Efficacy and tolerability of tapentadol prolonged release during rehabilitation: a prospective, observational study.

OBJECTIVE: The treatment of chronic pain frequently combines pharmacologic and non-pharmacological options, and analgesia after surgery is of major importance. Tapentadol is both µ-opioid receptor agonist (with a 40% agonism on these receptors) and noradrenaline reuptake inhibitor, with similar analgesic efficacy to strong opioids, but fewer adverse effects. For these reasons, tapentadol may represent a valuable first choice option in the treatment of chronic, neuropathic, and mixed pain. PATIENTS AND METHODS: The primary endpoint of the present study was the proportion of responder patients, with ≥30% reduction in pain intensity during loading on the NRS; several additional endpoints were also evaluated. RESULTS: Twenty-five adult patients were enrolled, with a rate of response to treatment of 100%. Moreover, pain reduction was as high as 50% in 23/25 patients (92%). The average NRS at rest at V0 was 7.2 ± 1.0, whereas the average NRS at loading was 7.7 ± 0.9; this score significantly decreased at all visits. The score of the Roland-Morris questionnaire, a score of disability, improved significantly throughout the study (p<0.0001), as well as the Barthel Index (p<0.0005), and the neuropathic component of pain, which was significantly reduced during the study, from 88% at V0 to 12% at V3. Sleep quality improved throughout the study, and the treatment was rated as good (91% of patients) or optimal (9%). CONCLUSIONS: Our findings show that tapentadol PR may contribute to improve patients' quality of life, especially during rehabilitation after back surgery, when tapentadol PR treatment is effective and well tolerated.

Use of Transparent Tips for Obtaining Tight Proximal Contacts in Direct Class II Composite Resin Restorations.

This article describes the clinical technique of using the transparent plastic tips of the LM-Contact Former system for obtaining tight proximal contacts in direct Class II composite resin restorations using noncontoured circumferential matrix bands. With this technique, the composite resin is pressed with the tip, which adapts intimately to the walls of the proximal box. Moreover, the total working time is reduced by filling the cavity, which remains after removing the transparent tip, with a bulk-fill flowable resin-based composite.

A clinical study of direct composite full-coverage crowns: long-term results.

OBJECTIVE: Long-term assessment of the clinical behavior of direct composite full-coverage crowns using transparent strip crowns as a matrix. METHOD: A retrospective observational study without controls of 21 restorations was performed: nine teeth with hypoplasia, six conoid teeth, and six with microdontia. The mean patient age was 22.5 ± 8.2 years. The clinical procedure consisted of cleaning the tooth, acid etching and application of adhesive, after which a transparent strip crown was filled with composite and placed on the tooth. The gingival contour was polished using multifluted burs and interproximal spaces polished with polishing strips. Patients were examined after a period of 12.5 (±4.6) years by two observers who recorded the plaque index and evaluated the restorations in accordance with the modified U. S. Public Health Service (USPHS) criteria. RESULTS: Except for one case, all the scores obtained on the basis of the USPHS criteria were within the acceptable range. There were no cases of secondary caries. The statistically significant variations were anatomical form, marginal adaptation, marginal discolouration, and surface roughness. DISCUSSION: This technique is simple and noninvasive. It is a viable long-term treatment option for teeth with amelogenesis or microdonts and is especially suitable for patients still undergoing growth.

Effect of dimethylthiourea on paraquat toxicity in rats.

We evaluated the utility of dimethylthiourea ( DMTU ), a hydroxyl radical scavenger, as potential therapy for paraquat poisoning. Seventy-five male Sprague-Dawley rats were divided into four groups ( DMTU -paraquat, paraquat, DMTU , control) and studied for up to 10 days. Clinical observations (dyspnea, weakness), mortality, hepatic and renal function tests, body weights, and histologic studies were performed. There was no mortality in the DMTU and control groups although various histologic and biochemical studies suggested that DMTU may be both hepatotoxic and nephrotoxic. In contrast, 74% of DMTU -paraquat rats and 39% of paraquat rats died (p less than 0.01). In addition, toxicity was clearly earlier in the DMTU -paraquat group than in the paraquat group. Hence, rather than being protective, treatment with dimethylthiourea was associated with increased mortality in paraquat-poisoned rats.