Evaluation of Effectiveness of Self-Adhesive Composites for Amalgam Repair with or Without Alloy Primer, in Terms of Shear Bond Strength / Evaluación de la efectividad de los compuestos autoadhesivos para la reparación de amalgamas con o sin imprimación de aleación, en términos de resistencia al cizallamiento

Abstract Purpose: The purpose of the present research was to evaluate the effectiveness of self-adhesive composites in amalgam repair as time-saving alternatives to universal bonding-universal composite materials, with or without the usage of Alloy Primer in terms of shear bond strength. Materials and Methods: Forty- two disc-shaped amalgam samples were prepared by condensing into 6×2 mm holes in acrylic resin blocks, sandblasted with 50 μm Al2O3 and randomly divided into 6 groups according to repair material [Constic (Group C), Fusio Liquid Dentin (Group FLD), Universal bonding+Universal composite (Group Control), Alloy Primer+Constic (Group APC), Alloy Primer+Fusio Liquid Dentin (Group APFLD), Alloy Primer+Universal bonding+Universal composite (Group APControl)]. After shear bond strength test, the fracture modes were determined under a digital microscope. Statistical analysis was performed using one-way analysis of variance and Tukey's post hoc test. Results: The highest shear bond strength values were obtained for Fusio Liquid Dentin, among the three repair materials when Alloy Primer was not applied (p<0.05). Usage of Alloy Primer increased shear bond strength values of the investigated repair materials to amalgam, except Fusio Liquid Dentin. Conclusion: Within the limitations of the present research, it can be concluded that; the investigated self-adhesive composite materials could be time-saving alternatives to the Universal bonding+Universal composite for the purpose of amalgam repair, in terms of shear bond strength. The clinicians could prefer Fusio Liquid Dentin self-adhesive composite material without Alloy Primer application for the purpose of amalgam repair in non-cooperative patients.

Resumen Propósito: El propósito de la presente investigación fue evaluar la efectividad de las resinas compuestas autoadhesivas en la reparación de amalgamas como alternativas que ahorran tiempo con respecto a las resinas compuestas universales de adhesión universal, con o sin el uso de Alloy Primer en términos de resistencia al cizallamiento. Materiales y métodos: Se prepararon 42 muestras de amalgama en forma de disco condensándolas en orificios de 6×2 mm en bloques de resina acrílica, arenadas con 50 μm de Al2O3 y divididas al azar en 6 grupos según el material de reparación [Constic (Grupo C), Fusio Liquid Dentin (Grupo FLD), Adhesivo universal+Resina universal (Grupo Control), Imprimación de aleación+Constic (Grupo APC), Imprimación de aleación+Fusio Liquid Dentin (Grupo APFLD), Imprimación de aleación+Adhesivo universal+Resina universal (Grupo APControl)]. Después de la prueba de resistencia al cizallamiento, los modos de fractura se determinaron bajo un microscopio digital. El análisis estadístico se realizó mediante análisis de varianza unidireccional y la prueba post hoc de Tukey. Resultados: Se obtuvieron los valores de resistencia al cizallamiento más altos para Fusio Liquid Dentin, entre los tres materiales de reparación cuando no se aplicó Alloy Primer (p<0.05). El uso de Alloy Primer aumentó los valores de resistencia al cizallamiento de los materiales de reparación investigados para la amalgama, excepto Fusio Liquid Dentin. Conclusión: Dentro de las limitaciones de la presente investigación, se puede concluir que; los materiales compuestos autoadhesivos investigados podrían ser alternativas que ahorran tiempo con respecto al adhesivo universal+resina universal con el fin de reparar las amalgamas, en términos de resistencia a la cizalladura. Los clínicos podrían preferir el material compuesto autoadhesivo Fusio Liquid Dentin sin la aplicación Alloy Primer con el fin de reparar amalgamas en pacientes poco cooperadores.

Fibroblast growth factor-23 but not sKlotho levels are related to diastolic dysfunction in type 1 diabetic patients with early diabetic nephropathy.

PURPOSE: To investigate the soluble Klotho (sKlotho) and fibroblast growth factor-23 (FGF-23) levels and echocardiographic findings in type 1 diabetic patients with no or early diabetic nephropathy. METHODS: A total of 147 subjects (mean age 34.1 ± 9.2 years, 55.8 % were females) including type 1 diabetic patients with glomerular filtration rate (GFR) >60 ml/min (n = 71, mean age 34.3 ± 9.5 years, 54.9 % were females) and healthy controls (n = 76, mean age 33.9 ± 9.1 years, 56.6 % were females) were included in this study. Data on demographic characteristics, blood biochemistry, urinalysis, diabetes-related complications and echocardiography were recorded. Serum levels for sKlotho and FGF-23 were determined by ELISA method. RESULTS: Patient and control groups were similar in terms of mean sKlotho (509.2 ± 183.5 and 547.6 ± 424.0 pg/ml, respectively) and FGF-23 (76.2 ± 15.6 and 77.2 ± 15.1 pg/ml, respectively) levels as well as echocardiographic findings. No significant correlation of sKlotho (pg/ml) and FGF-23 (pg/ml) levels with cardiac parameters was noted among diabetic patients. In subgroup analysis, the correlations between FGF-23 levels and isovolumic relaxation time (ms) and early diastolic velocity at medial/septal annulus (E'med) (m/s) were significant only in patients with early diabetic nephropathy (DN) but not in non-DN patients. No significant association of sKlotho levels with echocardiographic findings was noted. CONCLUSIONS: Our findings in young adult type 1 diabetic patients with GFR >60 ml/min versus healthy controls revealed no difference between groups in terms of sKlotho and FGF-23 levels and echocardiographic findings, while a significant correlation of FGF-23 (pg/ml) levels and diastolic dysfunction was noted only in patients with DN.

Determinants of hemoglobin variability in stable peritoneal dialysis patients.

PURPOSE: Significant within-patient hemoglobin (Hb) level variability is well recognized in particularly hemodialysis patients. Several factors such as hospitalizations, intercurrent diseases and IV iron therapy are found to be related to Hb variability (Hb-var). In this observational study, we aimed to identify predictors and outcome of Hb-var in peritoneal dialysis (PD) patients without hospitalization, intercurrent disease and IV iron therapy during the study period. METHODS: All patients were in the maintenance phase of short-acting erythropoiesis-stimulating agents (ESAs) therapy. The target range of Hb was 11-12 g/dL according to KDOQI Guidelines in 2007. The desired range of Hb was 11-12.5 g/dL. Patients' demographic and laboratory data were collected at baseline. Atherosclerotic disease was assessed using carotid intima-media thickness (CIMT). We assessed Hb variability with various methods using SD Hbmean, SD Hbrange and the velocity of Hb change. Hb deflectpositive, Hb deflectnegative, Hb values and ESA dosing were recorded monthly for 6 months. RESULTS: This study included 50 prevalent PD patients (mean age 46.9 ± 13.7 years, 25 women). The mean velocity of Hb change was negatively correlated with age and positively correlated with frequent ESA dose changes. Higher albumin and residual renal function (RRF) were also positively correlated with Hb deflectpositive. Patients with CIMT ≥0.7 cm had lower SD Hb range compared to CIMT <0.7 cm. Cumulative survival was better in patients with Hb levels consistently ≥10 g/dL compared to patients who had Hb <10 g/dL for at least 1 month. However, Hb-var was not associated with mortality. CONCLUSIONS: In PD patients without hospitalization, intercurrent disease(s) or IV iron therapy, young age, higher albumin or RRF and lower CIMT were associated with greater oscillations in response to ESA therapy. Careful and appropriate ESA dose changes considering these parameters could minimize Hb variability in these patients.

Massive hyperphosphatemia in a patient with neuronal intestinal dysplasia after bowel preparation with oral sodium phosphate.

Oral sodium phosphate-based laxatives are frequently used for bowel preparation or relief of constipation in some countries. However, these agents are not without risk. Small and clinical insignificant increments on serum phosphorus levels are observed in almost all individuals after use of oral sodium phosphate. Some patients are prone to severe hyperphosphatemia such as elders, those with chronic or acute renal disease and those with poor bowel motility. Severe hyperphosphatemia accompanied with hypocalcemia may be life-threatening in these patients. We present an 18-year-old woman with neuronal intestinal dysplasia who developed symptomatic and severe hyperphosphatemia after bowel preparation with oral sodium phosphate enema. Urgent hemodialysis was performed two times for severe hyperphosphatemia.

Multidisciplinary management of a fused tooth: a case report.

Objective. Fusion is a dental anomaly that arises through the union of two adjacent teeth. The case report presents multidisciplinary management of a fused maxillary anterior tooth. Case Report. A 10-year-old boy was referred to the pediatric dental clinic with the chief complaint of a large upper anterior tooth. Intraoral and radiographic examinations indicated fusion between the permanent maxillary right central incisor and a supernumerary tooth. According to the treatment plan, the fused tooth was sectioned, and the mesial portion was removed. The remaining tooth section was restored with composite resin, and the diastema between the central incisors was closed with orthodontic treatment. After an 18-month followup period, the tooth showed no sign of pathosis. Conclusion. The technique described here offers a simple and effective method for restoring a fused tooth that reestablishes function, shape, and esthetics.

Tissue and serum adiponectin levels in patients with gastric cancer: are there any correlations between adiponectin levels and histopathological variables?

BACKGROUND/AIMS: Adiponectin is secreted from adipose tissue and is characterized by hyperinsulinemia, which is related with obesity. Adiponectin levels are significantly lower in gastric cancer patients than in healthy controls. The aim of this study was to investigate the relationship between adiponectin levels in serum, tumor tissue and normal tissue with some other insulin resistance parameters. METHODOLOGY: A total of 35 patients with gastric cancer who had undergone curative gastrectomy by standard lymph node dissection were enrolled in this study. Their serum adiponectin levels, tumor tissue and normal breast tissue adiponectin levels were compared. RESULTS: The mean adiponectin levels of the tumor tissue, normal gastric tissue and serum were 48.6±2.9 (range, 39.7-50.6), 48.3±4.2 (range, 34.4-50.69) and 49.4±0.83 (range, 48.2-50.2), respectively. There was no relationship between the adiponectin levels in serum, normal tissue and tumor tissue (p=0.08). There was an inverse relationship between normal tissue adiponectin levels and insulin levels (p=0.002, r=-0.5), but this association was not detected with adiponectin levels in tumor and serum (p>0.05). CONCLUSIONS: Relationships between adiponectin levels in serum, normal tissue and tumor tissue for gastric cancer patients were not found. The small sample size in this study may have influenced the results. However, we believe that our results constitute a first in evaluating the tissue adiponectin levels in gastric cancer tissue.