A comparison of the effects of incremental and snowplow techniques on the mechanical properties of composite restorations.

BACKGROUND: Glass fibre-reinforced composite (GFRC) has the potential to enhance the mechanical properties of resin-based restorations. Nevertheless, the application technique can influence the cervical margin porosity, potentially reducing the mechanical strength of restorations. METHODS: In an in vitro setup, mould specimens underwent six different treatments to assess the effects of snowplow and incremental curing techniques on the properties of GFRC (EverX) and universal resin composite (Filtek). Mechanical properties, namely flexural strength (FS), compressive strength (CS) and Vickers hardness (VH), were evaluated following ISO 4049 standards. Data interpretation utilized the Kruskal-Wallis tests. RESULTS: No significant difference emerged across groups for FS. CS in the snowplow method with lesser EverX thickness (SnPl_1) was comparable with only EverX and Filtek (P > 0.05). The CS was reduced in the snowplow technique with greater EverX thickness (SnPl_2) (P < 0.05) and further decreased with the incremental method (P < 0.001). VH results showed that EverX Posterior was consistently softer than Filtek, with specific patterns of hardness variations among different application methods. CONCLUSIONS: Applying EverX and Filtek using the snowplow technique delivers superior CS and VH for restorations in contrast to the incremental method. Utilizing the snowplow approach in high-stress areas can make restorations more fracture-resistant.

Parapneumonic empyema in children: conservative approach.

Forty-nine patients, aged 3 months to 13 years, were studied to determine the clinical presentation, bacteriology, treatment and outcome of empyema complicating pneumonia in children. There were 28 (57.2%) males and 21 (42.8%) females in the study, with a male/female ratio of 1.3/1. We found malnutrition in 15 (30.6%) patients. The most common symptoms at presentation were fever (93.8%) and cough (85.7%). Radiography demonstrated minimal effusions (6 patients, 12.2%), moderate effusions (23 patients, 46.9%), and massive effusions (20 patients, 40.9%). The pleural fluid was on the right side in 26 (53.1%) cases, the left side in 17 (34.6%) cases, and bilateral in 6 (12.3%) cases. Staphylococcus aureus was the most frequently isolated microorganism in pleural fluid. No organism was recovered in 33 (67.3%) patients. Most cases were treated with a combination of intravenous antibiotics and chest tube drainage. Decortication was carried out in only two patients. The hospitalization period was 28.02 +/- 10.18 days (11 to 57 days). There was one death due to widespread Staphylococcus aureus septicemia. All patients who were followed-up showed complete or near complete resolution of the chest radiography at six months, regardless of severity of disease or treatment modality. Children with pleural empyema can be successfully treated with appropriate antimicrobial therapy and adequate closed chest tube drainage. Further surgical intervention is rarely required.