A Combined Approach for the Aesthetic Management of Stained Enamel Opacities: External Bleaching Followed by Resin Infiltration.

Stained enamel opacities are frequently encountered in dental practice. However, due to the risk of unaesthetic outcome, managing such lesions by resin infiltration techniques alone is not advised. Therefore, performing external bleaching before resin infiltration procedure is mandatory to eliminate stains from the hypomineralized lesions in order to aesthetically infiltrate them. In this work, we describe clinical cases in which external bleaching and resin infiltration techniques were used for managing stained enamel hypomineralized lesions related to traumatic dental injuries and molar incisor hypomineralization. Despite the fact that this approach has some limitations, it could be concluded that external bleaching associated with the resin infiltration technique shows promising results to aesthetically manage stained enamel opacities when the stain is totally removed after bleaching.

[Evaluation of blood pressure control by ambulatory blood pressure monitoring and study of factors associated with poor blood pressure control in 300 treated hypertensive type 2 diabetic patients]. / Évaluation de l'équilibre tensionnel par la mesure ambulatoire de la pression artérielle et étude des facteurs associés à un mauvais contrôle tensionnel chez 300 diabétiques de type 2 hypertendus traités.

UNLABELLED: Hypertension is frequently associated with type 2 diabetes and is often difficult to control. AIM: Evaluate the frequency of controlled hypertension in our type 2 diabetic patients with known and treated hypertension and determine the factors associated with poor blood pressure control. SUBJECTS AND METHODS: Prospective study concerning 300 type 2 diabetic patients with a known and treated hypertension, sex-ratio: 0.64, mean age: 61.2±9.1 years (37-86). All subjects underwent physical examination, biological investigations and a 24 hours ambulatory blood pressure monitoring (ABPM). RESULTS: Hypertension was well controlled in 70 patients (23.3%). The concordance rate between clinical measure of blood pressure and ABPM was 70.3%. Subjects with uncontrolled hypertension were older (61.8±8.9 vs 59.1±9.3 years, P<0.05), more frequently of male sex (sex-ratio: 0.77 vs 0.34, P<0.01), smokers (36.4 vs 21.7%, P<0.05) and with abdominal adiposity (P<0.05). Duration of diabetes, body mass index and the frequency of peripheral neuropathy, retinopathy and coronary insufficiency were not different between the two groups. Diabetic nephropathy was more frequent (29.8 vs 16.1%, P<0.05) in the group with uncontrolled hypertension. Loss of circadian blood pressure rhythm was noted in 239 patients (79.6%) and it was more frequently observed in patients with uncontrolled hypertension (84 vs 66%, P<0.001). CONCLUSION: Our type 2 diabetic patients had a poorly controlled hypertension. Close monitoring of blood pressure with adjustment of antihypertensive treatment are necessary to improve cardiovascular prognosis of our patients.