Can direct bilirubin-to-lymphocyte ratio predict surgery for pediatric adhesive small bowel obstruction?

OBJECTIVE: Estimating which patients might require surgical intervention is crucial. Patients with complete bowel obstructions exhibit disrupted enterohepatic cycles of bile and bacteremia due to bacterial translocation. The goal of this study was to develop a prediction index using laboratory inflammatory data to identify patients who may need surgery. MATERIALS AND METHODS: The patients were divided into two groups based on their management strategy: Non-operative management (Group 1) and surgical management (Group 2). RESULTS: The indirect bilirubin, direct bilirubin, and total bilirubin were significantly higher in Group 2 than in Group 1 (p = 0.001, p < 0.001, and p < 0.001, respectively). The neutrophil-to-lymphocyte ratio (NLR), platelet-to-NLR (PNLR), and direct bilirubin-to-lymphocyte ratio (DBR) were significantly higher in Group 2 compared to Group 1 (p = 0.041, p = 0.020, and p < 0.001, respectively). In group 2, 78% have viable bowels. Resection was performed in 40% of cases, with 12% mortality and a 10-day average hospital stay. DLR performs the best overall accuracy (72%), demonstrating a well-balanced sensitivity (62%) and specificity (81%). CONCLUSIONS: This study suggested that DBR is a more accurate predictive index for surgical intervention in pediatric adhesive small bowel obstruction patients compared to NLR and PNLR, providing valuable guidance for treatment strategies.

OBJETIVO: Desarrollar un índice de predicción utilizando datos inflamatorios de laboratorio para identificar qué pacientes podrían necesitar cirugía. MÉTODO: Los pacientes se dividieron en dos grupos según su estrategia de manejo: no quirúrgico (grupo 1) o quirúrgico (grupo 2). RESULTADOS: Las bilirrubinas indirecta, directa y total fueron significativamente más altas en el grupo 2 que en el grupo 1 (p = 0.001, p < 0.001 y p < 0.001, respectivamente). Las relaciones neutrófilos-linfocitos, plaquetas-neutrófilos-linfocitos y bilirrubina directa-linfocitos fueron significativamente más altas en el grupo 2 que en el grupo 1 (p = 0.041, p = 0.020 y p < 0.001, respectivamente). En el grupo 2, el 78% tenían intestino viable. Se realizó resección en el 40% de los casos, con un 12% de mortalidad y una estancia hospitalaria promedio de 10 días. La relación bilirrubina directa-linfocitos tuvo la mejor precisión general (72%), demostrando una sensibilidad bien equilibrada (62%) y una buena especificidad (81%). CONCLUSIONES: Este estudio sugiere que la relación bilirrubina directa-linfocitos es un índice predictivo más preciso para la intervención quirúrgica en pacientes pediátricos con obstrucción adhesiva de intestino delgado en comparación con la de neutrófilos-linfocitos y la de plaquetas-neutrófilos-linfocitos, proporcionando una valiosa orientación para las estrategias de tratamiento.

Occlusal veneer restoration treatment outcomes of cracked tooth syndrome: A 22.4-month follow-up study.

OBJECTIVES: The aims of this clinical study were to investigate success rate, vital pulp survival rate, tooth survival rate and patient-reported masticatory ability by evaluating the pain symptoms and signs of the cracked teeth as well as Index of Eating Difficulty (IED) and Oral Health Impact Profile-14 (OHIP-14) questionnaire after cracked teeth were restored with occlusal veneers. MATERIALS AND METHODS: 27 cracked teeth of 24 patients with cold and/or biting pains without spontaneous/nocturnal pains were recruited in this study. The cracked teeth were restored with occlusal veneers fabricated by lithium disilicate ceramic. Cold test and biting test were used to evaluate pain signs. IED and OHIP-14 questionnaire were used to evaluate masticatory ability. FDI criteria was used to evaluate restorations. The paired Wilcoxon test was used to analyze significant differences of detection rate of pain signs, OHIP scores and IED grade before and after restorations. Kaplan-Meier survival curve was used to describe the success rate, vital pulp survival rate, and tooth survival rate. RESULTS: 27 cracked teeth were restored with occlusal veneers with average of 22.4-month follow-up. Two cracked teeth had pulpitis and pain signs of the other cracked teeth completely disappeared. OHIP total scores were significantly reduced after treatment. Scores of 'pain', 'occlusal discomfort', 'uncomfortable to eat', 'diet unsatisfactory' and 'interrupted meals' reduced significantly after treatment. After treatment, IED grades of 25 vital teeth were significantly lower than those before treatment. FDI scores of 25 restorations except for 2 teeth with pulpitis were no greater than 2. The 12 months accumulated pulp survival rate of the cracked teeth was 92.6%. The 12 months accumulated tooth survival rate was 100%. The success rate at the latest recall was 92.6%. CONCLUSION: Occlusal veneer restorations with success rate of 92.6% and the same pulp survival rate might be an effective restoration for treating the cracked teeth. CLINICAL RELEVANCE: The occlusal veneer restorations might be an option for treating the cracked teeth when cracks only involve enamel and dentin, not dental pulp.

Bleaching effect on bonding performance of composite to enamel.

This study aimed to assess the effects of dental bleaching on the immediate shear bond strength (SBS) of composite to enamel. Different bleaching methods and time intervals between bleaching and composite restoration were examined. A total of 45 enamel specimens were divided into three groups (n = 15) based on the applied bleaching protocol: in-office (A), at-home (B), and unbleached control (C). Groups A and B were then subdivided into three time intervals until bonding: 1, 3, and 7 days. The composite was bonded to enamel using self-etch adhesive technique and submitted to SBS testing. The enamel surface and adhesive interface were observed under scanning electron microscope (SEM). The highest average SBS was measured in the control (unbleached) group (31.1 ± 3.4). A significant difference in SBS was found between the control and in-office bleaching (p < .001), as well as between control and at-home bleaching (p = .034), while the difference between in-office and at-home bleaching methods was insignificant. In relation to the waiting period, a significant reduction in SBS (p < .001) was found 1 day post-bleaching. The weakest marginal sealing to enamel under SEM was observed also 1 day after bleaching. Both bleaching methods significantly reduced the SBS of composite to enamel, especially immediately after the bleaching procedure. Reduction in SBS is temporary and 3-day waiting period seems to be sufficient to reverse the adverse effects of bleaching. RESEARCH HIGHLIGHTS: SBS of composite to enamel is significantly reduced by bleaching procedures, especially immediately after bleaching. The reduction in SBS is temporary and reversible by delaying the restoration for a minimum of 3 days.

A case report of complex suicide in physician: attempt drugs poisoning and adhesive tape asphyxia.

Complex suicides are rare occurrences that can be categorized into planned (or primary) cases and unplanned (or secondary) cases. Additionally, individuals often select suicide methods based on their availability and accessibility. The body of a 58-year-old man was discovered deceased inside his medical office. He was found seated on the waiting room sofa, with his airways obstructed by several layers of adhesive tape wrapped around his head. An intravenous needle was observed in his left arm, and on the table in front of him, an empty 50 ml syringe, two empty vials of 10 ml potassium chloride, and an empty 10 mg vial of Valium (diazepam) were found. A roll of adhesive tape, similar to the one around his head, was also present. The autopsy, conducted 36 h after the body's discovery, revealed therapeutic concentrations of diazepam and its metabolite nordiazepam in the blood samples, while potassium chloride was not detected. Integrating forensic findings obtained from autopsy, histology, and other postmortem investigation, including toxicological analysis, can aid in defining suicidal behavior and preventing misinterpretation, particularly in differentiating diagnosis between homicide and suicide. It is crucial to consider circumstantial data and professional knowledge in such cases.

Adhesive capsulitis: the importance of early diagnosis and treatment.

BACKGROUND: Adhesive capsulitis (AC), more commonly known as "frozen shoulder", is a painful shoulder condition. The illness progresses through three phases: freezing, frozen and thawing. A gold standard treatment for adhesive capsulitis is not defined. The goal of any treatment is to reduce pain and restore shoulder movement. OBJECTIVE: Objective of the present study is to evaluate the efficacy of gleno-humeral hydrodistension associated with physical therapy in patients with diagnosed adhesive capsulitis comparing the outcomes in term of pain and range of motion in patients with a phase 1 and a phase 2 disease. METHOD: Between January 2022 and April 2023, We evaluated 87 patients with adhesive capsulitis, 47 were excluded for others concomitant pathologies, finally 40 patients were enrolled for the study, of whom 23 had capsulitis in stage 1 and 17 in stage 2. Patients were evaluated at baseline and at 2, 4 and 6 months after infiltration recording range of motion in all planes, pain and functionality scores. RESULTS: A significant improvement was recorded in shoulder range of motion in all planes with the except of extension in both groups. Phase 2 patients were able to regain shoulder range of motion in all planes except internal rotation which was recovered with more difficulty. Pain and functionality scores improved significantly between baseline and follow-up visits. CONCLUSION: Ultrasound-assisted hydrodistention of the glenohumeral joint combined with targeted exercise has been successful in improving pain relief, reducing disability, and increasing range of motion in subjects with stage 1 and 2 adhesive capsulitis, especially if diagnosed before phase 2 (when the range of motion is completely reduced).

Antibacterial Activity of the Vancomycin and Cefotaxime-Incorporated Total Etch Adhesive System - An In Vitro Study.

Background: Marginal failure at the resin dentin interface promotes biofilm formation, which further leads to secondary caries and hypersensitivity. This likelihood also increases if residual bacteria are present following cavity preparation. In order to achieve a proper biological seal without jeopardizing bonding, efforts were made to functionalize the adhesive system with antibacterial activity. Aim and objectives: To appraise the antibacterial activity of a total-etch adhesive system against S. mutans with and without incorporation of antibiotics Vancomycin and Cefotaxime. Materials and Method: A commercially available 5th-generation total-etch bonding agent (Te-Econorm) was used. S. mutans broth had been standardized and streaked over Muller-Hinton agar culture medium and round wells about 6 mm in diameter were made in the centre of the agar plates. Each experimental group comprised 10 samples, which include: Group 1 - 30µg Cefotaxime, Group 2- 30µg Cefotaxime + Bonding agent, Group 3- 30µg Vancomycin, Group 4- 30µg Vancomycin + Bonding agent, Group 5- Bonding agent, and Group 6- No material. Inoculated culture plates were examined for the zone of inhibition after incubation at 37° C for 24 hours. Results: There was a significant difference in the mean diameter of zone of inhibition (p=0.000), with the maximum exhibited by Group 4, followed by Group 3 and Group 2. The least zone of inhibition was exhibited by Groups 1 and 5. The negative control showed no zone of inhibition. Conclusion: The combination of Vancomycin and bonding agent had superior antibacterial activity against S. mutans in comparison to cefotaxime and bonding agent.

The effect of orthodontic bracket base shape on shear bond strength to human enamel, an in vitro study.

The purpose of this study was to evaluate the in vitro effect of orthodontic bracket base shape on shear bond strength (SBS) to human enamel and assess the nature of debonding fractures using the Adhesive Remnant Index (ARI). Orthodontic brackets with different-shaped bases (flower, heart, rectangle) were bonded to 120 extracted human third molars. Shear bond strength was measured using a Servohydraulic Test System at 24 h and 2 months after bonding. Adhesive Remnant Index scores were evaluated under 10x magnification to assess the amount of resin left on the tooth. The control bracket (rectangular base shape) had the highest mean SBS (26.8 ± 8.2 megapascals [MPa]), and significantly differed from the flower (17.2 ± 4.4 MPa) and heart (18.9 ± 3.5 MPa) base shapes (p < 0.001). The mean SBS between debonding times at 24 h (21.5 ± 7.4 MPa) and 2 months (20.4 ± 6.7 MPa) were not statistically significant (p > 0.05). Analysis of ARI scores showed a significant difference between flower-24 h versus heart-2 months (p = 0.039), flower-24 h versus heart-24 h (p = 0.004), and control-2 months versus heart-24 h (p = 0.015). Bracket base shape influenced SBS, with the rectangular base shape having a higher mean SBS compared to flower and heart base shapes. Variations in ARI scores occurred based on bracket shape and were of a mixed adhesive-cohesive nature. All bracket shapes had bond strengths above the clinically acceptable range of 6-8 MPa, and may thus provide adequate SBS in a clinical situation.

From waste to strength: Tailor-made enzyme activation design transformation of denatured soy meal into high-performance all-biomass adhesive.

Given the severe protein denaturation and self-aggregation during the high-temperature desolubilization, denatured soy meal (DSM) is limited by its low reactivity, high viscosity, and poor water solubility. Preparing low-cost and high-performance adhesives with DSM as the key feedstock is still challenging. Herein, this study reveals a double-enzyme co-activation method targeting DSM with the glycosidic bonds in protein-carbohydrate complexes and partial amide bonds in protein, increasing the protein dispersion index from 10.2 % to 75.1 % improves the reactivity of DSM. The green crosslinker transglutaminase (TGase) constructs a robust adhesive isopeptide bond network with high water-resistant bonding strength comparable to chemical crosslinkers. The adhesive has demonstrated high dry/wet shear strength (2.56 and 0.93 MPa) for plywood. After molecular recombination by enzyme strategy, the adhesive had the proper viscosity, high reactivity, and strong water resistance. This research showcases a novel perspective on developing a DSM-based adhesive and blazes new avenues for changes in protein structural function and adhesive performance.

On the design of lignin reinforced acrylic acid/hyaluronic acid adhesive hydrogels with conductive PEDOT:HA nanoparticles.

Hydrogels are of great importance in biomedical engineering. They possess the ability to mimic bodily soft tissues, and this allows exciting possibilities for applications such as tissue engineering, drug delivery and wound healing, however much work remains on stability and mechanical robustness to allow for translation to clinical applications. The work herein describes the synthesis and analysis of a biocompatible, versatile hydrogel that has tailorable swelling, high stability when swollen and thermal stability. The synthesis methods used produce a hydrogel with high elasticity, good mechanical properties and rapid crosslinking whilst displaying biocompatibility, adhesion, and conductivity. It has been shown that cell viability in the samples is above 80 % in all cases, a Young's Modulus of up to 85 kPa and high swelling degrees were achieved. These materials show potential for use in numerous applications such as adhesive sensors, skin grafts and drug delivery systems.

A prospective single-arm clinical trial to assess the safety and efficacy of monofilament polydioxanone barbed suture, MONOFIX®, on abdominal fascial closure.

BACKGROUND: For abdominal fascial closure, the choice of optimal suture material and appropriate suture technique are of paramount importance to prevent the incidence of incisional hernia. Although barbed sutures are widely used in various surgical fields, their safety and feasibility on abdominal fascial closure which requires the most tensile strength for security have not been established yet. METHODS: We conducted a prospective, single-arm, interventional clinical trial to present the postoperative outcomes of using barbed sutures in abdominal fascial closure between April 2021 and August 2021. Patients with colorectal cancer who underwent minimally invasive surgery in elective setting were included. For all participants, monofilament polydioxanone barbed suture, MONOFIX®, was used to secure the abdominal fasica. The primary outcome was the 1-year incidence of incisional hernia assessed by computed tomography. RESULTS: A total of 30 patients were included. The median fascial incision length and suture length were 6.5 cm (range, 6-7.5 cm) and 31 cm (range, 27.5-39.0 cm), respectively. The median procedure time of abdominal fascial closure was 4 min (range, 3-9 min). There was no incidence of unexpected event related to suturing including suture cutting, stopper separation from threads, and suture loosening. One case of superficial surgical site infection occurred during postoperative hospital stays. There was no fascial dehiscence, incisional hernia, and adhesive ileus during a median follow-up period of 17.5 months. CONCLUSION: Monofilament polydioxanone barbed suture, MONOFIX®, may be used safely and effectively on abdominal fascial closure. GOV NUMBER: NCT05872334.

Selective Binding of Tannic Acid-Conjugated Lipid Nanovesicles to Proline-Rich Proteins Enhances Transdermal Lipophilic-Antioxidant Delivery.

Tannic acid (TA) possesses a notable ability to adhere to proline-rich proteins that make up skin cells and the extracellular matrix (ECM) in the skin tissue. Drug carriers with this specific adhesion ability exhibit improved drug delivery efficiency on the skin. Taking advantage of this, this study presents skin-adhesive TA-conjugated lipid nanovesicles (TANVs) for enhanced transdermal antioxidant delivery. We found that TANVs exhibited selective intermolecular interactions with keratinocyte proline-rich proteins (KPRPs) and collagen that makes up skin cells by hydrogen bonding and van der Waals interactions, further enabling the strong bonding to macroscopic skin itself and ECM. We used vitamin E (α-tocopherol), which is known to effectively reduce oxidative stress but has limited skin penetration, as a drug to verify improved in vitro delivery and therapeutic efficacy. The evaluation revealed that the antioxidant-loaded TANVs exerted excellent scavenging effects against reactive oxygen species induced by ultraviolet light or peroxides in the skin, thereby enabling the development of an active drug delivery system for dermal therapy.

Metal-organic framework adhesives with exceptionally high heat resistance.

We synthesized high-heat-resistant adhesives based on metal - organic frameworks owing to their high decomposition temperature and the absence of a glass transition. Heat-resistance tests were performed on adhesive joints consisting of zeolitic imidazolate framework (ZIF)-67-based adhesives and a copper substrate. The as-synthesized ZIF-67-based adhesive exhibited heat resistances at 600 and 700°C in air and nitrogen atmospheres, respectively, comparable to those of conventional high-heat-resistant polymer-based adhesives. The degradation mechanism of the ZIF-67 adhesives was investigated, and their high heat resistance was attributed to the stable existence of the ZIF-67 qtz phase in the adhesive layer at high temperatures without the formation of voids. Thus, adhesives based on ZIF-67 and other metal - organic frameworks can be applied in high-temperature industrial systems.

By focusing on its high thermal stability and absence of glass transition, the ZIF-67 gel was found to have high potential that is comparable to existing heat-resistant adhesives.

Effect of Phytic Acid Etching and Airborne-Particle Abrasion Treatment on the Resin Bond Strength.

Objective: This study aimed to evaluate the bond strength of a universal adhesive to dentin (µTBS) using different time periods of airborne particle abrasion (APA) and two types of acid etching. Methods: Seventy-two human third molars were divided into 9 groups (n=8) according to dentin pretreatment: APA duration (0, 5, or 10s) and acid etching (no acid - NA, 37% phosphoric acid - PhoA, or 1% phytic acid - PhyA). APA was performed at a 0.5 cm distance and air pressure of 60 psi using 50 µm aluminum oxide particles. Afterwards, two coats of Single Bond Universal adhesive (3M) were applied to the dentin surface. Composite blocks were built using the incremental technique, sectioned into 1×1 mm slices and subjected to microtensile bond strength (µTBS) testing. Fracture patterns and surface topography of each dentinal pretreatment were evaluated using a Scanning electron microscope (SEM). Bond strength data were analyzed using two-way ANOVA and Bonferroni post-hoc tests. Results: The group that received pretreatment with 5s APA and PhoA presented higher µTBS values among all groups, which was statistically different when compared with the PhoA, 10APA+PhoA, and 5APA+PhyA groups. PhyA did not significantly influence the bond strength of the air-abraded groups. Finally, adhesive failure was considered the predominant failure in all groups. Conclusion: Dentin pretreated by airborne particle abrasion using aluminum oxide demonstrated an increase in bond strength when abraded for 5 seconds and conditioned with phosphoric acid in a universal adhesive system.

Construction of the pulmonary bio-adhesive delivery system of nintedanib nanocrystalline for effective treatment of pulmonary fibrosis.

Pulmonary fibrosis (PF) is a chronic, progressive, and fatal lung disease with a high mortality rate. Nintedanib, as a multi-tyrosine kinase inhibitor, is widely used as the first line drug for PF patients. However, only nintedanib oral formulations are used currently in clinic and show a low drug selectivity, significant first-pass effect and low bioavailability with 4.7%, thus limiting the clinical outcome of nintedanib. In this study, nintedanib was prepared in the form of nintedanib nanocrystalline (Nib-NC) and then encapsulated with hyaluronic acid (HA) to construct a nanocrystalline-in-adhesive delivery system Nib-NC@HA with high drug loading efficacy and pulmonary bio-adhesive properties, which could avoid the first-pass effects, increase the bioavailability and reduce the systemic side effects of nintedanib. After inhalation administration of Nib-NC@HA, due to the bio-adhesive properties of HA, Nib-NC@HA could prolong the retention time of drug in the lungs and inhibit the expression of inflammation associated factors such as IL-6, IL-1ß and TNF-α in lung tissue, reduce the release of pro-fibrotic growth factor, and improve the lung function, thus showing enhanced anti-fibrotic effect than Nib-NC. The results suggested that Nib-NC@HA is an efficient and optimal targeted bio-adhesive delivery system for the lungs to treat pulmonary fibrosis.

Wearable, battery-free, wireless multiplexed printed sensors for heat stroke prevention with mussel-inspired bio-adhesive membranes.

Wearable technologies are becoming pervasive in our society, and their development continues to accelerate the untapped potential of continuous and ubiquitous sensing, coupled with big data analysis and interpretation, has only just begun to unfold. However, existing wearable devices are still bulky (mainly due to batteries and electronics) and have suboptimal skin contact. In this work, we propose a novel approach based on a sensor network produced through inkjet printing of nanofunctional inks onto a semipermeable substrate. This network enables real-time monitoring of critical physiological parameters, including temperature, humidity, and muscle contraction. Remarkably, our system operates under battery-free and wireless near-field communication (NFC) technology for data readout via smartphones. Moreover, two of the three sensors were integrated onto a naturally adhesive bioinspired membrane. This membrane, developed using an eco-friendly, high-throughput process, draws inspiration from the remarkable adhesive properties of mussel-inspired molecules. The resulting ultra-conformable membrane adheres effortlessly to the skin, ensuring reliable and continuous data collection. The urgency of effective monitoring systems cannot be overstated, especially in the context of rising heat stroke incidents attributed to climate change and high-risk occupations. Heat stroke manifests as elevated skin temperature, lack of sweating, and seizures. Swift intervention is crucial to prevent progression to coma or fatality. Therefore, our proposed system holds immense promise for the monitoring of these parameters on the field, benefiting both the general population and high-risk workers, such as firefighters.

Precise and High-Throughput Delivery of Micronutrients in Plants Enabled by Pollen-Inspired Spiny and Biodegradable Microcapsules.

Decarbonizing food production and mitigating agriculture's environmental impact require new technologies for precise delivery of fertilizers and pesticides to plants. The cuticle, a waxy barrier that protects the surface of leaves, causes 60%-90% runoff of fertilizers and pesticides, leading to the wastage of intensive resources, soil depletion, and water bodies pollution. Solutions to mitigate runoff include adding chemicals (e.g., surfactants) to decrease surface tension and enhance cuticles' permeability but have low efficacy. In this study, vapor-induced synergistic differentiation (VISDi) is used to nanomanufacture echinate pollen-like, high payload content (≈50 wt%) microcapsules decorated with robust spines that mechanically disrupt the cuticle and adhere to the leaf. VISDi induces a core-shell structure in the spines, enabling the release of agrochemicals from the microparticles' body into the leaf. As proof of concept, precise and highthroughput delivery of iron fertilizer in Fe-deficient spinach plants is demonstrated. Spray of spiny microparticles improves leaf adhesion by mechanical interlocking, reduces wash-off by an ≈12.5 fold, and enhances chlorophyll content by ≈7.3 times compared to the application of spherical counterparts. Together, these results show that spiny microparticles can mitigate agricultural runoff and provide a high-throughput tool for precise plant drug delivery.

Ultrasonic activation of adhesive systems increases bond strength and intratubular penetration of resin cement in root dentin subjected to radiation therapy.

OBJECTIVE: This study aimed to evaluate the effect of ultrasonic activation of etch-and-rinse and self-etch adhesive systems on the bond strength of resin cement to irradiated root dentin. MATERIALS AND METHODS: Eighty human maxillary anterior teeth were distributed into 8 groups (n = 10), according to the type of adhesive system used (etch-and-rinse and self-etch), the ultrasonic activation of the adhesive systems, and the dentin condition (irradiated or non-irradiated - 70 Gy). Endodontic treatment was performed followed by fiberglass post-space preparation. After fiberglass posts' luting, the roots were transversely sectioned on dentin discs and submitted to the push-out bond strength test (0.5 mm/min). The fractured specimens were analyzed under a stereomicroscope and Scanning Electron Microscope (SEM) for failure mode classification. One of the dentin discs was analyzed under SEM to evaluate the characteristics of the adhesive interface. RESULTS: Irradiated specimens had lower bond strength than non-irradiated specimens (P < 0.0001). Ultrasonic activation of both adhesive systems increased the bond strength of the resin cement to irradiated dentin (P < 0.0001). Radiotherapy significantly affected the failure mode in the middle (P = 0.024) and apical thirds (P = 0.032) (adhesive failure). CONCLUSION: Non-irradiated specimens had a more homogeneous adhesive interface. When ultrasonically activated, both adhesive systems showed a greater number of resinous tags, regardless of the dentin condition. CLINICAL RELEVANCE: Ultrasonic activation of adhesive systems is a feasible strategy to enhance fiberglass posts retention in oncological patients.

Influence of Surface Preparation of Aluminum Alloy AW-5754 and Stainless Steel X5CRNI18-10 on the Properties of Bonded Joints.

Adhesive bonding has proven to be a reliable method of joining materials, and the development of new adhesives has made it possible to use bonding in a variety of applications. This article addresses the challenges of bonding metals such as the aluminum alloy EN AW-5754 and the stainless steel X5CrNi18-10. In this study, the effects of laser cleaning and texturing on the surface properties and strength of two bonded joints were investigated and compared with mechanical preparation (hand sanding with Scotch-Brite and P180 sandpaper). The bonded joints were tested with three different epoxy adhesives. During the tests, the adhesion properties of the bonded surface were determined by measuring the contact angle and assessing the wettability, the surface roughness parameters for the different surface preparations, and the mechanical properties (tensile lap-shear strength). Based on the strength test results, it was found that bonded joints made of stainless steel had 16% to 40% higher strength than aluminum alloys when using the same adhesive and surface preparation. Laser cleaning resulted in maximum shear strength of the aluminum alloy bond, while the most suitable surface preparation for both materials was preparation with P180 sandpaper for all adhesives.

Effect of photodynamic therapy with two photosensitizers on the microtensile bond strength of a universal adhesive to affected dentin.

BACKGROUND: This study aimed to evaluate the impact of photodynamic therapy (PDT) using two photosensitizers, methylene blue and indocyanine green, on the microtensile bond strength of a universal adhesive to caries-affected dentin. METHODS: The occlusal enamel of 60 third molars was cut to expose the inner one-third of the dentin. Artificial caries were induced through a pH cycling process. The samples were divided into three groups: M (Methylene blue+ diode laser), I (Indocyanine green agents+ diode laser irradiation), and control. Each group was further divided into two subgroups according to the adhesive protocol (self-etch, total-etch). After restoring with Gradia composite resin, teeth were sectioned and exposed to 5000 thermal cycles. Microtensile bond strength was measured using a universal testing machine. The data were subjected to two- and one-way ANOVA and paired comparisons were performed by the Tamhane and Tukey tests. RESULTS: The study found significant effects of the photosensitizer, etching pattern, and their interactions on the microtensile bond strength of composite resin to caries-affected dentin (P<0.001). In the self-etching mode, PDT with indocyanine green exhibited significantly higher bond strength values compared to PDT with methylene blue (P=0.001) and the control groups (P<0.001). However, no significant differences were observed in the total-etch mode. (P=0.54). CONCLUSIONS: The etching mode played a more significant role in the bond strength when using the universal adhesive alongside PDT with methylene blue and indocyanine green. Employing two photosensitizers in PDT during the self-etch mode significantly increased the bond strength values.

Desensitizing efficacy of a universal dentin adhesive containing mesoporous bioactive glass on dentin hypersensitivity: a randomized clinical trial with a split-mouth model.

This split-mouth blinded randomized controlled study compared the efficacy of a desensitizing agent with oxalate/resin polymer and a universal adhesive containing mesoporous bioactive glass (MBG) for dentin hypersensitivity (DH) relief, using Schiff sensitivity score (SSS) and visual analog scale (VAS). Split quadrants containing teeth with DH were treated with either MS Coat ONE or Hi-Bond Universal with MBG as the functional additive. Assessments at baseline, immediately post-application, and at 1- and 2-week follow-ups used standardized stimulus protocols (air, cold, and acid). The SSS difference was the primary outcome, while the VAS difference was the secondary outcome. A mixed linear effect model performed statistical analysis. Immediate DH reduction occurred in response to air stimuli, with a significant decrease in Group HB than in Group MS (p = 0.0178). Cold stimulus reduction exhibited a gradual cumulative effect, with consistently greater reductions in Group HB than in Group MS (p ≤ 0.0377). Both groups effectively managed acidic stimuli, with no significant differences (p > 0.05). The VAS scores decreased gradually over the follow-up period (p < 0.0001). This study highlights the differential efficacy of treatments for various DH triggers and recommends specific approaches based on different stimulus types. The universal adhesive containing MBG demonstrated DH relief potential, promising efficacy identical to or superior to that of a dedicated desensitizing agent. Further research exploring the long-term efficacy and underlying mechanisms is warranted. The universal adhesive containing MBG can be adopted as an in-office desensitizing agent for DH relief. The desensitizing efficacy of universal adhesive matches or surpasses dedicated agents for air and cold stimuli.