Comparative Evaluation of Fracture Resistance in Different Post and Core Systems with Varying Ferrule Locations: An In Vitro Study.

AIM: Endodontically treated teeth often require 360° ferrule to retain post and core restoration. The literature support on scientific evidence of partial ferrule is limited, hence this study was conducted to evaluate the fracture resistance of two post and core systems, i.e., Edelweiss and glass fiber post and core system with varying ferrule locations. MATERIALS AND METHODS: About 54 extracted mandibular 1st premolars were divided into Edelweiss post and core (Group A) and glass fiber post and core (Group B). They were further subdivided into 3 groups each (Partial functional, partial non-functional, and circumferential). A standardized endodontic procedure was carried out on all the specimens. For group A, an Edelweiss drill of 1.4 mm was used to prepare the post space. Canals were then etched, a bonding agent was applied and posts were luted with paracore resin. For group B, post space was prepared with a straight fissure bur, followed by the same procedure as that of group A. Core build-up was done with composite resin. Cast crowns were fabricated and cemented with GIC. Fracture resistance was evaluated with UTM with a compressive load capacity of 1000 N until fracture occurred. RESULTS: The results of this study stated that in the Edelweiss group partial functional ferrule showed higher fracture resistance and in the glass fiber group circumferential ferrule showed higher fracture resistance. The study also showed that MOF is favorable in all the groups. CONCLUSION: The type of ferrule was one of the factors that affected the fracture resistance of Edelweiss and Glass fiber post and core group of specimens. The study also concluded that there was a predominant favorable mode of fracture across all groups, in all different ferrule locations. CLINICAL SIGNIFICANCE: This study opens multiple avenues and methods in tooth restoration and shows that even a partial functional ferrule is sufficient for restoration, provided the right system is used. How to cite this article: Jadhav PD, Shetty R, Mehta D, et al. Comparative Evaluation of Fracture Resistance in Different Post and Core Systems with Varying Ferrule Locations: An In Vitro Study. J Contemp Dent Pract 2024;25(5):480-485.

Quality evaluation of strawberries coated with water-in-oil based emulsion using an advanced electrostatic spray coating system.

In this study, the impact of formulated emulsion was studied on strawberries which were coated using dip and electrostatic spray coating methods. The coated strawberries were kept at room temperature for a period of 12 days. A significant level of chargeability of w/o emulsion was achieved in terms of charge-to-mass ratio of 2.81 mC/kg at an applied high voltage of 2.0 kV, applied air pressure of 0.3 MPa, and liquid flow rate of 33.6 ml/min. The distance of 170 mm from the nozzle tip to Faraday cage was maintained during the measurements. As compared to uncoated and dip coated strawberries, the water-in-oil based electrostatically charged sprays considerably (p < 0.05) reduced the weight loss, decay rate, pH, titrable acidity, TSS, and antioxidant activity. In both the cases, i.e. strawberries coated with dip and electrostatic spray coating methods, the same weight loss was observed, however, there was a considerably less weight loss as compared to uncoated samples. The textures of the uncoated (9.02 N) and dip coated (12.58 N) samples were significantly different from the electrostatic spray coated (15.85 N) samples. Since, the coating formulation had no impact on the sensory attributes, the samples were considered as acceptable at the end of the storage. Furthermore, compared to uncoated, water-in-oil based electrostatically charged spray coating was more effective at delaying the decay by 12 days.

Ultrasound-assisted extraction and encapsulation of betalain from prickly pear: Process optimization, in-vitro digestive stability, and development of functional gummies.

The study aimed to extract and encapsulate betalain pigment from prickly pear (Opuntia ficus-indica) using ultrasound-assisted extraction and eco-friendly glycerol. Subsequent analysis encompassed assessing its thermal stability, shelf-life, bio-accessibility, and biological properties. The process optimization employed Response Surface Methodology (RSM), focusing on glycerol concentration (20-50 %), sample to solvent ratio (1:10-1:20), temperature (30-60 °C), and time (10-30 min). Optimal conditions were determined as 23.15 % glycerol, 1:10 sample to solvent ratio, 10.43 min treatment time, and 31.15 °C temperature. Under these conditions, betalain content reached 858.28 mg/L with a 93.76 % encapsulation efficiency. Thermal stability tests (80-180 °C; 30 & 60 min) showed degradation of betalain with higher temperatures and longer durations, affecting the visual aspect (ΔE) of the pigment. Encapsulated betalain exhibited favorable shelf stability, with optimal storage life of 404.27 days at 4 °C in amber conditions, compared to 271.99 days at 4 °C without amber, 141.92 days at 25 °C without amber, and 134.22 days at 25 °C with amber. Bio-accessibility of encapsulated betalain was significantly higher (2.05 ± 0.03 %) than conventionally extracted pigment (1.03 ± 0.09 %). The encapsulated pigment displayed strong anti-inflammatory properties in dosages of 2-20 µL, with no cytotoxic effects. Additionally, incorporation into gummies was successful and visually approved by sensory panellists. Glycerol proved to be a green encapsulating agent for betalain, offering high shelf life and bio-accessibility, making it suitable for food industry applications. The encapsulated pigment demonstrated robust thermal stability and shelf life, making it suitable for food industry applications. This study highlights glycerol's potential as a sustainable alternative for natural pigment extraction.

Reasons for Crown Failures in Primary Teeth: Protocol for a Systematic Review and Meta-Analysis.

BACKGROUND: There is a tendency nowadays to restore large defects in primary dentition with pediatric crowns instead of conventional restorations. Thus, understanding the factors contributing to the survival or failure of dental crowns in pediatric dentistry is essential for optimizing treatment outcomes. OBJECTIVE: The primary objective of this protocol is to outline the methodological approach for analyzing data from observational studies and randomized controlled trials to investigate reasons for the failure of dental crowns in primary teeth and to compute their survival and failure rates. METHODS: A comprehensive literature review will be performed in electronic databases, including PubMed (MEDLINE), Cochrane, Embase, and Web of Science. As per predefined inclusion criteria, we will include observational studies (prospective clinical studies) and randomized clinical trials that have an English abstract and involve children aged 1-10 years undergoing crown restorations. Two independent reviewers will independently screen all retrieved records and full-text articles and extract data. The study's methodological quality will be appraised using suitable tools. Assessments of publication bias will be performed using funnel plots. The findings will be described qualitatively for the systematic review. If possible, a meta-analysis will be performed to estimate failure rates by dividing the number of failures by the total exposure time. A Poisson regression model, assuming constant event rates, will be used to compute 3-year and 5-year survival proportions. The Pearson goodness-of-fit statistics will be used to assess the heterogeneity of the model. A P value <.05 will be considered significant. All analyses will be performed using R Statistical software (version 4.1.2; R Core Team). RESULTS: This systematic review and synthesis aim to assess the survival and failure rates of dental crowns in pediatric dentistry. By following this rigorous methodology, we seek to provide valuable insights into the factors contributing to the success or failure of these restorations. The results of our full review will have implications for pediatric dentists, researchers, and policy makers, helping to improve dental care for children. CONCLUSIONS: This systematic review protocol helps in establishing a thorough approach for reviewing failures in pediatric crowns. By following this methodology, standardization and transparency of the process as well as accountability for the stated methods and outcomes will be ensured. The findings of this review and analysis will provide useful data on the survival of crowns to pediatric dentists and researchers. TRIAL REGISTRATION: PROSPERO CRD42023442266; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=442266. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51505.

Reasons for Failure of CAD/CAM Restorations in Clinical Studies: A Systematic Review and Meta-analysis.

AIM: The systematic review presented herein was performed to descriptively analyze the causes for the failure of computer-aided design/computer-aided manufacture (CAD/CAM) restorations. The meta-analysis reported herein was performed to estimate long-term survival and success rates of CAD-CAM fabrications. MATERIALS AND METHODS: Using the PICOS paradigm, a systematic search was carried out in the PubMed and Cochrane databases to identify randomized controlled trials (RCTs) and prospective observational studies reporting survival data for CAD/CAM restorations. After selecting studies with a predefined set of selection criteria, data from included prospective clinical studies and RCTs were used for a systematic review aimed at a descriptive analysis of factors associated with failure of CAD-CAM restorations. Data from the included prospective clinical studies were used for meta-analysis, wherein 5-year and 10-year survival and success rates were estimated using Poisson regression models. RESULTS: The systematic review included data from 9 RCTs and 6 observational studies, which had a median follow-up of 36 months and 60 months, respectively. About 58 failures and 118 technical/ biological complications were noted in the included RCTs and 9 failures along with 58 technical/biological complications were noted in the prospective clinical studies. Poisson regression indicated an estimated 5-year and 10-year survival rates of 85.55-100 and 71-100, respectively. The estimated 5-year and 10-year success rates were 74.2-92.75 and 33.3-85.5, respectively. CONCLUSION: Several technical and biological complications contribute to failure of CAD/CAM restorations. However, CAD/CAM restorations with routine chairside materials might have clinically meaningful success rates in the long term. CLINICAL SIGNIFICANCE: The results presented herein indicate that optimal strategies for mitigation of biological and technical complications may augment the success of CAD/CAM fabrications in restorative dentistry. Studies aimed at identification of such strategies are needed to further enhance the long-term success rates of CAD/CAM restorations.

Type 2 diabetes alters the viscoelastic behavior and macromolecular composition of vertebra.

Type 2 diabetes (T2D) affects the functional behavior of vertebra bone by altering its structural and mechanical properties. The vertebral bones are responsible to carry the body weight and it remains under prolonged constant load which results to viscoelastic deformation. The effect of T2D on the viscoelastic behavior of vertebral bone is not well explored yet. In this study, the effects of T2D on the creep and stress relaxation behavior of vertebral bone are investigated. Also, this study established a correlation between T2D associated alteration in macromolecular structure and viscoelastic behavior of vertebra. In this study T2D female rat SD model was used. The obtained results demonstrated a significant reduction in the amount of creep strain (p ≤ 0.05) and stress relaxation (p ≤ 0.01) in T2D specimens than the control. Also, the creep rate was found significantly lower in T2D specimens. On the other hand, molecular structural parameters such as mineral-to-matrix ratio (control vs T2D: 2.93 ± 0.78 vs 3.72 ± 0.53; p = 0.02), and non-enzymatic cross link ratio (NE-xL) (control vs T2D: 1.53 ± 0.07 vs 3.84 ± 0.20; p = 0.01) were found significantly altered in T2D specimens. Pearson linear correlation tests show a significant correlation; between creep rate and NE-xL (r = -0.94, p < 0.01), and between stress relaxation and NE-xL (r = -0.946, p < 0.01). Overall this study explored the understanding about the disease associated alteration in viscoelastic response of vertebra and its correlation with macromolecular composition which can help to understand the disease related impaired functioning of the vertebrae body.

Documentation in Pediatric Microlaryngoscopy/Bronchoscopy: International Modified Delphi Consensus.

BACKGROUND: Complete and accurate documentation of surgical procedures is essential for optimizing patient care, yet significant variation in operative notes persists within and across institutions. We sought to reach consensus on the most important components of an operative note for pediatric microlaryngoscopy and bronchoscopy. METHODS: A modified Delphi consensus process was used. A checklist for operative documentation, created by fellowship-trained pediatric otolaryngologists-head and neck surgeons, was sent to surgeons identified as experts in pediatric laryngoscopy and bronchoscopy. In the first round, items were rated as "keep" or "remove". In the second round, each item was rated on a 7-point Likert scale for importance. The mean score of each item was calculated to determine if consensus was reached. RESULTS: Overall, 43/74 (58.1%) surgeons responded to our survey. After two rounds of editing, 28 components reached consensus, 24 were near consensus, and 26 did not reach consensus. Items that reached final consensus had mean (SD) ratings of 6.12 (0.94) (range, 5.31-6.72). CONCLUSION: Pediatric otolaryngologists identified as bronchoscopy experts were able to create a checklist of essential components of an operative note for pediatric laryngoscopy and bronchoscopy using a Delphi method. Items reaching consensus included procedure name, description of breathing, grade of airway view, description of normal anatomic structures, grade of subglottic stenosis if present, presence and description of tracheobronchomalacia, presence of fistulae, cleft and rings, and several special cases including foreign body and tracheostomy management, as well as end of procedure disposition and complications. LEVEL OF EVIDENCE: 5 Laryngoscope, 133:1234-1238, 2023.

Fetoscopic Balloon Dilation and Stent Placement of Congenital High Airway Obstruction Syndrome Leading to Successful Cesarean Delivery.

INTRODUCTION: Without fetal or perinatal intervention, congenital high airway obstruction syndrome (CHAOS) is a fatal anomaly. The ex utero intrapartum treatment (EXIT) procedure has been used to secure the fetal airway and minimize neonatal hypoxia but is associated with increased maternal morbidity. CASE PRESENTATION: A 16-year-old woman (gravida 1, para 0) was referred to our hospital at 31 weeks gestation with fetal anomalies, including echogenic lungs, tracheobronchial dilation, and flattened diaphragms. At 32 weeks, fetoscopic evaluation identified laryngeal stenosis, which was subsequently treated with balloon dilation and stent placement. The patient developed symptomatic and regular preterm contractions at postoperative day 7 with persistent sonographic signs of CHAOS, which prompted a repeat fetoscopy with confirmation of a patent fetal airway followed by Cesarean delivery under neuraxial anesthesia. Attempts to intubate through the tracheal stent were limited and resulted in removal of the stent. A neonatal airway was successfully established with rigid bronchoscopy. Direct laryngoscopy and bronchoscopy confirmed laryngeal stenosis with a small tracheoesophageal fistula immediately inferior to the laryngeal stenosis and significant tracheomalacia. A tracheostomy was then immediately performed for anticipated long-term airway and pulmonary management. The procedures were well tolerated by both mom and baby. The baby demonstrated spontaneous healing of the tracheoesophageal fistula by day of life 7 with discharge home with ventilator support at 3 months of life. CONCLUSION: Use of repeated fetoscopy in order to relieve fetal upper airway obstruction offers the potential to minimize neonatal hypoxia, while concurrently decreasing maternal morbidity by avoiding an EXIT procedure. Use of the tracheal stent in CHAOS requires further investigation. The long-term reconstruction and respiratory support of children with CHAOS remain challenging.

Surgical Techniques for Tonsillectomy and Perioperative Respiratory Complications in Children.

OBJECTIVES: The aim of this study was to determine the incidence of perioperative respiratory complications in children following tonsillectomy with cold and hot dissection surgical techniques. STUDY DESIGN: The study was a retrospective cohort study. SETTING: Retrospective chart review was performed for all children presenting for a tonsillectomy at Texas Children's Hospital from November 2015 to December 2017. METHODS: Pre- and intraoperative patient factors, including surgical technique with cold or hot dissection (electrocautery or radiofrequency ablation), and perioperative anesthetic factors were collected to determine the incidence of perioperative respiratory complications. RESULTS: A total of 2437 patients underwent a tonsillectomy at Texas Children's Hospital from November 2015 to December 2017. The incidence of perioperative respiratory complications was 20.0% (n = 487). Sickle cell disease, cardiac disease, reactive airway disease, pulmonary disease, age >2 and <3 years, and obesity, defined as a body mass index >95th percentile for age, were significant for overall perioperative respiratory complications. There was no difference in the incidence of perioperative respiratory complications in children undergoing tonsillectomy by cold or hot dissection. CONCLUSION: Perioperative respiratory complications following tonsillectomy are more affected by patient factors than surgical technique.

Successful Repair of Non-facing Sinus ALCAPA Associated With Left-Sided Cardiomegaly Using Takeuchi Technique.

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease that may present isolated or may be associated with other cardiac malformations. Most of the patients develop symptoms during infancy but some may remain asymptomatic up to adulthood. Symptoms range from mild distress to severe irritability and feed intolerance. We report a case of a five-month-old male child who presented with congestive heart failure and was diagnosed as a case of ALCAPA with left atrial and left ventricular dilation based on two-dimensional echocardiography and computed tomography (CT) coronary angiogram. Left main coronary artery was shown to be arising from the posteroinferior wall of main pulmonary artery. Various surgical approaches have been suggested in the repair but the Takeuchi technique was preferred owing to its origin from the non-facing sinus of the pulmonary artery and co-existing dilatation of left atria and ventricle. The surgery was uneventful and there were no postoperative complications. A cardiac CT dynamic study was also done on the follow-up visit five months later and no signs of abnormality or complications were reported. Early intervention is necessary to prevent irreversible cardiac complications and early mortality.