The effect of different surface preparation methods and various aging periods on microtensile bond strength for composite resin repair.

AIMS: To evaluate the effect of various aging periods and different surface preparation methods on microtensile bond strength (µTBS) for composite repair. MATERIALS AND METHODS: One hundred twelve composite resin blocks were formed using a nanohybrid composite resin. The samples were distributed into four groups according to surface preparation methods (n = 28): control (sound composite blocks); Er, Cr: YSGG laser; air abrasion; silicone carbide. All samples were then divided into four subgroups according to various aging periods: (i) No aging, (ii) 10,000 thermocycling, (iii) 30,000 thermocycling, and (iv) 50,000 thermocycling. Following surface preparation and aging procedures, surface topography of one sample from each group was evaluated under scanning electron microscope (SEM). The repair composites were bonded to the sample surfaces, using a three-step etch&rinse adhesive. Finally, thirty beams of size 1 × 1 × 8 mm from each group were subjected to µTBS test and failure modes were determined. The data were analyzed using two-way ANOVA, Post-hoc Bonferroni, and Chi-square tests (P = 0.05). RESULTS: When different surface preparation methods were evaluated together, no aging and 10,000 thermocycling groups displayed higher µTBS values (P < 0.05). When all aging periods were evaluated together, the surface preparation with air abrasion provided higher µTBS (P < 0.05). The interactions of various aging periods with different surface preparation methods revealed significant variations in repair µTBS (P < 0.05). There were statistically significant differences on failure mode distributions among surface preparation methods (P < 0.001). SEM evaluations provided valuable outcomes that help to comment on the µTBS findings. CONCLUSIONS: Different surface preparation methods, various aging periods, and the interaction of both affected the repair µTBS of the tested nanohybrid composite resin.

Comparison of two different composite resins used for tooth reshaping and diastema closure in a 4-year follow-up.

AIMS: This aim of this study is to evaluate and to compare the clinical performances of two nanohybrid composite resin systems used for diastema closure and tooth reshaping at 4 years. SUBJECTS AND METHODS: Twenty-three patients with midline or multidiastema problem were enrolled in this study. Nanohybrid resin composite systems to be used on each patient were randomly selected. Thirty seven teeth of 10 patients were restored with Filtek-Z550 (3M/ESPE) in combination with Adper™ Single Bond 2 (3M/ESPE) etch and rinse adhesive in Group 1 whereas 39 teeth of 13 patients were restored with Charisma-Diamond (Heraeus Kulzer) in combination with Gluma2 Bond (Heraeus Kulzer) etch and rinse adhesive in Group 2, by two operators. Esthetic, functional, and biological properties of the restorations were evaluated at baseline, 1, 2, 3, and 4 years using foreign direct investment criteria by two independent examiners. STATISTICAL ANALYSIS USED: The data were evaluated using Fisher's Chi-Square (P = 0.05). RESULTS: Fifty-eight restorations (19 patients) with a mean service time of 43.4 months were evaluated (recall rate 82.6%). One Filtek-Z550 and two Charisma-Diamond restorations were repaired due to partial fracture (Score 4). Survival rates of Group 1 and Group 2 were 96.3% and 93.5%, respectively (Kaplan-Meier) (P > 0.05). Qualitative deteriorations were observed within each group according to baseline regarding surface luster, surface/marginal staining, marginal adaptation, patient's view, and periodontal response (P < 0.05). However, there were no significant differences between two restorative materials for any of the criteria assessed (P > 0.05). CONCLUSIONS: Both nanohybrid composite resin systems revealed esthetically, functionally, and biologically acceptable clinical performance when used for diastema closure and tooth reshaping at 4 years.

Clinical Follow-up of a Fissure Sealant Placed Using Different Adhesive Protocols: A 24-month Split-mouth Study.

The purpose of this study was to evaluate the retention rates of a fissure sealant placed using different adhesive protocols over 24 months. Twenty-four subjects with no restorations or caries received fissure sealants (Clinpro Sealant, 3M ESPE) placed using different adhesive protocols. A total of 292 sealants were placed as follows by two previously calibrated dentists using a table of random numbers (n=73): group I, acid-etch/without adhesive; group II, with a self-etch adhesive (Adper Easy Bond, 3M ESPE); group III, with an etch-and-rinse adhesive (Adper Single Bond 2, 3M ESPE); group IV, with acid + self-etch adhesive (Adper Easy Bond). Two other calibrated examiners independently evaluated the sealants at baseline and at six-, 12-, 18-, and 24-month recalls. Each sealant was evaluated in terms of caries formation being present or absent and retention using the following criteria: 1 = total retention, 2 = partial loss, and 3 = total loss. Pearson's χ2 test was used to evaluate differences in retention rates among the sealants for each evaluation period. At the end of 24 months, total retention rates were 57.5%, 27.4%, 84.9%, and 76.7% in the acid-etch, self-etch adhesive, etch-and-rinse adhesive, and acid + self-etch adhesive groups, respectively. Although there were no statistically significant differences between the retention rates among the adhesive protocols at 6 months ( p=0.684), significant differences were observed at the 12-, 18-, and 24-month evaluations. At 24 months, the lowest retention rates were observed in the self-etch group ( p<0.05). No caries development was observed in any of the groups. The retention rate of sealants placed using self-etch adhesive was poor compared with the other groups.

Thirty-Six-Month Clinical Comparison of Bulk Fill and Nanofill Composite Restorations.

OBJECTIVES: The aim of this study was to evaluate the clinical performance of a nanofill and a bulk fill resin composite in class II restorations. METHODS AND MATERIALS: In accordance with a split-mouth design, 50 patients received at least one pair of restorations, restored with a nanofill resin composite (Filtek Ultimate [FU]) and with a bulk fill resin composite (Tetric EvoCeram Bulk Fill [TB]). Each restorative resin was used with its respective adhesive system according to the manufacturers' instructions. A total of 104 class II restorations were placed by two operators. The restorations were blindly evaluated by two examiners at baseline and at six, 12, 18, 24, and 36 months using modified US Public Health Service Ryge criteria. The comparison of the two restorative materials for each category was performed with the chi-square test (α=0.05). The baseline scores were compared with those at the recall visits using the Cochran Q-test. RESULTS: At six, 12, 18, and 24 months, the recall rate was 100%, 98%, 94%, and 82%, respectively, with a retention rate of 100%. At 36 months, 81 restorations were evaluated in 39 patients with a recall rate of 78%. For marginal adaptation, four restorations from the TB group and 10 from the FU group rated as Bravo. Two restorations from the TB and eight restorations from the FU group showed marginal discoloration. There were statistically significant differences between the two restorative resins in terms of marginal adaptation and marginal discoloration (p<0.05). No differences were observed between the restorative resins in terms of retention (p>0.05). One restored tooth from the FU group was crowned. The retention rates for the TB and the FU groups were 100%. In the FU group, two restorations showed slightly rough surfaces, and two showed a slight mismatch in color. None of the restorations showed postoperative sensitivity, secondary caries, or loss of anatomic form. CONCLUSIONS: The tested bulk fill restorative resin demonstrated better clinical performance in terms of marginal discoloration and marginal adaptation.

The effect of single-task and dual-task balance exercise programs on balance performance in adults with osteoporosis: a randomized controlled preliminary trial.

Osteoporosis is a serious disease characterized by muscle weakness in the lower extremities, shortened length of trunk, and increased dorsal kyphosis leading to poor balance performance. Although balance impairment increases in adults with osteoporosis, falls and fall-related injuries have been shown to occur mainly during the dual-task performance. Several studies have shown that dual-task performance was improved with specific repetitive dual-task exercises. INTRODUCTION: The aims of this study were to compare the effect of single- and dual-task balance exercise programs on static balance, dynamic balance, and activity-specific balance confidence in adults with osteoporosis and to assess the effectiveness of dual-task balance training on gait speed under dual-task conditions. METHODS: Older adults (N = 42) (age range, 45-88 years) with osteoporosis were randomly assigned into two groups. Single-task balance training group was given single-task balance exercises for 4 weeks, whereas dual-task balance training group received dual-task balance exercises. Participants received 45-min individualized training session, three times a week. Static balance was evaluated by one-leg stance (OLS) and a kinesthetic ability trainer (KAT) device. Dynamic balance was measured by the Berg Balance Scale (BBS), Time Up and Go (TUG) test, and gait speed. Self-confidence was assessed with the Activities-specific Balance Confidence (ABC-6) scale. Assessments were performed at baseline and after the 4-week program. RESULTS: At the end of the treatment periods, KAT score, BBS score, time in OLS and TUG, gait speeds under single- and dual-task conditions, and ABC-6 scale scores improved significantly in all patients (p < 0.05). However, BBS and gait speeds under single- and dual-task conditions showed significantly greater improvement in the dual-task balance training group than in the single-task balance training group (p < 0.05). ABC-6 scale scores improved more in the single-task balance training group than in the dual-task balance training group (p < 0.05). CONCLUSIONS: A 4-week single- and dual-task balance exercise programs are effective in improving static balance, dynamic balance, and balance confidence during daily activities in older adults with osteoporosis. However, single- and dual-task gait speeds showed greater improvement following the application of a specific type of dual-task exercise programs. CLINICAL TRIAL REGISTRATION NUMBER: 24102014-2.

Four-year randomized clinical trial to evaluate the clinical performance of a glass ionomer restorative system.

OBJECTIVE: The aim of this study was to evaluate the clinical performance of a glass ionomer restorative system compared with a microfilled hybrid posterior composite in a four-year randomized clinical trial. METHODS: A total of 140 (80 Class 1 and 60 Class 2) lesions in 59 patients were either restored with a glass ionomer restorative system (Equia, GC, Tokyo, Japan), which was a combination of a packable glass ionomer (Equia Fil, GC) and a self-adhesive nanofilled coating (Equia Coat, GC), or with a microfilled hybrid composite (Gradia Direct Posterior, GC) in combination with a self-etch adhesive (G-Bond, GC) by two experienced operators according to the manufacturer's instructions. Two independent examiners evaluated the restorations at baseline and at one, two, three, and four years postrestoration according to the modified US Public Health Service criteria. Polyvinyl siloxane impression negative replicas at each recall were observed under scanning electron microscopy (SEM) to evaluate surface characteristics. The statistical analyses were carried out with McNemar, Pearson Chi-square, and Cochran Q-tests (p<0.05). RESULTS: After four years, 126 (76 Class 1 and 50 Class 2) restorations were evaluated in 52 patients, with a recall rate of 88.1%. None of the restorations showed trends to downgrade in anatomical form, secondary caries, surface texture, postoperative sensitivity, and color match (p>0.05). Significant differences in marginal adaptation and discoloration were found at four years compared to baseline for both restorative materials for Class 1 and Class 2 restorations (p<0.05). Only one Class 2 Equia restoration was missing at three years (3.9%), and another one was missing at four years (7.7%) (p>0.05). SEM evaluations were in accordance with the clinical findings. CONCLUSIONS: The use of both materials for the restoration of posterior teeth exhibited a similar and clinically successful performance after four years.

Effects of gibberellic acid on hemocytes of Galleria mellonella L. (Lepidoptera: Pyralidae).

The impacts of different doses of the plant growth regulator gibberellic acid (GA(3)) in diet on the number of total and differential hemocytes, frequency of apoptotic, and necrotic hemocytes, mitotic indices, encapsulation, and melanization responses were investigated using the greater wax moth Galleria mellonella L. (Lepidoptera: Pyralidae) larvae. Total hemocyte counts increased in G. mellonella larvae at all treatment doses whereas GA(3) application had no effect on the number of different hemocyte types. The occurrence of apoptosis, necrosis and mitotic indices in GA(3) treated and untreated last instars were detected by acridine orange or ethidium bromide double staining by fluorescence microscopy. While the ratio of necrotic hemocytes increased at all GA(3) treatments, that of late apoptotic cells was only higher at doses >200 ppm when compared with untreated larvae. The percentage of mitotic index also increased at 5,000 ppm. Positively charged DEAE Sephadex A-25 beads were used for analysis of the levels of encapsulation and melanization in GA(3) treated G. mellonella larvae. At four and 24 h posttreatments with Sephadex A-25 bead injection, insects were dissected under a stereomicroscope. Encapsulation rates of larval hemocytes were dependent on the extent of encapsulation and time but not treatment groups. While the extent of melanization of hemocytes showed differences related to time, in general, a decrease was observed at all doses of GA(3) treated larvae at 24 h. We suggest that GA(3) treatment negatively affects hemocyte physiology and cell immune responses inducing cells to die by necrosis and apoptosis in G. mellonella larvae.

Surgical repair of a post-traumatic arteriovenous fistula complicated by stent-graft misplacement.

An arteriovenous fistula (AVF) is an abnormal connection between an artery and a vein which may result from a traumatic injury or occur as a congenital abnormality. It may be asymptomatic or may present with a variety of symptoms. Surgical or endovascular treatment can be preferred. We present a case of unsuccessful percutaneous treatment of a femoral AVF due to misplacement of the stent-grafts, necessitating surgical correction.

Crural ligation surgery for the young male with venogenic erectile dysfunction: technique.

Isolated crural venous leak is an uncommon cause of erectile dysfunction. Recent data have suggested that ligation of the crura in men with this condition may result in significant improvement in erectile function. This report outlines the criteria for patient selection and the technique we use to accomplish crural ligation.

Infertility treatment in autosomal dominant polycystic kidney disease (ADPKD)--a case report.

Autosomal dominant polycystic kidney disease (ADPKD) is a frequently occurring inherited condition with cysts in many organs including the kidneys. However, a combination of seminal vesicle cysts, cystic obstruction of ejaculatory duct and ADPKD is rarely encountered. The following case report presents an infertile ADPKD patient who had seminal vesicle cysts and ejaculatory duct cyst, and describes the treatment by transurethral resection of the ejaculatory duct.

Effects of metals on elastase from Pseudomonas aeruginosa SES-938-1.

Among the numerous virulance factors produced by Pseudomonas aeruginosa, elastase is the one most often associated with pathogenesis. In this study, effects of various metal ions on elastase from a new isolate of P. aeruginosa (Strain SES-938-1) was investigated. Crude elastase was prepared from culture supernatant via salting out by ammonium sulfate, and then desalting and concentrating the sample using a centricon microconcentrator. Activities were measured at 450 nm using N-succinyl-L-(ala)3-p-nitroanilide as the substrate. The metal chelating agents EDTA and EGTA inhibited the Pseudomonas elastase, which shows that the enzyme is a typical metalloproteinase. At a 10-mM concentration, Mn2+, Ni2+, and Zn2+ strongly inhibited the elastase, whereas Mg2+ effect was negligable. There was a gradual decrease in the enzyme activity in accordance with an increase in the concentration of metal ions.