin, even layer of freshly prepared sealer (10 wells per sealer), which was allowed to set before application of a suspension of E faecalis. Control wells were obtained by placing an identical bacterial suspension in 10 uncoated wells. The optical density of the sealer and control groups was measured immediately and 1, 3, and 7 days after sealer preparation. Data were analyzed for normality with the Shapiro-Wilk and Kolmogorov-Smirnov tests. Two-way analysis of variance (ANOVA), Student t test, and 1-way ANOVA with Tukey post hoc tests were all utilized with a significance level of P < 0.05. TotalFill maintained significantly higher pH and Ca²âº release levels than Sealapex at all evaluation times (P < 0.05). Both sealers demonstrated significantly greater antibacterial effect (lower optical density) than the control group; however, TotalFill resulted in significantly lower optical density values than Sealapex (P < 0.05). TotalFill bioceramic sealer demonstrated superior Ca(OH)2-related properties compared to Sealapex Ca(OH)2 sealer.

Once Daily Versus Twice Daily External Beam Accelerated Partial Breast Irradiation: A Randomized Prospective Study.

PURPOSE: The aim of the current study was to compare toxicity, cosmesis, and local control between the once daily and the twice daily fractionation schemes for external beam accelerated partial breast irradiation. METHODS AND MATERIALS: From December 2012 to June 2018, we enrolled 113 patients with ductal carcinoma in situ or invasive breast cancer, node negative disease, and tumors less than 3 cm in size to receive accelerated partial breast irradiation (APBI) to a total dose of 38.5 Gy over 10 fractions given either once (oAPBI) or twice daily (tAPBI). Sixty patients were included in the tAPBI arm and 53 patients were included in the oAPBI arm. RESULTS: Median follow-up was 74 months (range, 24-105). The median pain score during treatment was 3 out of 10 in the oAPBI and 5 in the tAPBI (P = .001). No differences were observed in GIII early skin toxicity (P = .4) or GI early pulmonary toxicity (P = 1.0) between the 2 treatment arms. GIII late skin toxicity developed in 3.8% and 11.7% of patients in the oAPBI and tAPBI arms, respectively (P = .001). GIII subcutaneous fibrosis developed in 1.9% and 8.3% of patients in the oAPBI and tAPBI, respectively (P = .001). The rate of patients with adverse cosmesis (poor/fair) was 7.5% at 12 months and at 24 months in the oAPBI arm compared with 21.7% and 26.7% in the tAPBI arm (P = .03 and .008, respectively). CONCLUSIONS: oAPBI is a safe, well-tolerated schedule with more favorable outcomes than the tAPBI schedule with regards to late toxicity and cosmesis.