Effect of Dentin Contamination with Hemostatic Agents and Cleaning Techniques on Bonding with Self-Adhesive Resin Cement.

BACKGROUND Dentin contamination with hemostatic agents before bonding indirect restorations negatively affects the bond strength. However, the consensus on which materials could be used to clean contamination of hemostatic agents has not been explored. The aim of this study was to assess the effect of Katana Cleaner applied on the surface of dentin contaminated with hemostatic agents on the shear bond strength (SBS) of self-adhesive resin cement by comparing it with three other surface cleaners. MATERIAL AND METHODS Ninety dentin specimens were divided into a no contamination group (control) (n=10), 4 groups contaminated with 25% aluminum chloride (Viscostat Clear) (n=40), and 4 groups contaminated with 20% ferric sulfate (Viscostat) (n=40). Subsequently, 4 different cleaners were used for each contamination group (water rinse, phosphoric acid, chlorhexidine, and Katana Cleaner). Then, self-adhesive resin cement was directly bonded to the treated surfaces. All specimens were subjected to 5000 thermal cycles of artificial aging. The shear bond strength was measured using a universal testing machine. RESULTS Two-way analysis of variance showed that the contaminant type as the main factor was statistically non-significant (p=0.655), cleaner type as the main factor was highly significant (p<0.001), and interaction between the contaminant and cleaner was non-significant (p=0.51). The cleaner type was the main factor influencing the bond strength. Phosphoric acid and chlorhexidine showed better performance than Katana Cleaner. CONCLUSIONS Cleaning dentin surface contamination with phosphoric acid and chlorhexidine had better performance than with Katana Cleaner.

Flexural strength, flexural modulus and microhardness of milled vs. fused deposition modeling printed Zirconia; effect of conventional vs. speed sintering.

BACKGROUND: Various methods can be used for creating zirconia dental restorations, including 3-dimensional (3D) printing and computer-aided design/ computer-aided manufacturing (CAD/CAM) milling. The fused deposition modeling (FDM) printing method for zirconia presents numerous advantages, albeit research on the mechanical properties of these materials and resultant restorations remains scarce. Such developments are undeniably intriguing and warrant further investigation. The objective of the present study was to evaluate the impact of the sintering firing cycle (Conventional vs. Speed sintering) on the flexural strength, flexural modulus, and Vickers Microhardness of milled vs. FDM printed zirconia. METHODS: A total of 60 bars (2 × 5 × 27 mm) were fabricated for flexural strength testing, along with 40 discs (12 × 1.5 mm) for Vickers microhardness testing. Half of the specimens underwent conventional sintering, while the other half underwent a speed sintering cycle. The flexural strength and modulus were determined by a three-point bending test in a universal testing machine. The microhardness of the specimens was evaluated using a Vickers microhardness tester. Statistical analysis was performed using a two-way ANOVA test with a post-hoc Tukey test (p < 0.05). RESULTS: CAD/CAM milled zirconia had significantly higher flexural strength and modulus than FDM-printed zirconia. The sintering process did not significantly affect the flexural strength or modulus of milled or FDM-printed zirconia. The milled speed sintering group had significantly higher values in the Vickers microhardness test compared to the other groups. CONCLUSIONS: The mechanical properties of FDM-printed zirconia specimens were not found to be comparable to those of milled zirconia. Speed sintering cycle may produce milled zirconia restorations with similar flexural strength and modulus to conventional sintering, and even higher Vickers Microhardness values.

Influence of inorganic nanoparticles on dental materials' mechanical properties. A narrative review.

Inorganic nanoparticles have been widely incorporated in conventional dental materials to help in improving their properties. The literature has shown that incorporating nanoparticles in dental materials in different specialties could have a positive effect on reinforcing the mechanical properties of those materials; however, there was no consensus on the effectiveness of using nanoparticles in enhancing the mechanical properties of dental materials, due to the variety of the properties of nanoparticles itself and their effect on the mechanical properties. This article attempted to analytically review all the studies that assessed the effect of different types of inorganic nanoparticles on the most commonly used dental materials in dental specialties such as polymethyl methacrylate, glass ionomer cement, resin composite, resin adhesive, orthodontic adhesive, and endodontic sealer. The results had shown that those inorganic nanoparticles demonstrated positive potential in improving those mechanical properties in most of the dental materials studied. That potential was attributed to the ultra-small sizes and unique physical and chemical qualities that those inorganic nanoparticles possess, together with the significant surface area to volume ratio. It was concluded from this comprehensive analysis that while a definitive recommendation cannot be provided due to the variety of nanoparticle types, shapes, and incorporated dental material, the consensus suggests using nanoparticles in low concentrations less than 1% by weight along with a silane coupling agent to minimize agglomeration issues and benefit from their properties.

Color behavior of composite resin enhanced with different shapes of new antimicrobial polymer coated nanoparticles.

BACKGROUND: Zein-coated magnesium oxide nanoparticles (zMgO NPs) demonstrate a potent antimicrobial effect, endorsing it as a compelling additive to dental materials formulations for oral health care advances. However, currently there is no data on the imprint of zMgO NPs on the color permanence of dental composites. The objective of this study is to evaluate the color stability of different types of composite enhanced with antimicrobial zein-coated magnesium oxide nanoparticles (zMgO NPs) of different shapes before and after thermocycling. METHODS: Two hundred composite samples were divided into four groups: Gp1: Tetric N-Flow with zMgO nanowires, Gp2: Tetric N-Flow with zMgO nanospheres, Gp3: Tetric N-Ceram with zMgO nanowires; Gp4: Tetric N-Ceram with zMgO nanospheres. Each group was subdivided into 5 subgroups (n = 10) with concentrations of zMgO NPs 0%, 0.3%, 0.5%, 1% and 2%. The characterization of the modified composite containing the zMgO was done via X-ray Diffraction, Field Emission Scanning Electron Microscopy (FESEM), and Fourier Transform Infrared Spectroscopy (FTIR). Colorimetric evaluation was performed through spectrophotometry with a white background. Samples underwent color assessment using a spectrophotometer, followed by thermocycling, and then another color assessment. RESULTS: FESEM analysis showed a uniform distribution of the zMgO nanoparticles in the composite and FTIR illustrated no change in the spectra. However, the XRD spectra exhibited an amorphous pattern in the composite enhanced with zMgO NPs. There was no compelling discrepancy in color variation ΔE among the different groups before and after thermocycling (p > 0.05). A statistically notable variation in ΔL was found amid the control and N-Flow and N-Ceram with 2% zMgO nanospheres before and after thermocycling respectively (p < 0.05). While after thermocycling, there was a statistically significant difference in Δa in N-Flow and N-Ceram wires amid the control and the different groups (p < 0.05). Additionally, after thermocycling there was a statistically significant difference in Δb in N-Flow and N-Ceram wires between the control and the different groups (p < 0.05). The Tukey test exhibited no variation among the groups with different zMgO concentrations (p > 0.05). CONCLUSION: Enhancing N-Flow and N-Ceram composite with antimicrobial zMgO nanowires and nanospheres did not alter the total color stability of the materials before and after thermocycling.

Cytotoxic effects of dose dependent inorganic magnesium oxide nanoparticles on the reproductive organs of rats.

INTRODUCTION: Magnesium oxide nanoparticles (MgO NPs) have a variety of applications that have contributed to their elevated popularity, however, the safety and toxic effects on humans are also of concern with these increased applications. There is insufficient data regarding the effect of MgO NPs on reproductive organs, which are crucial aspects to the body's vital physiological functions. The present study was undertaken in male and female rats to assess the reproductive toxicological potential of two doses (low versus high) of MgO NPs on testicular and ovarian tissues. The toxicity was evaluated using histological, hormonal, and oxidative parameters. MATERIAL AND METHODS: In this work, magnesium oxide nanoparticles (MgO NPs) were synthesized by the sol-gel route and were characterized by X ray diffraction analysis (XRD) and Fourier transform infra-red spectroscopy (FTIR). Forty-eight adult Wister albino rats were used in this experiment which were divided into groups of male and female, and then further into control, low dose MgO NPs, and high dose MgO NPs. The low dose used was 131.5 mg/kg b.w. (1/10 LD50) while the high dose used was 263 mg/kg b.w. (1/5 LD50). All doses were given orally by gastric tube. After 4 weeks, blood samples were collected to investigate the level of sex hormones and both ovarian and testicular tissues were examined for variable oxidative parameters and histopathological changes by light microscopy. RESULTS: The obtained findings showed that high dose of MgO NPs produced considerable changes in sex hormones and stress parameters in both male and female rats in comparison to the low dose and control groups. Histomorphometric analysis demonstrated the presence of histopathological alterations in the testicular and ovarian tissues. CONCLUSION: The results of this study showed dose-dependent adverse effects of MgO NPs on the testis and ovary both functionally and histopathologically as compared to the control rats.

Leiomyoma as a rare cause of small bowel obstruction: A case report.

INTRODUCTION AND IMPORTANCE: Small bowel obstruction (SBO) is common in daily practice in emergency department. It has many causes such as adhesions or hernias. Other causes are obstruction by a bulky mass such as tumors of the intestine. CASE PRESENTATION: We present a rare case of small bowel obstruction in a 48 years old male patient with Crohn's disease. Laparotomy showed a mass that caused the obstruction. Pathology report demonstrated that it is leiomyoma. This finding may cause a delay in making the diagnosis of SBO. CLINICAL DISCUSSION: Small bowel obstruction is considered an emergency case in the emergency. It needs special attention and advanced medical practice to reach the diagnosis. Rare cases may lead to delay the diagnosis because they present unusually. CONCLUSION: Physicians should consider leiomyoma as a cause of SBO with patients without clear cause of SBO.

Mechanical Properties of Three-Dimensional Printed Provisional Resin Materials for Crown and Fixed Dental Prosthesis: A Systematic Review.

The emergence of digital dentistry has led to the introduction of various three-dimensional (3D) printing materials in the market, specifically for provisional fixed restoration. This study aimed to undertake a systematic review of the published literature on the Mechanical Properties of 3D- Printed Provisional Resin Materials for crown and fixed dental prosthesis (FDP). The electronic database on PubMed/Medline was searched for relevant studies. The search retrieved articles that were published from January 2011 to March 2023. The established focus question was: "Do provisional 3D-printed materials have better mechanical properties than conventional or milled provisional materials?". The systematically extracted data included the researcher's name(s), publication year, evaluation method, number of samples, types of materials, and study outcome. A total of 19 studies were included in this systematic review. These studies examined different aspects of the mechanical properties of 3D-printed provisional materials. Flexural Strength and Microhardness were the frequently used mechanical testing. Furthermore, 3D-printed provisional restorations showed higher hardness, smoother surfaces, less wear volume loss, and higher wear resistance compared to either milled or conventional, or both. 3D-printed provisional resin materials appear to be a promising option for fabricating provisional crowns and FDPs.

Perirenal abscess as a cause of intrauterine fetal death: A case report.

Urinary tract infection is one of the most common causes of hospital admission during pregnancy. We present a 27 years old woman who was at 28 weeks of pregnancy and she urinary tract infection developed to acute pyelonephritis. This condition developed to form perirenal abscess and intrauterine fetus death. Computed tomography scan showed right perirenal abscess. Ultrasonography is the imaging modality of choice during pregnancy because of its lack of ionizing radiation. Our patient developed perirenal abscess as a complication of untreated acute pyelonephritis. Pyelonephritis during pregnancy is considered a serious condition and should be treated promptly.

Acute tubular necrosis after transurethral resection of the prostate: a case report.

Transurethral resection of the prostate (TURP) is currently the gold standard for the surgical treatment of benign prostatic hyperplasia. This surgery may lead to TURP syndrome and in some cases, acute tubular necrosis can develop. Case Presentation: We had a 67-year-old male patient who had benign prostate hyperplasia unresponsive to tamsulosin. He underwent TURP surgery. After that, he had acute tubular necrosis because of hemolysis. We performed hemodialysis to decrease serum creatinine level. Discussion: Acute tubular necrosis is the result of hemolysis. Rapid absorption of large volumes of glycerin may lead to hypotension and acute kidney injury. Conclusion: Using distilled water for irrigation during TURP may lead to severe complications like hypotension and acute tubular necrosis.

A rare cause of urinary retention in A child: A case report.

A Ten-year-old child presented to our emergency department with acute urinary retention. Three months ago, he was diagnosed with right renal hydronephrosis with renal calculus. Firstly, right nephrostomy was inserted. Next, he had been treated with ESWL for right renal stone in another center. After unsuccessful attempts for urethral catheterization, he was brought to the operating room for meatotomy and calculus extraction. An impacted urethral stone was detected at this point. He had a successful extraction of the stone. A six-month follow-up period has passed with no recurrence. This shows that although they are uncommon, urethral stones do happen.

Upward migration of a double J ureteral stent in a boy: A rare case report.

Introduction: Inserting double j ureteral stents is considered a common practice in the urology field. With the wide range of use, many complications were reported. Case presentation: We are presenting a rare case of five years old boy that had a right renal stone with moderate hydronephrosis. Inserting a double j stent was the first procedure to relieve the obstruction. Metabolic studies were negative. Twelve days later, the double j stent migrated upward. As a result, we performed an open surgery to remove the stone and the double j. During surgery, we inserted a new double j stent that was removed six weeks later. Follow-up showed no complaints. Discussion: Upward migration of a double j ureteral stent in a child is considered a rare entity. We performed open surgery to remove the ureteral stent and the stone. Such complication in a child has not been reported widely. Conclusion: We aim to report an upward migration double j ureteral stent in a boy and how we dealt with it.

The Effect of Repeated Pressing on the Flexural Strength, Color Stability, Vickers Hardness, and Surface Topography of Heat-Pressed Lithium Disilicate.

The aim of this study was to investigate the effect of repressing leftover heat-pressed lithium disilicate material on its mechanical and optical properties. A lithium disilicate ingot (IPS e.max® Press, IvoclarVivadent, Schaan, Liechtenstein) shade (A1) low translucency was first heat-pressed to yield ceramic bars and disks. Then, the second and third presses were fabricated from the leftovers of the previous pressing cycles. A total of 36 bars and 15 disk specimens were fabricated and divided into three groups according to the number of pressing cycles (n = 12 bars and n = 5 disks): P1: first press (control), P2: second press, and P3: third press. The specimens were tested for flexural strength, color change, Vickers hardness, and surface topography under scanning electron microscopy. One-way ANOVA testing was used to evaluate flexural strength and hardness, while an independent t-test was performed to evaluate color change. There was no significant difference in flexural strength as the number of heat-pressed cycles increased (p = 0.283). Similarly, there was no significant difference in the microhardness values between all groups (p = 0.220). The overall color change ∆E between P1-P2 and P1-P3 were 2.01 and 2.14, respectively. The SEM images showed evenly distributed and densely packed lithium disilicate crystals in the P1 group. However, larger and less densely packed crystals were noticeable in P2 and P3. The IPS e.max Press could be repressed up to two times without an adverse effect on mechanical properties or color stability. These results may support the reuse of pressed lithium disilicate for economical purposes, but further clinical evaluation should be conducted to confirm these findings.

An otherwise healthy male developed COVID-19 disease after the use of anabolic steroid: The second case report.

Introduction: COVID-19 disease is considered a highly risky pandemic which led to more victims during the last two years. Case presentation: We present a case of a 32 athlete male patient who presented with covid-19 symptoms. Past medical history was unremarkable except for oxandrolone (an anabolic steroid) 30/day for bodybuilding 21 days before the presentation. He reported that his symptoms developed rapidly in the past two days. After taking patient consent, we started the treatment with a single dose of anti-androgen (proxlatumide 400 mg) followed by 200 mg daily for one week. There was no need for hospital admission. On-call follow-up showed a marked response with resolving of most symptoms. Follow-up for six weeks later demonstrated a full recovery. Discussion: Using anabolic androgen steroids have been considered a risk factor for developing pneumonia. With the wide use between bodybuilders, many reports showed a link between the use of such drugs and COVID-19 disease. Anti-androgen drugs may lead to resolution of the symptoms. Conclusion: To the best of our knowledge, this is the second case reporting the link between anabolic steroids use and covid-19 disease severity.

Giant neglected hydronephrosis in an adult diagnosed after a blunt trauma: A case report.

Giant hydronephrosis is a rare urological condition which led to serious complication. We reported a rare case of giant hydronephrosis in a 21 years old male patient with no known medical issues diagnosed after a blunt trauma. Computed tomography scan of the abdomen and pelvis showed a right giant hydronephrosis with no renal parenchyma. Simple nephrectomy with open surgery was performed. Pathology report concluded that it is a neglected ureteropelvic junction obstruction. Follow-up for three months showed no complains.

Forgotten Double-J ureteral stent: An analysis of 25 cases in a tertiary hospital.

Introduction: Double-J (DJ) ureteral stents are considered basic and common in daily urological practice. We aim to share our experience of managing 25 cases of forgotten double-J (DJ) stents in our tertiary care center. Methods and materials: We did a retrospective analysis of cases with forgotten DJ stent for a period of one year spanning from February 2021 to February 2022. Detailed information like age, sex, the indication for insertion of the double-J, the period of insertion, presenting symptoms, and the definite procedure performed to remove the double-J. Results: The total number of cases was 25. We had 60% of patients underwent previous procedure in our hospital and the rest 40% were in other centers. The mean age was 38.44 years. The mean duration of the indwelling stent was 20.36 months, and the duration ranged from 13 months to 33 months.Most common indications for stenting were URS (64%). Presenting complaints were dysuria (n = 19; 76%), hematuria (n = 13, 52%), flank pain (n = 9; 36%), storage lower urinary tract symptoms (n = 8; 32%), and recurrent urinary tract infection (n = 5; 20%).Several complications were noted during or after forgotten stent removal like stent fragmentation (20%), fever (16%), sepsis (8%), and hematuria requiring transfusion (4%). Conclusion: Forgotten double-J ureteral stents are a source for morbidity. Patients should be educated about the complications of the forgotten double-J. Creating a scheduled program for notifying patients with double-J stent is another good way.

A 23 -year- old male with muscle-invasive bladder tumor: A rare case report.

•Bladder tumor is the seventh most commonly diagnosed cancer in males.•The peak incidence of bladder tumor is in the sixth decade of life.•Diagnosis of bladder tumor is rare in patients <30 years of age.•Muscle-invasive bladder tumor in young patients is considered extremely rare.

Comparison complications rate between double-J ureteral stent and percutaneous nephrostomy in obstructive uropathy due to stone disease:A randomized controlled trial.

Background: Obstructive uropathy due to stone disease is seen every day in urological practice. Percutaneous nephrostomy and double j ureteral stent procedures are used. Methodology: A randomized controlled trial was conducted in one center from January 2021 to January 2022. A total of 104 patients of age ≥18 years who had unilateral or bilateral obstructive uropathy due to stone disease were divided into two groups. In Group A, 50 patients underwent to double j stent while in Group B, 54 patients who underwent percutaneous nephrostomy insertion tube. Under local anesthesia, the stent was inserted by cystoscopy. While the percutaneous nephrostomy was done under ultrasound guidance by using local anesthetic agent. Complications were noted in immediate postoperative period and on follow up. Results: Mean age of Group A was 35 ± 12.7 years whereas mean age in Group B was 36.7 ± 12.5 years and 49 out of patients were male. The most common complication in double j group and nephrostomy group was hematuria (16% and 5.5% respectively). Post DJ stent, complications like septicemia, painful trigon irritation, and stent encrustation were seen in 8.0%, 10.0%, 10.0% and 4.0% patients respectively. On the other hand, post-PCN septicemia, tube dislodgment or blockage, and injury to adjacent organs were seen in 3.7%, 5.5% and 1.8% respectively. In our trial, overall success rate for double j stenting was up to 84.0% and for percutaneous nephrostomy (PCN) was 96.29% (p < 0.0001). Conclusion: We found percutaneous nephrostomy is better and had overall higher success rate with less complications post procedure.

A missed and fragmented double-j ureteral stent: A rare case report.

In the last two decades, the usage of double-j ureteral stents is highly increased. This led to increase in complications like encrustation, stent migration, retained double-j, and fragmentation. Herein, we report a rare complication of double-j ureteral stent. A 46 years old male patient presented with left flank pain and lower urinary tract symptoms. KUB image revealed a left fragmented double-j ureteral stent. We used cystoscopy to remove the distal part and ureteroscopy to remove the proximal part. We discharged the patient in same day with no complications.

Effect of Different Cleaning Methods on Shear Bond Strength of Resin Cement to Contaminated Zirconia.

The aim of this study was to evaluate the effect of different cleaning methods on the shear bond strength (SBS) of resin cement to contaminated zirconia specimens. Eighty rectangular-shaped specimens (2 × 5 × 10 mm) were fabricated from Zirconia blocks (IPS e.max ZirCAD) and randomly divided into 8 groups (n = 10). Group A (control) was not exposed to contaminants. The following tests specimens were contaminated with saliva and silicone indicating paste. Group B was coated with ceramic primer, then subjected to contamination. Groups C, D, E, F, G, and H were contaminated; cleaned with water rinse, Ivoclean, air particle abrasion, hydrofluoric acid, KATANATM Cleaner and ZirCleanTM, respectively, and then coated with ceramic primer and bonded to dual cure resin cement cylinders. All the specimens were subjected to artificial aging and surviving specimens were subjected to the SBS test. For statistical analysis, ANOVA and multiple comparison methods at the 0.05 significance level were used. There was no statistically significant difference among Ivoclean (21.48 ± 2.90 MPa), air particle abrasion (21.92 ± 2.85 MPa), and the control group (24.68 ± 5.46). The application of ceramic primer before contamination did not preserve the SBS of resin cement to zirconia. Cleaning the contaminated zirconia surface with hydrofluoric acid (15.03 ± 3.63) or KATANATM Cleaner (17.27 ± 7.63) did not restore SBS to the uncontaminated state, but it was significantly higher than simply rinsing with water (12.46 ± 5.17) or the use of ZirCleanTM (11.59 ± 5.53). The bond strength of resin cement to zirconia was influenced by cleaning methods.

Emphysematous pyelonephritis in a young male Syrian patient: A rare case report.

Emphysematous pyelonephritis, a necrotizing kidney infection, is a rare condition with a poor prognosis. We present a case of 24-year-old male with fever, malaise, and left flank pain. Computed tomography of abdominal and pelvis showed left emphysematous pyelonephritis. Treatment included IV antibiotics. A left nephrectomy was necessitated for definitive treatment. Clinical course after surgery was unremarkable. In conclusion, prompt diagnosis of emphysematous pyelonephritis is necessary to reduce morbidity and mortality. In some cases, nephrectomy is the definite treatment.