Active application of liquid etching agent improves adhesion of fibre posts to intraradicular dentine.

AIM: To assess the effectiveness of an active application of liquid etching, compared with the standard gel formulation on smear layer removal from post space walls and push-out bond strength of luted fibre posts. METHODOLOGY: Human extracted teeth were collected and root filled. After post space preparation and cleaning with 10% ethylenediaminetetraacetic acid for 30 s, teeth were assigned to four groups (n = 11) according to etching procedure: (i) 37% phosphoric acid (H3 PO4 ) gel; (ii) 37% H3 PO4 liquid applied with an endodontic needle; (iii) 37% H3 PO4 liquid applied with an Endovac; (iv) no etching procedure (control group). Three teeth per group were sectioned longitudinally and prepared for SEM examination to evaluate the presence of smear layer, debris, sealer/gutta-percha remnants, and the number of open tubules. Eight teeth per group were bonded with an etch-and-rinse adhesive, and fibre posts were luted with a resin-based cement. After cutting, specimens were prepared for a push-out test. Data were analysed by anova and post hoc tests (P < 0.05). RESULTS: Improved smear layer removal was obtained in Group 2, followed by Group 1, Group 3, and the control group (P < 0.05). The mean values for the bond strength of the push-out test were: Group 1, 8.3 ± 2.9 MPa (coronal); 7.7 ± 3.0 (middle); 3.3 ±1.9 MPa (apical); Group 2, 7.8 ± 2.1 MPa (coronal); 6.9 ± 3.9 MPa (middle); 3.7 ± 1.3 MPa (apical); Group 3, 9.7 ± 2.8 MPa (coronal); 8.6 ± 2.1 MPa (middle); 6.9 ± 2.3 MPa (apical); and Group 4, 2.9 ± 3.0 MPa (coronal); 2.6 ± 2.0 MPa (middle); 1.1 ± 2.0 MPa (apical). CONCLUSIONS: Liquid phosphoric acid applied with an endodontic needle yielded better canal wall smear layer removal and higher bond strength values when an etch-and-rinse system was used.

Biliopancreatic diversion. Clinical experience.

AIM: Biliopancreatic diversion (BPD) has been accepted as an effective surgical treatment of morbid obesity. The paper presents the results of a personal clinical experience with this procedure, with special focus on the quality of life. METHODS: From January 1, 1992 to June 30, 2002, 122 patients (F/M: 108/14, mean age: 40.2 years, range 21-61) underwent BPD. Mean preoperative body weight was 122.4 kg (range 91-200), with a mean Body Mass Index of 49.1 kg/m2 (range 38-78). Three of these patients were converted from a previous vertical banded gastroplasty to BPD (1 patients with stomach preservation). After at least a 36-month follow-up, 10 patients underwent abdominal dermolipectomy (8 associated to incisional hernia repair, 1 associated to thigh dermolipectomy). RESULTS: Mean postoperative hospital stay was 12 days (range: 11-30). Follow-up is currently in progress in all patients. Weight loss of initial overweight was 75% in 88 patients with a 36-month follow-up, with excellent long-term weight maintenance. Protein deficiency was the main specific complication, encountered in 6 patients (4.9%). Beneficial effects, other than those consequent to weight loss, included permanent normalization of serum cholesterol and glucose without any medication and on a totally free diet. Almost 80% of the patients reported an improvement in their self-esteem, physical activity, work condition and social life. CONCLUSIONS: This clinical experience supports the effectiveness and safety of BPD, despite some criticism. The small number of side effects and complications, the excellent weight loss and the recovery of most co-morbidity leads to a great improvement in quality of life.