Effect of root canal rinsing protocol on dentin bond strength of two resin cements using three different method of test.

BACKGROUND: Different studies have used different tests to evaluate bond strength of resin cements to root dentin. In this in vitrostudy, three different tests were used to evaluate the bond strength of two resin cements to root dentin using two root dentin irrigation protocols. MATERIAL AND METHODS: Ninety-six intact single-rooted teeth were selected for this study. Forty-eight teeth, with a root length of 15mm, were randomly divided into two groups and irrigated with normal saline or 2.5% sodium hypochlorite solutions during root canal preparation, respectively. For each 12 specimens from each group, fiber post #1 was bonded using an etch-and-rinse (Duo-Link) and a self-adhesive (BisCem) resin cement, respectively. After incubation, two specimens were prepared for the push-out test from the middle thirds of the roots. In another 24 teeth, after two 1.5-mm sections were prepared from the middle thirds of the prepared roots, sections of the post were bonded in two subgroups with each of the cements mentioned above and the samples were prepared for the pull-out test. For shear test, the crowns of 48 teeth were cut away, the dentin surfaces were prepared, the two irrigation solutions were used, and the resin cements were bonded. Data collected from the three tests were evaluated by ANOVA, post-hoc Tukey and Weibull tests (α=0.05). RESULTS: There were significant differences in the mean bond strength values between the three bond strength tests (P<0.001). Rinsing protocol and cement type resulted in similar variations in the mean bond strength in all tests (P>0.05). CONCLUSIONS: Under the limitations of the present study, the method of the test used had an effect on the recorded bond strength between the resin cement and root dentin. Cement type and irrigation protocol resulted in similar variations with all the tests. Push-out and shear tests exhibited more coherent results. KEY WORDS: Bond strength, endodontically treated tooth, fiber post, resin cement, sodium hypochlorite.

Socioeconomic determinants and metabolic syndrome: Results from the Isfahan Healthy Heart Program.

Introduction: The prevalence of metabolic syndrome (MetS) is increasing in Iran. We assessed the relationship between socioeconomic status (SES) and Mets components in the Iranian population. MATERIALS AND METHODS: The sample for this study comprised a random cross-section of men and women from two province districts who participated in the Isfahan Healthy Heart Program (IHHP) in 2007. Each participant completed a questionnaire, underwent anthropometric testing and blood pressure measurements, and provided a blood sample. Mets was defined based on ATPIII criteria. Several SES dimensions, such as education, occupation, and number of children, as well as home, car, and personal computer ownership, were assessed to determine the participant's SES. RESULTS: A higher-than-average income, car ownership, owning or renting a private home, and having a computer are increasing towards increment in SES. All MetS components were more prevalent in participants defined as having a lower SES, while low HDL levels were more common in participants having an SES II (P>0.001). A multivariate analysis showed that having the lowest SES (I) increased the risk of MetS by 1.72 [1.44-2.07], whereas subjects having an SES III had a 1.23 [1.04-1.47] lower risk for MetS. CONCLUSIONS: The relationship between SES and Mets is due largely to behavioural factors, such as practicing unhealthy eating habits. Given the high prevalence of Mets in Iran, we propose that regular health check-ups may be useful in the early detection of the syndrome and, consequently, in the prevention of its effects. In addition, the early detection of MetS may result in the early diagnosis and prevention of cardiovascular diseases.

Prevention of post-spinal hypotension using crystalloid, colloid and ephedrine with three different combinations: A double blind randomized study.

BACKGROUND: The benefit of prophylactic combination therapy using crystalloid and colloid preload with ephedrine has not been cleared to prevent maternal hypotension after spinal anesthesia at cesarean delivery. This study evaluated the efficacy of three combinational methods to prevent hypotension following spinal anesthesia. MATERIALS AND METHODS: In this prospective double blind trial, 150 candidates of elective cesarean delivery under spinal anesthesia were randomly allocated to three treatment groups; 1---Ringer's Lactate (RL) solution (15 ml/kg) plus Hemaxel (7 ml/kg) preload, 2---RL solution (15 ml/kg) preload plus ephedrine (15 mg, IV, bolus), 3---Hemaxel (7 ml/kg) preload plus ephedrine (15 mg, IV, bolus). Maternal hemodynamic changes during 60 min after spinal injection, nausea/vomiting, and neonatal condition were compared among the groups. RESULTS: The cumulative incidence of hypotension was 44%, 40%, and 46% in groups 1 to 3, respectively. There were not significant differences in supplementary ephedrine requirement among groups which received or among groups which did not receive prophylactic ephedrine. Groups were not different in the incidence of hypertension and nausea or vomiting. There were no significant differences among groups in Apgar scores at 1 or 5 min and umbilical artery PH. CONCLUSION: Combination of preventive methods decreased the occurrence of hypotension following spinal anesthesia to an acceptable level. Overall, the most effective method was a combination of crystalloid preload with ephedrine.

Comparative study of two anesthesia methods according to postoperative complications and one month mortality rate in the candidates of hip surgery.

BACKGROUND: Surgery for hip fractures can be done under general or neuraxial anesthesia. This study aimed to compare these two methods concerning their postoperative complications, duration of operation, hospitalization and the mortality rate within a period of one month after surgery. METHODS: 400 patients aged more than 30 years old and scheduled for elective operative fixation of fractured hip, randomly enrolled in two equal groups of general (GA) and neuraxial (NA) anesthesia. Hemoglobin level was measured before and 6 hours, 2, 3 and 5 days after the surgery. The intra and postoperative blood loss, duration of surgery, the severity of pain at the time of discharge from recovery and at the 2(nd), 3(rd) and 5(th) postoperative days were recorded. Statistical analysis was performed using SPSS version 12.0 by Mann-Whitney, chi-square, and t tests. P < 0.05 was considered significant. RESULTS: Both groups were similar regarding age, weight, and gender ratio. There was no significant difference in baseline hemoglobin, duration of surgery, length of hospitalization before surgery and the type of surgery. The mean of intraoperative blood loss and visual analogue score (VAS) in recovery and at the 3(rd) postoperative day, and also the length of hospitalization after surgery were significantly less in neuraxial anesthesia group. Both groups showed a significant decrease in hemoglobin values on the 2(nd) and 3(rd) postoperative days comparing to the baseline (p < 0.001). CONCLUSIONS: The morbidity and mortality rates of patients undergoing hip surgery were similar in both methods of anesthesia, but postoperative pain, blood loss, and duration of hospitalization were more in patients undergoing general anesthesia.

The impact of generic form of Clopidogrel on cardiovascular events in patients with coronary artery stent: results of the OPCES study.

BACKGROUND: To compare the early and late cardiovascular events as well as side effects of Osvix, a generic form of Clopidogrel versus Plavix regimens in patients with chronic stable angina, undergoing bare metal stent (BMS) or drug eluting stent (DES) placement, this study was carried out. METHODS: A total of 442 patients with chronic stable angina who were scheduled for elective percutaneous coronary intervention (PCI) were included in a randomized, double blind, multi-centric clinical trial being performed in 6 distinct university hospitals in 5 cities of Iran from March 2007 to November 2009. Baseline, demographic and history of risk factors were recorded using the patients' medical charts. Stenting procedure was performed via transfemoral approach using low osmolar contrast agents. Patients underwent BMS or DES placements based on the physician selection and were randomly assigned to Osvix or Plavix groups. Patients were followed by telephone in 0 and 6 months intervals regarding the major adverse cardiovascular events (MACE) including death, myocardial infarction, in-stent thrombosis, stroke, target lesion revascularization, and target vascular revascularization. Angina episodes, bleeding, liver enzymes, neutrophils and platelets count were also assessed in these intervals. RESULTS: There was not any significant difference between these two groups regarding the baseline characteristics. In the DES group, the 6-month mortality rate and the incidence of MACE in Osvix and Plavix groups were 0.9% and 1.9% (p = 0.61) and 1.8% and 4.9% (p = 0.26), respectively. During the follow up period after DES or BMS placement, there wasn't any significant difference regarding neutrophil and platelet counts or liver enzymes between study groups. CONCLUSIONS: Using Osvix and Plavix are followed by similar major cardiovascular events and side-effect profile in patients undergoing PCI.

A randomized comparative trial of combinational methods for preventing post-spinal hypotension at elective cesarean delivery.

BACKGROUND: Various methods have been applied to prevent maternal hypotension after spinal anesthesia for cesarean delivery. We compared the efficacy of three combinational methods in this regard in the current study. METHODS: In this randomized comparative trial, 150 candidates of elective cesarean delivery under spinal anesthesia were assigned to three groups: crystalloid preload and leg bandage, colloid preload and leg bandage, and ephedrine and leg bandage. Maternal hemodynamic changes during 60 minutes after spinal injection and neonatal condition were compared among the groups. RESULTS: The cumulative incidence of hypotension was 54%, 64%, and 36% in groups 1 to 3, respectively (p = 0.018). Spinal injection to hypotension interval was similar among the groups (p = 0.828). Heart rate in group 3 was significantly lower at the most time measures after anesthesia compared with the other two groups (p < 0.05 to <0.001). Regarding neonatal outcomes, the interval between the birth and the first breath was longer and the Apgar score at minute 1 was lower in group 3 compared with the other groups (p < 0.001 and 0.038, respectively) but it was not clinically important. Umbilical cord blood pH was similar among the three groups (p = 0.248). CONCLUSIONS: Among the three studied methods, administration of ephedrine plus bandage of the lower extremities was the most effective one in reducing the incidence of post-spinal hypotension. The groups were not clinically different concerning the effect of treatment on newborn health.

A study on the relationship of sexual satisfaction and common contraceptive methods employed by the couples.

BACKGROUND: Sexual relationship is a basis for mental health and continuity of the healthy generation. Enjoying the healthy body and mind will cause the sexual relationships to run their normal course in life. One of the problems that couples are faced within their sexual relationships is the issue of employing family planning methods. Studies have revealed that contraceptive methods are in connection with the sexual function and health in different ways. This study was aimed to determine the mean and the relation of scores of sexual satisfaction of men and women with the common contraceptive methods. METHODS: This was a descriptive-correlative study. Samples included 280 individuals (140 couples) to use the common contraceptive methods including withdrawal method, tubal ligation in women, oral contraceptive method, condom, vasectomy, IUD and injection contraceptive method. Tools for gathering the data were Female Sexual Function Index (FSFI) and the questionnaire provided by Dr. Abdo on sexual satisfaction in men in 2004. The validity and reliability of these questionnaires were approved by researches conducted in worldwide and Iran. Descriptive and inferential statistic methods were applied in analyzing the data. RESULTS: The results suggested a significant statistic relation between scores of men's sexual satisfaction and separate contraceptive methods (p = 0.001) whereas this relation was not observed between the women's scores of sexual satisfaction and the contraceptive methods. CONCLUSIONS: According to the results of the present study, training family planning counselors in relation to choose suitable contraceptive method, in view of its probable effects on the couple's sexual satisfaction, seems essential.

A comparison of two methods of removing zinc oxide-eugenol provisional cement residue from the internal surface of cast restorations.

AIM: Remnants of provisional cement on the internal surface of cast restorations can have an adverse effect on the performance of the definitive luting agent. The purpose of this study was to evaluate the effect of eugenol-containing temporary cement removal by an ultrasonic or an organic solvent on the retentive strength of metallic rings cemented to amalgam cores using zinc phosphate cement. METHODS AND MATERIALS: A total of 36 cylindrical amalgam cores measuring 5.9 x 6 mm were made by condensing amalgam in brass molds for use in this in vitro study. Thirty-six cylindrical spaces measuring 6 x 6 mm were machined in the center of cast rods of Rexillium III alloy to create simulated retainers. The amalgam cores were divided into two groups and provisionally cemented in these cylindrical spaces (retainers) using zinc oxide-eugenol cement. After separation of the cores from the retainers, one group was cleaned with an ultrasonic cleaning device with water and the other group was cleaned with Solitine organic solvent. All specimens were then cemented with zinc phosphate cement and the samples were stored at 100% humidity in a 37 degrees C water bath after which they were tested with a DARTEK testing machine at a 0.02 cm/minute cross head speed. The data were analyzed using the Independent t-test. RESULTS: The statistical analysis revealed a significant difference between the two groups (p<0.0005) with the ultrasonic group having significantly higher separation forces than the Solitine group. CONCLUSION: Specimens treated with the ultrasonic cleaner showed a higher mean separation force (282.2 MPa) than the solvent group (439.5 MPa). CLINICAL SIGNIFICANCE: Despite the convenience of using an organic solvent for cleaning the internal surface of cast restorations, the ultrasonic cleaning method is more effective for removing zinc-oxide temporary cement.