[Caregiving in an exceptional environment: the military operating theater nurse in a tropical zone]. / Soignant en milieu d'exception : l'infirmier de bloc opératoire militaire en zone tropicale.

The profession of operating theater nurse in the French Armed Forces Medical Corps is often little-known. Called upon to serve in mainland France, but also deployed on overseas operations, they provide medical and surgical support to the French armed forces. Personal qualities - human, physical and technical - are essential to adapt to the environmental constraints of this isolated post.

A Cross-sectional Study of Community-level Physician Retention and Diabetes Management in Rural Ontario.

OBJECTIVE: Our aim in this study was to determine the impact of community-level physician retention on the quality of diabetes care in rural Ontario. METHODS: Using administrative data, we compared diabetes quality of care. We defined retention as the proportion of physicians in a community from one year to the next. We grouped retention level by tertile and added a category for those communities with no physician. RESULTS: Residents of high-retention communities were more likely to have had glycated hemoglobin (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.06 to 1.14) and low-density lipoprotein (OR, 1.17; 95% CI, 1.13 to 1.22) testing, but less likely to have had testing for urine albumin-to-creatine ratio (OR, 0.86; 95% CI, 0.83 to 0.89) or to have received an angiotensin-converting enzyme inhibitor or angiotensin-2 receptor blocker (OR, 0.91; 95% CI, 0.86 to 0.95) or a statin (OR, 0.91; 95% CI, 0.87 to 0.96), when compared with low-retention communities. Communities with no residing physician had care that was equivalent to or better than that in high-retention communities. CONCLUSIONS: Community-level physician retention, based on a 2-year time frame, was significantly related to quality of diabetes care. A closer look at models of care in communities with no residing physician is warranted. Community-level physician retention can be used to assess the impact of physician shortages on diabetes management in rural communities.

Prueba de Push-Out para Evaluar la Fuerza de Adhesión entre dos Tipos de Postes Estéticos

Posterior a un tratamiento endodóntico, muchas veces el remanente es insuficiente para la retención de un material de restauración, por este motivo es necesario la colocación de un sistema de poste-muñón para otorgar retención a la restauración final. Con la aparición de diversos materiales para las restauraciones estéticas, se utilizan actualmente resinas reforzadas con fibra de vidrio como sistemas de postes y muñones para la restauración de dientes tratados endodónticamente. El objetivo del presente trabajo fue comparar la fuerza de adhesión en la prueba push-out de dos diferentes tipos de postes de fibra de vidrio; 3M RelyX y Rebilda Post GT (VOCO) adheridos con cementos duales correspondientes a la marca de los postes; RelyX U-200® Automix (3M ESPE) y Rebilda DC (VOCO). Se llevó a cabo un análisis de ANOVA de dos vías para comparar la fuerza adhesiva con la prueba push-out entre ambos grupos de estudio. Pese a que se observó que los postes Rebilda presentaron una media de fuerza de adhesión ligeramente mayor en comparación con los postes 3M (sin diferencia estadística significativa P>0,05) los últimos son clínicamente más fáciles de colocar, lo cual pudiera ser un factor decisivo para el clínico en el momento de la elección de un poste y su sistema de adhesión.

After an endodontic treatment, many times the remnant is insufficient for the retention of a restorative material, for this reason it is necessary to place a post-stump system to provide retention to the final restoration. With the advent of various materials for esthetic restorations, fiberglass-reinforced resins are now used as post and core systems for the restoration of endodontically treated teeth. The objective of the present work was to compare the bond strength in the push-out test of 2 different types of fiberglass posts; 3M RelyX and Rebilda Post GT (VOCO) bonded with dual cements corresponding to the post brand; RelyX U-200® Automix (3M ESPE) and Rebilda DC (VOCO). A 2-way ANOVA analysis was performed to compare push-out strength between both study groups. Although it was observed that the Rebilda posts presented a slightly higher mean bond strength compared to the 3M posts (with no significant statistical difference P>0.05), the latter are clinically easier to place, which could be a decisive factor for the clinician at the time of choosing a post and its adhesion system.

[POCT-management during the first wave of Covid-19 in France. Results of a national survey leaded by the SFBC-POCT Working Group]. / Gestion de la biologie délocalisée lors de la première vague de Covid-19 en France. Résultats de l'enquête nationale menée par le groupe de travail des EBMD de la SFBC.

During the first wave of Covid-19 in France, in spring 2020, healthcare institution's laboratory had to adapt itself quickly to the growing demand for emergency biology, in particular by reorganizing their POCT analyzers: redeployment of analyzers and/or new installations. In order to analyze this management, a subgroup of 15 hospital biologists from the SFBC Working Group "Biochemical markers of Covid-19" sent, in fall 2020, an on-line survey to French hospital laboratories using POCT. Answers analysis (n = 86) shows a territorial disparity related to the severity of the first wave: increased activity essentially in red zones, management of unexpected situations, training of additional nursing staff for 40 % of the laboratories... The survey also showed simplification of aspects related to accreditation those periods of health crisis. An additional survey, carried out in the spring of 2021, showed good overall satisfaction of the healthcare services (n = 139) concerning the services provided by biology in the POCT sector. Because of their great adaptation capacity, the laboratories and their POCT-teams have played a key role in the management of the first wave of Covid-19 in France. However, the success of these organizations requires an essential collaboration between laboratories and healthcare services. The results of this survey are fundamental in the context of the prolongation of the pandemia throughout the world with a POCT sector appearing to be growing.

Resistencia a la fuerza de tracción de espigos de fibra de vidrio y anatomizados / Tensile bond strength of fiberglass and anatomized posts

Introducción: Es frecuente el desprendimiento de los espigos de fibra de vidrio por pérdida de adhesión cuando son sometidos a las fuerzas masticatorias. Objetivo: Comparar in vitro la resistencia a las fuerzas de tracción de espigos de fibra de vidrio y anatomizado con un mismo cemento. Métodos: Estudio in vitro, de tipo experimental. Se seleccionaron 20 premolares extraídos por motivos ortodónticos que fueron distribuidos aleatoriamente en dos grupos. Se les realizó el tratamiento de conductos por un especialista, la preparación fue manual y la técnica de obturación por condensación lateral. Los dientes fueron preparados para, en forma estándar, recibir el espigo de fibra de vidrio y anatomizados con resina. Para ambos grupos la cementación siguió el protocolo sugerido por el fabricante de Allcem Core® (cemento dual). Los especímenes fueron troquelados en acrílico de autocurado. Para luego ser sometido a fuerza de tracción vertical en la máquina de pruebas de materiales (Instrom©). Resultados: En el grupo de dientes con espigos anatomizados se obtuvo una media de 31 Kg/F, postes de fibra de vidrio 12,47 Kg/F. Según las pruebas de Shapiro-Wilk, las muestras presentaron distribución normal (p > 0,05). Se contrastó la hipótesis con la prueba de t de Student y se encontró diferencia estadística altamente significativas entre los grupos (p = 0,001) Conclusiones: Existe una mayor resistencia a la tracción vertical en los espigos anatomizados(AU)

Introduction: Fiberglass posts often fall off their position due to loss of adhesive capacity when they are subjected to masticatory force. Objective: Compare in vitro the tensile bond strength of fiberglass and anatomized posts cemented with the same adhesive material. Methods: An in vitro experimental study was conducted. A selection was made of 20 premolars extracted by orthodontic indication which were then randomly distributed into two groups. The premolars underwent root canal treatment by a specialist. The preparation was manual and sealing was performed by lateral condensation. The teeth were prepared in the standard manner to receive the fiberglass and resin-anatomized posts. In both groups' cementation followed the protocol suggested by the manufacturer of Allcem Core® (dual cement). The specimens were stamped in self-curing acrylic. Next, they were subjected to vertical tensile strength in an materials testing machine (Instrom©). Results: The mean values obtained were 31 kg/F for teeth with anatomized posts and 12.47 kg/F for fiberglass posts. According to Shapiro-Wilk tests, the samples exhibited a normal distribution (p > 0.05). The hypothesis was contrasted with Student's t test, obtaining a highly significant statistical difference between the groups (p = 0.001). Conclusions: Vertical tensile bond strength is greater in anatomized posts(AU)

Go Set a Watchman: revealing phantom narratives and shattering projections in the era of Black Lives Matter.

Harper Lee's novels, To Kill a Mockingbird and Go Set a Watchman, are examined through the lens of reader-response theory and the Jungian concept of the cultural complex or phantom narratives. Socio-historical context includes the American civil rights movement of the 60's as well as Black Lives Matter. The clinical and institutional implications are briefly considered.

Les romans de Harper Lee, Ne tirez pas sur l'oiseau moqueur et Va et poste une sentinelle, sont étudiés sous l'angle de la théorie de la réception (reader-response theory) et du concept Jungien de complexe culturel, ou narratifs fantômes. Le contexte historico-social inclut le mouvement américain pour les droits civiques dans les années 60 ainsi que Black Lives Matter. Les implications cliniques et institutionnelles sont envisagées succinctement.

Las novelas de Harper Lee, 'Matar a un Ruiseñor y 'Ve y Pon un Centinela', son exploradas a través de la teoría de la respuesta social del lector y el concepto Junguiano de complejo cultural o las narrativas fantasmales. El contexto sociocultural incluye al movimiento por los derechos civiles en América de los años 60, así como también al movimiento Black Lives Matter. Son consideradas brevemente las implicancias clínicas e institucionales.

Evaluation of The Cleaning Protocol of Post Space on Bond Strength of Glass Fiber Posts

ABSTRACT: This study aimed to compare the effect of four irrigation solutions for post space cleaning on the bond strength between glass fiber post and root dentine. Forty bovine roots were root-filled and randomly divided into four groups (n=10), according to the irrigation solution: CG (Control Group): saline solution; SH (Sodium Hypochlorite Group); CLX (Chlorhexidine group) and EDTA (ethylenediaminetetraacetic acid group). Specimens were submitted to mechanical aging and push-out test. Statistical analysis (ANOVA two-way and Tukey test; p<0.05) was performed. A stereomicroscope was used for failure mode classification. EDTA showed higher bond strength values, differing statistically from SH and CG (p<0.05). Adhesive failure between dentin and resinous cement was predominant, followed by mixed failures. SEM images showed pronounced smear layer removal in the EDTA group. 17 % EDTA was better than other solutions for cleaning of post space when using glass fiber posts.

RESUMEN: Este estudio tuvo como objetivo comparar el efecto de cuatro soluciones de irrigación para la limpieza del espacio del poste sobre la fuerza de unión entre el poste de fibra de vidrio y la dentina radicular. Se rellenaron cuarenta raíces bovinas y se dividieron aleatoriamente en cuatro grupos (n = 10), según la solu- ción de riego: CG (Grupo Control): solución salina; SH (Gru- po de hipoclorito de sodio); CLX (grupo clorhexidina) y EDTA (grupo ácido etilendiaminotetraacético). Las muestras se sometieron a una prueba de envejecimiento mecánico y de expulsión. Se realizó análisis estadístico (ANOVA bidireccional y prueba de Tukey; p <0,05). Se utilizó un microscopio estereoscópico para la clasificación del modo de falla. EDTA mostró valores de fuerza de unión más altos, difiriendo estadísticamente de SH y CG (p <0,05). Pre-dominó la falla adhesiva entre dentina y cemento resinoso, seguida de fallas mixtas. Las imágenes SEM mostraron una eliminación pronunciada de la capa de frotis en el grupo de EDTA. El EDTA al 17 % fue mejor que otras soluciones para la limpieza del espacio de los postes cuando se utilizan postes de fibra de vidrio.

[Experimentation of a night shift nursing position in EHPAD]. / Expérimentation d'un poste infirmier de nuit en Ehpad.

The Nouvelle-Aquitaine Regional Health Agency is experimenting with a night nurse position shared between several accommodation facilities for dependent elderly.

[Sleep disorders and psycho-affective problems in paramedical personnel working an atypical schedule]. / Troubles du sommeil et troubles psychoaffectifs chez le personnel paramédical travaillant à horaire atypique.

INTRODUCTION: Shift work can cause health problems and sleep disorders and therefore affect mental health. These psycho-affective disorders can, in return, worsen sleep disorders and thus establish a vicious circle. The aims of our study were to assess the frequency of sleep and psycho-affective disorders among paramedical personnel doing shift work and to screen them for obstructive sleep apnoea-hypopnoea syndrome (OSA). METHODS: It was a cross-sectional study carried out among paramedical staff at the University Hospital Center Mongi Slim La Marsa in Tunis. Three questionnaires translated into Arabic (the Berlin questionnaire, the Spiegel questionnaire and the Hospital Anxiety and Depression Scale [HAD]) were presented by the same investigator during the survey. RESULTS: One hundred and fifty-eight paramedics were interviewed (46.2% were nurses, 23.4% were blue-collar workers, 19% were senior technicians and 11.4% were health care aides, midwives and physiotherapists). The average duration of shift work was 10.27 years, the average age was 36.48 years and there was a female prevalence of 70.9%. Sleep disorders were detected in 40.5% of the cases, OSA in 24%, anxiety in 53.2% and depression in 17.1%. CONCLUSION: Sleep and psycho-affective disorders are frequent among paramedical personnel undertaking shift work in hospitals. Screening consultations in occupational medicine are necessary in order to detect these disorders at an early stage.

[Burnout syndrome in hemodialysis health workers in Cameroon: Prevalence and associated factors]. / Prévalence et facteurs associés au syndrome d'épuisement professionnel chez le personnel de santé des centres d'hémodialyse au Cameroun.

BACKGROUND: Hemodialysis medical staffs usually work in a stressful environment. In low resource countries, professional conditions are worse and can lead to burnout syndrome. The aim of this study was to determine the prevalence of burnout syndrome and its associated factors in hemodialysis health care workers in Cameroon. PATIENTS AND METHODS: We conducted a cross sectional study in all hemodialysis centers from Cameroon between January to August 2017. The Maslach Burnout Inventory was used for assessment of burnout level. Burnout syndrome was defined as the presence of emotional exhaustion, depersonalization or decreased professional achievement. RESULTS: A total of 92 health workers (women 60%; n=55) among 105 identified were recorded. The median age was 42 years. Most of the workers were nurses (78.5%) and 8.5% were nephrologists. Burnout syndrome was found in 76 (82.6%) workers, 35 (38%) had emotional exhaustion, 44 (48%) depersonalization and 57 (62%) decreased professional achievements. Burnout was significantly more prevalent in overcrowded centers (100% vs. 47%; P<0.001). Hemodialysis position<5 years was less prevalent in participants with emotional exhaustion and depersonalization. Desire to change position (OR 19.61 [2.074-185.4]; P=0,009) was associated with burnout syndrome. CONCLUSION: Burnout syndrome is very common among Cameroonian hemodialysis medical staff. Improvement of work conditions, limiting posting in hemodialysis to less than 5 years and change of position when requested may be potential preventive measures.

Endocrown: una alternativa rehabilitadora a las restauraciones rígidas totales clásicas / Endocrown: a rehabilitative alternative to

La restauración ideal en los dientes tratados endodónticamente (DTE) ha sido un tema controversial y ampliamente discutido en la literatura odontológica. El alto índice de fracasos en los dientes endodónticos se asocia principalmente a la falta de un adecuado sellado coronario, motivo por el cual la restauración post endodóntica cumple un papel fundamental. Los propios tejidos del DTE constituyen el refuerzo más importante de la pieza dentaria. La odontología considerada hoy en día como ideal es la mínimamente invasiva. A su vez la restauración de elección deberá ser aquella que respete mayor cantidad de tejido remanente a la hora de seleccionar la restauración coronaria. Se deberá considerar la cantidad y la calidad del remanente dentario sano, como los requisitos funcionales de cada pieza en particular. Si bien existen diversos tipos de restauraciones que podrían rehabilitar un DTE, en este trabajo sólo nos referiremos a las de inserción rígida, específicamente a las endo-onlays, también denominadas endocrowns (AU)

Resistência de união de pinos de fibra de vidro utilizando diferentes tratamentos radiculares / Resistencia a la unión de postes de fibra de vidrio utilizando diferentes tratamientos endodónticos / Bond strength of glass fiber posts using different endodontic treatments

Resumo Introdução: Os pinos de fibra de vidro têm sido amplamente utilizados na reconstrução de elementos com perda excessiva de estrutura dentária. Objetivo: Avaliar a força de adesão de pinos de fibra de vidro após diferentes tratamentos radiculares em diferentes regiões (terço cervical, médio e apical) da dentina radicular. Métodos: Este é um estudo experimental in vitro. Quarenta dentes bovinos foram selecionados, preparados e distribuídos em quatro grupos de acordo com o tratamento de superfície utilizado: adesivo (1), agente quelante (2), ácido poliacrílico (3), não tratado (4). A cimentação dos pinos de fibra de vidro foi realizada com cimento resinosante autocondicionante. Após vinte dias, cada raiz foi cortada em três fatias (um milímetro de espessura) obtidas de três regiões. A resistência de união de cada seção foi determinada usando um teste de resistência da junta de encaixe. Os dados de resistência à flexão (MPa) foram analisados pelos testes ANOVA e Tukey (α = 0,05). Resultados: Na porção cervical, o grupo com tratamento prévio com ácido poliacrílico apresentou menor resistência ao cisalhamento por extrusão (push-out) do que o grupo sem tratamento prévio. O grupo com aplicação do sistema adesivo (28,89 ± 6,64 MPa) e o grupo com tratamento prévio com EDTA (21,58 ± 6,39 MPa) não apresentaram diferenças estatisticamente significantes em relação ao grupo sem tratamento prévio (grupo controle) no terço cervical. Nas porções média e apical, o grupo tratado com adesivo FGM Ambar apresentou maiores valores de ligação em comparação com os outros grupos. Conclusão: A aplicação prévia do adesivo aumentou a resistência de união nos terços médio e apical, em comparação aos outros grupos, podendo ter um efeito benéfico no sucesso clínico do tratamento restaurador(AU)

Resumen Introducción: Los postes de fibra de vidrio se han utilizado ampliamente en la reconstrucción de elementos con pérdida excesiva de estructura dental. Objetivo: Evaluar la fuerza de adhesión de postes de fibra de vidrio después de distintos tratamientos de raíz en diferentes regiones (tercios cervical, medio y apical) de dentina de raíz. Métodos: Estudio experimental in vitro. Se seleccionaron cuarenta dientes bovinos, se prepararon y se distribuyeron en cuatro grupos de acuerdo con el tratamiento de superficie utilizado: (1) adhesivo, (2) agente quelante, (3) ácido poliacrílico, (4) sin tratar. La cementación de los postes de fibra de vidrio se realizó con cemento de resina autograbante. Después de 20 días, cada raíz se seccionó transversalmente en tres rodajas (1 mm de espesor) obtenidas de tres regiones. La resistencia a la unión de cada sección se determinó usando una prueba de resistencia al corte por extrusión (push-out). Los datos de resistencia a la flexión (MPa) se analizaron mediante pruebas ANOVA y Tukey (α = 0,05). Resultados: En la porción cervical, el grupo con tratamiento previo de ácido poliacrílico mostró menor resistencia que el grupo sin tratamiento previo. El grupo con aplicación del sistema adhesivo (28,89 ± 6,64 MPa) y el grupo con tratamiento previo de EDTA (21,58 ± 6,39 MPa) no presentaron diferencias estadísticamente significativas en comparación con el grupo sin tratamiento previo (grupo control) en el tercio cervical. En las porciones media y apical, el grupo tratado con adhesivo Ambar® de FGM Dental Group mostró valores más altos de unión en comparación con los otros grupos. Conclusión: La aplicación previa del adhesivo aumentó la fuerza de unión en los tercios medio y apical, en comparación con los otros grupos, puede tener un efecto beneficioso sobre el éxito clínico del tratamiento restaurador(AU)

ABSTRACT Introduction: Glass fiber posts have been widely used for the reconstruction of elements with excessive dental structure loss. Objective: Evaluate the bond strength of glass fiber posts after various root dentin treatments in different regions (cervical, middle and apical thirds). Methods: An experimental in vitro study was conducted. Forty bovine teeth were selected, prepared and distributed into four groups according to the surface treatment used: (1) adhesive, (2) chelating agent, (3) polyacrylic acid, (4) not treated. The glass fiber posts were cemented with self-etch resin cement. After 20 days, each root was sectioned crosswise into three slices (1 mm in thickness) obtained from three regions. Bond strength was determined in each section with a push-out bond strength test. Flexural strength data (MPa) were analyzed with ANOVA and Tukey's tests. Results: In the cervical portion, the group with previous polyacrylic acid treatment displayed lower push-out strength than the group without previous treatment. The group with application of the adhesive system (28.89 ± 6.64 MPa) and the group with previous EDTA treatment (21.58 ± 6.39 MPa) did not exhibit any statistically significant differences in comparison with the group without previous treatment (control group) in the cervical third. In the middle and apical portions, the group treated with the adhesive Ambar® of FGM Dental Group showed higher bond values in comparison with the other groups. Conclusion: Previous adhesive application increased bond strength in the middle and apical thirds in comparison with the other groups, and may thus have a beneficial effect on the clinical success of the restorative treatment(AU)

A Fiberglass and Resin Post Technique Combined with Fragment Collage of an Upper Central Incisor: Multidisciplinary Treatment / Unión de fragmento de un incisivo central superior con una técnica combinada: Tratamiento multidisciplinario

ABSTRACT: The clinical treatment of anterior tooth fractures requires specialized knowledge, technical skill, and a degree of artistic sense to ensure successful treatment. Herein, we describe the reattachment of an original tooth fragment with endodontic involvement via the utilization of a micro-hybrid composite resin and an aesthetic fiberglass post.

RESUMEN El tratamiento clínico de las fracturas coronarias en dientes anteriores superiores requiere de conocimientos especializados, habilidades técnicas y un grado de sentido artístico para garantizar un exitoso tratamiento. En este reporte de caso, se describe la unión de un fragmento de un incisivo superior, que requirió previamente un tratamiento endodóntico, mediante la utilización de una resina compuesta micro- híbrida y un poste de fibra de vidrio.

Mínimo espesor dentinario de conductos de premolares preparados para postes de fibra / Minimum dentin thickness in premolars after root canal and fiber post preparation

INTRODUCCIÓN: Los elementos tratados endodónticamente pierden estructura dentinaria, como resultado de caries, preparación de acceso endodóntico y ensanchamiento para pernos. La preparación del espacio para poste consiste en conformar el conducto radicular, que posee formas irregulares y variables, generando un espacio de formas regulares que se correspondan con las del poste. El espacio para el poste no debe exceder un tercio del diámetro de la raíz y el espesor de dentina remanente no debe ser menor de 1 mm. OBJETIVO GENERAL: Evaluar in vitro el espesor de dentina residual en premolares con un solo conducto luego de la instrumentación endodóntica y posterior preparación para poste de fibra de vidrio. OBJETIVOS ESPECÍFICOS: 1) Medir el espesor dentinario desde la superficie del conducto hasta la superficie externa de la raíz. 2) Reconocer la zona de mínimo espesor de dentina en el espacio del conducto preparado para poste, entre la obturación de gutapercha y el hombro tallado en el elemento dentario. 3) Comparar la ubicación de la zona de mínimo espesor entre los elementos dentarios. 4) Determinar en qué cara del elemento dentario, libre o proximal, se observa el mínimo espesor dentinario. MATERIALES Y MÉTODOS: Se seleccionaron 20 premolares extraídos con un solo conducto radicular. Se tomaron radiografías de frente y perfil, y posteriormente se talló la cavidad de acceso coronario. Se realizó un pre-tallado coronario y se instrumentaron los conductos con el Sistema Reciproc Blue (VDW). Se procedió a la obturación con cono de gutapercha y cemento Ad-Seal (META) mediante la técnica de compactación lateral. Se realizó la preparación para poste de fibra de vidrio con fresa Gates Glidden n°2, fresa Peeso n°1, seguida de la n°2 y se finalizó con el ensanchador para postes RTD N°2; dejando 5 mm de obturación con gutapercha a nivel apical. Se tomó una tomografía computada de haz cónico (CBCT) sobre la cual se realizaron las mediciones de los espesores de dentina, desde la superficie del conducto radicular hasta la superficie externa de la raíz, en las caras libres y proximales del elemento dentario. Se registraron las mediciones a la altura del hombro de tallado coronario, a la altura del conducto donde comienza la obturación con gutapercha y en un punto equidistante entre el hombro y la gutapercha. Los datos obtenidos fueron registrados en una hoja de captura de datos y analizados estadísticamente mediante el test Student Newman Keuls. RESULTADOS: En 5 piezas dentarias el espesor residual de dentina fue menor a 1 mm. El promedio de mesial y distal fue significativamente menor que las caras libres. Los mínimos espesores dentinarios se presentaron en mesial y distal del nivel apical, seguido por mesial de la zona media. CONCLUSIÓN: La preparación del conducto para la colocación de postes de fibra en premolares implica remoción de dentina y el mínimo espesor remanente fue observado en las caras mesial y distal de la raíz. (AU)

INTRODUCTION: Endodontically treated teeth lose dental structure, as a result of caries, endodontic access and post space preparation. This space is prepared by conforming the root canal which has irregular and variable shapes, creating a space which shape corresponds with the posts.Post space should not exceed one third of the root diameter and the residual dentin thickness should not be less than one millimiter GENERAL OBJECTIVE: To evaluate in vitro the residual dentin thickness of premolar root canals after endodontic instrumentation and post space preparation. SPECIFIC OBJECTIVES: 1. To measure dentin thickness from the canal to the external surface of the root. 2. To recognize the area with mínimum dentin thickness in the post space. 3.To compare the location of the area with minimum dentin thickness between theeth. 4.To determine the site of the tooth where the minimum dentin thickness is located. MATERIAL AND METHODS: Twenty extacted premolars with one canal were selected. Buccal and proximal radiographs were taken and access cavities were prepeared. A pre-carved was done in the crown, and the canals were instrumented with the Reciproc Blue system (VDW). Root canals were obturated with gutapercha cones and AD SEAL sealer, using lateral condensation technique. Post space preparation was performed No 1 Gates-Glidden drills, No 1 and No 2 Peesso drills and No 2 specific RTD drills, leaving five millimeters of gutapecha obturation in the apical level. A Cone- Beam Computed Tomography (CBCT) was taken and cross-sections measurements were calculated from the canal to the external surface of the root. Residual dentin thickness was registered at three levels: obturation with gutapecha, the carved shoulder and equidistant point between previous both points. Obtained data was registered for statistical analysis by Student Newman Keuls test. RESULTS: Residual dentin thickness was lower than 1mm in 5 teeth. The difference between mesial/distal dentin thickness and buccal/lingual dentine thicknes was statistically significant. Minimum dentin thickness were observed at mesial and distal sides, at apical level, followed by medium level. CONCLUSION: Root canal and fiber post preparation in premolars remove dentin structure and the minimum residual thickness was observed at mesial and distal sides of the root. (AU)

Evaluation of the risk of metabolic syndrome among shift workers in Tunisia.

BACKGROUND: Shift work is a source of health problems for workers around the world. The metabolic syndrome is one of the pathologies that can occur because of this work pattern. AIMS: Investigate possible association between shift work and the development risk of the metabolic syndrome (MS). METHODS: A cross-sectional study was conducted among male gender agents of company of electricity production in the Center of Tunisia. This population was divided into two groups according to the organization of their work: a group of shift workers and a group of non-shift workers. Data collection was based on a questionnaire, a clinical examination and a biological assessment. The definition of International Diabetes Federation 2005 (IDF) was adopted to retain the diagnosis of the MS. RESULTS: A total of 263 agents responded to our invitation with a participation rate of 65.5%. The shift workers group accounted for 48.3% of the participants and the fixed workers group accounted for 51.7% of the participants. The diagnosis of MS was retained in 51.2% of shift workers and 27.2% of non-posted workers, with a statistically significant difference (p <10-3). This association persisted after adjusting for the confounding variables with an OR of 2.64 [1.38-5.04]. CONCLUSION: Our study underlined a higher risk of MS development among shift workers. These findings highlight the importance of taking specific preventive measures. This prevention is based not only on hygieno-dietetic measures and regular physical activity, but also the improvement of working conditions.

Pretratamiento y mejoría de la fuerza de unión de los cementos autoadhesivos de resina a los postes / Pretreatment and improvement of bonding strength of self-adhesive resin cements to posts

ABSTRACT Introduction: Posts and core are frequently used in endodontically treated teeth with excessive loss of coronal tooth structure. Objective: To evaluate the effectiveness of self-adhesive cements under different pre-treatments of dentin in the resistance to extrusion of fiberglass posts. Methods: An experimental in vitro study was conducted. The randomly selected sample was 56 extracted bovine incisors with mature apices and without root curvature. Before the cementing procedure, pretreatment of dentin was performed with 11.5 percent polyacrylic acid, 17 percent EDTA or sodium hypochlorite. The type of failure between the post/cement/dentin was evaluated by stereomicroscope. Two hundred and sixteen bovine dentin discs were used. The disks were approximately 1 mm thick, and were obtained from 72 bovine roots restored with intraradicular retentions. Data were analyzed for better comprehension in an SPSS database for Windows version 15. Results: The highest values were found in groups G3, G4 and G5, and there was no bond strength significant difference in group G2. Conclusions: The pre-treatment had no effect on dentin bond strength, and the self-adhesive cement RelyX U100 appears to be a viable option in the cementation of fiber posts(AU)

RESUMEN Introducción: Los postes y el núcleo se utilizan con frecuencia en los dientes tratados endodónticamente con una pérdida excesiva de la estructura dental coronal. Objetivo: Evaluar la efectividad de los cementos autoadhesivos bajo diferentes pretratamientos de dentina en la resistencia a la extrusión de postes de fibra de vidrio. Métodos: Se realizó una investigación experimental in vitro en 56 dientes de ganado seleccionados al azar con cierre apical maduro y sin curvaturas radiculares. Antes del procedimiento de cementación, se llevó a cabo el pretratamiento de la dentina con 11,5 por ciento de ácido poliacrílico, 17 por ciento de EDTA o hipoclorito de sodio. El estereomicroscopio evaluó el tipo de falla entre el poste / cemento / dentina. Se usaron 216 discos de dentina bovina. Los discos tenían aproximadamente 1 mm de espesor y se obtuvieron de 72 raíces bovinas restauradas con retenciones intrarradiculares. Los datos se analizaron para una mejor comprensión en una base de datos de SPSS para Windows versión 15. Resultados: Los valores más elevados fueron encontrados en los grupos G3, G4 y G5 y no fue significativa la prueba de resistencia en el grupo G2. Conclusiones: El pretratamiento no tuvo efecto sobre la fuerza de unión dentinaria, y el cemento autoadhesivo RelyX U100 parece ser una opción viable en la cementación postes de fibra(AU)

Tratamiento multidisciplinario de diente con pronóstico desfavorable. Reporte de caso / Multidisciplinary tooth treatment with unfavorable prognosis. Case report

RESUMEN: Las perforaciones radiculares son uno de los accidentes que pueden ocurrir dentro del tratamiento endodóntico rehabilitador de un diente y comprometen el pronóstico de éste. El objetivo de este reporte es describir el tratamiento y seguimiento de un diente con pronóstico desfavorable, con falsa vía y perforación en el 1/3 medio radicular. El manejo de la perforación se realizó con BiodentineTM y la rehabilitación con prótesis fija unitaria con poste de fibra individualizado. A los controles clínicos y radiográficos de 6, 12 y 24 meses el tratamiento se encontró asintomático y en función, pudiéndose considerar exitoso.

ABSTRACT: A radicular perforation is a mishap that can occur during the Endodontic and Restorative Treatment of a tooth and it can compromise its short and long-term prognosis. The aim of this report is to describe the treatment and follow up of a tooth with an unfavorable prognosis that had a perforation in the radicular middle third. The perforation was repaired with BiodentineTM and a fiber post and crown were placed. The patient had a follow up at 6, 12 and 24 months and the tooth was found asymptomatic and functional, which can be considered a clinical success.

Does Sterilization Affect the Push Out Bond Strength of Experimental Dentin Posts? / ¿Afecta la esterilización la fuerza de adherencia de los postes de dentina experimentales?

ABSTRACT The purpose of this preliminary study is to evaluate the push-out bond strength (PBS) of experimental dentin posts (EDPs) obtained from human and bovine teeth sterilized by autoclaving and gamma radiation. Eighty-four mandibulary premolars were obturated and divided into three post groups: the glass fiber group (Fb) human EDP group (Hm) and the bovine EDP group (Bv). Three subgroups (n=12) were obtained for each EDP groups according to the sterilization methods; no sterilization (Cnt), steam autoclaving (Aut), and gamma radiation (Rad) a total dose of 25 kGy. All posts were cemented to root canals using a dual cured resin cement (Panavia SA). After the micro slices (1mm in thickness) were obtained of each subgroup, PBS test was performed. Data were analyzed using two-way ANOVA and Tukey's multiple comparison tests (α=.05). The post type and sterilization method was significantly effective on the PBS values according to the ANOVA (P<.001). No sterilization apllied EDP groups showed significantly higher PBS values than the sterilized groups (P<.001). Bv_Cnt (9.42 ±1.31) showed significantly lower PBS values than both Fb (12.36 ±1.54) and Hm_Cnt (11.06 ±1.38) groups (P<.001). Both steam autoclaving and gamma radiation affect the PBS values and fracture modes of EDPs negatively. The bovine EDPs are not as effective as human EDPs with regard to the PBS to the root dentin.

RESUMEN El propósito de este estudio preliminar es evaluar el push-out bond strength de los postes de dentina experimentales (PDE) obtenidos de dientes humanos y bovinos esterilizados por autoclave y radiación gamma. Ochenta y cuatro premolares mandibulares fueron obturadores y se dividieron en tres grupos experimentales de postes: el grupo de fibra de vidrio (Fb) grupo PDE humano (Hm) y el grupo PDE bovino (Bv). Se obtuvieron tres subgrupos (n=12) para cada grupo de PDE según los métodos de esterilización; sin esterilización (Cnt), autoclave a vapor (Aut) y radiación gamma (Rad) con una dosis total de 25 kGy. Todos los postes se cementaron a los conductos radiculares utilizando un cemento de resina de curado doble (Panavia SA). Después de que se obtuvieron las micro rebanadas (1 mm de espesor) de cada subgrupo, se realizó una prueba de push-out bond strength. Los datos se analizaron utilizando ANOVA de dos vías y las pruebas de comparación múltiple de Tukey (α=.05). El tipo de poste y el método de esterilización fueron significativamente efectivos en los valores de push-out bond strength según el ANOVA (P <.001). Los grupos de PDE no aplicados a la esterilización mostraron valores de push-out bond strength significativamente mayores que los grupos esterilizados (p <0,001). Bv_Cnt (9.42 ±1.31) mostró valores de push-out bond strength significativamente más bajos que los grupos Fb (12.36 ±1.54) y Hm_Cnt (11.06 ±1.38) (P <.001). Tanto el autoclave al vapor como la radiación gamma afectan negativamente los valores de push-out bond strength y los modos de fractura de los PDE. Los PDE bovinos no son tan efectivos como los PDE humanos con respecto a la fuerza de adhesión a la dentina de la raíz.

Uso de un poste y núcleo de fibra de vidrio compuesto fabricados con CAD / CAM para restaurar un diente tratado endodónticamente: reporte de caso / Use of a CAD / CAM-fabricated composite fiberglass post and core to restore an endodontically treated tooth: case report

En la actualidad existe un amplio uso de los postes de fibra de vidrio. Sin embargo, tienen la desventaja que su forma no se pueden cambiar y son inadecuadas para casos de dientes con amplia destrucción coronal y conductos radiculares amplios. Este reporte de caso clínico describe el uso de un poste y núcleo de fibra de vidrio fabricados con un sistema CAD/CAM para restaurar un diente premolar inferior tratado endodónticamente. Este poste de fibra de vidrio CAD/CAM se adapta mejor al conducto radicular que un poste prefabricado, sin necesidad de emplear resina compuesta para el muñón y reduce el espesor de la capa de cemento.

Currently, there is a wide use of fiberglass post. However, they have the disadvantage that their shape can not be changed and are inadequate for cases of teeth with extensive coronal destruction and wide root canals. This case report describes the use of a fiberglass post and core manufactured with a CAD / CAM system to restore a lower premolar tooth treated endodontically. This CAD / CAM fiberglass post adapts better to the root canal than a prefabricated post, without the need to use composite resin for the stump and reduces the thickness of the cement layer.