ABSTRACT
One of the primary objectives in management of chronic obstructive pulmonary disease (COPD) is preventing decrease in lung function and reducing the annual number of acute exacerbations of COPD (AECOPD). An oral course of systemic corticosteroids is a commonly used treatment in AECOPD. We hypothesize that this treatment also increases exercise performance and decreases muscle fatigue. In a randomized double-blinded, parallel, placebo-controlled trial, we investigated 14 men (8 on prednisolone 37.5 mg vs. 6 on placebo) with severe and very severe COPD. For 5 consecutive days, the patients performed a submaximal endurance test measuring time to exhaustion (TTE, primary endpoint), spirometry, maximal inspiratory and expiratory pressure and maximal isometric contraction of the quadriceps femoris muscle (maximum voluntary contraction (MVC)). At visits 2, 3 and 4, a fatigue protocol was carried out after 40 minutes of cycling at 40% of maximal effort. No differences between groups were found for TTE, lung function or maximal inspiratory or expiratory pressure, however, patients on prednisolone showed significant increased MVC: median 5.15 [3.35; 9.15] against placebo: -2 [-5.57; 3.95] ( p = 0.03). This finding indicates an impact of corticosteroids on muscle groups being exposed to submaximal endurance.
Subject(s)
Exercise Tolerance , Glucocorticoids/therapeutic use , Muscle Strength , Prednisolone/therapeutic use , Pulmonary Disease, Chronic Obstructive/drug therapy , Quadriceps Muscle/physiopathology , Aged , Double-Blind Method , Exercise Test , Forced Expiratory Volume , Humans , Isometric Contraction , Male , Maximal Respiratory Pressures , Middle Aged , Muscle Fatigue , Pulmonary Disease, Chronic Obstructive/physiopathology , Severity of Illness Index , Spirometry , Treatment OutcomeABSTRACT
PURPOSE: The present follow-up study aimed to evaluate the clinical quality and longevity of 3 ceramic inlay systems and compare them with gold inlays. MATERIALS AND METHODS: Twenty patients were treated with one Cerec, one Mirage, one Empress, and one gold inlay, respectively, inserted in a randomly selected order in the mandible. The inlays were examined independently by 2 calibrated examiners immediately after and 1, 3, and 5 years after luting. The inlays were rated using the California Dental Association (CDA) quality evaluation system. RESULTS: Two Empress inlays required replacement because of fracture between examination (Ex) 1 and Ex 2, and 2 Empress inlays were fractured between Ex 3 and Ex 4. One Cerec inlay had to be recemented after 3 months, and one Cerec inlay fractured between Ex 3 and Ex 4 and was replaced with a gold inlay. Examination showed that the mismatch of color increased from 15% to 50% between Ex 1 and Ex 4 for all ceramic systems. Visible evidence of ditching along the margin increased from 5% at Ex 1 to 70% at Ex 4, and an apparent discoloration of the margin between the tooth and the restoration was seen in 0% to 5% at Ex 1 compared to 30% to 55% at Ex 4. CONCLUSION: Eight percent of the ceramic inlays were fractured during the follow-up period of 5 years. Based on the criteria of the CDA quality evaluation system, 92% of the 60 ceramic inlays and 100% of the 20 gold inlays were rated satisfactory 5 years after luting.
Subject(s)
Ceramics , Inlays , Acid Etching, Dental , Adult , Aluminum Silicates/chemistry , Cementation , Ceramics/chemistry , Color , Composite Resins/chemistry , Computer-Aided Design , Dental Marginal Adaptation , Dental Polishing , Dental Porcelain/chemistry , Dental Restoration Failure , Dentin-Bonding Agents/chemistry , Female , Follow-Up Studies , Glass/chemistry , Gold Alloys/chemistry , Humans , Hydrofluoric Acid , Male , Middle Aged , Observer Variation , Resin Cements/chemistry , Silanes , Surface PropertiesABSTRACT
OBJECTIVES: The purpose of this study was to evaluate the influence of different film thicknesses of resin composite luting agents on the joint bend strength of a ceramic/resin interface. METHODS: Mirage FLC (Chamelon Dental Products) and Vita Cerec (Coltène AG) duo cement were used in combination with the ceramic materials, Mirage and Vita Cerec blocks. Cement layers with thicknesses of 20 microns, 50 microns, 100 microns and 200 microns were light-cured with a high-intensity curing light. Ten specimens of each ceramic/cement combination and thickness provided a total of 80 complete test specimens. Each specimen was placed in a four-point bending jig mounted in a universal tensile testing machine and underwent loading. A paired two-tailed Student's 1-test was used to evaluate differences between different series of film thicknesses and resin cement combinations. RESULTS: Within each ceramic/cement combination, the bond strength values were significantly lower for the 20 micron film then the thicker films. SIGNIFICANCE: Taking into account the physical and clinical properties of resin-based luting agents, available knowledge indicates that a marginal gap on the order of 50-100 microns seems to optimize performance.
Subject(s)
Composite Resins , Dental Bonding , Dental Porcelain , Resin Cements , Cementation/methods , Ceramics , Dental Bonding/methods , Dental Cements , Dental Stress Analysis , Materials Testing/instrumentation , Methacrylates , Microscopy, Electron, Scanning , Pliability , Tensile StrengthABSTRACT
The ability to monitor and record activity within the masticatory system is of importance to both general practitioner and research worker. Recent developments in physiological data collection and analysis at the Department of Anatomy, University of Queensland, have achieved that objective in a simple and cost-effective manner. Recording, printing, plotting, and a wide range of analysis procedures can be undertaken utilizing relatively inexpensive available computers.
Subject(s)
Diagnosis, Computer-Assisted/instrumentation , Diagnosis, Oral/instrumentation , Jaw Relation Record/instrumentation , Malocclusion/diagnosis , Mastication , Electric Impedance , Electromyography/instrumentation , Humans , Software , Temporomandibular Joint Disorders/diagnosisABSTRACT
A method is presented for high magnification, clinical examination and recording of the marginal fit of dental restorations. An endoscopic microscope used in conjunction with video recording facilities affords acceptable colour records of restorative procedures for monitoring purposes. The suggestion is made that the concept of 'fit' in the clinical context has not been adequately addressed. The technique described has other clinical and research implications.
