Comparison of push-out bond strength and apical microleakage of different calcium silicate-based cements after using EDTA, chitosan and phytic acid irrigations

This research was aimed to evaluate push-out bond strength and apical-microleakage after application of three different calcium silicate-based cements with irrigation solutions on simulated immature teeth. 40 maxillary permanent canine teeth were used for push-out bond strength test, and 120 maxillary permanent incisors were used for microleakage evaluation. 120 root slices were divided into four main groups (EDTA, Chitosan, Phytic acid, and Saline) and immersed these solutiouns according to irrigation procedures. Each irrigation group was divided into 3 subgroups (Biodentine, MTA Repair HP, and NeoPUTTY). The prepared teeth were divided into four groups according to irrigation procedure for microleakage test. EDTA irrigation with Biodentine group showed highest push-out bond strength value and saline group with Neoputty showed the lowest push-out bond strength value. The highest microleakage value was seen in saline group with MTA Repair HP, while the lowest microleakage value was observed chitosan with Biodentine group. Chitosan and phytic acid solutions can be recommended as an alternative irrigation solution to 17% EDTA in single-session apexification treatment, since they are non-toxic, naturally occurring materials, effectively remove the smear layer, and have a positive effect on bond strength and apical leakage. RESEARCH HIGHLIGHTS: One of the factors affecting the long-term success of root canal treatment is a hermetic seal. Non-hermetic or inadequate filling triggers a chronic inflammatory reaction in periapical tissues, causing fluids to enter the spaces and negatively affecting the success of the treatment. Therefore, this study will help clinicians choose the right biomaterial and irrigation solution that will affect the success of root canal treatment.

Comparison of the analgesic efficacy of the ultrasound-guided transversalis fascia plane block and erector spinae plane block in patients undergoing open inguinal hernia repair under spinal anesthesia

BACKGROUND

Open inguinal hernia repair (OIHR) surgery is a common surgical procedure, and ultrasound guided interfascial plane blocks can also be included in current approaches to postoperative multimodal analgesia regimens. This study aimed to compare the postoperative analgesic efficacy of the erector spinae plane block (ESPB) and transversalis fascia plane block (TFPB) in patients undergoing OIHR.

METHODS

This prospective, randomized, assessor-blinded comparative study was conducted in the postoperative recovery room and ward of a tertiary hospital. A total of 80 patients with American Society of Anesthesiologists physical status I-III were enrolled and allocated equally to either the ESPB or TFPB group. The patients received standard multimodal analgesia in addition to an ultrasound-guided ESPB or TFPB. During the first 24 h postoperatively, tramadol consumption was assessed and pain levels at rest and during movement were compared using numeric rating scale (NRS) scores at 1, 3, 6, 9, 12, 18, and 24 h postoperatively.

RESULTS

The results showed no difference in NRS scores at any time point between the groups, except for NRS at rest in the third hour. However, tramadol consumption was lower in the TFPB group than in the ESPB group overall (88 ± 75.2 vs. 131 ± 93.7 mg, respectively; P = 0.027, mean difference: -43, 95% CI [-80.82, -5.18]).

CONCLUSIONS

The TFPB leads to lower tramadol requirements in the first 24 h postoperatively than the ESPB in patients undergoing OIHR.

The effect of various inhaled asthma medications on the color stability of paediatric dental restorative materials

BACKGROUND

The purpose of the study is to analyse the effects of different inhaled asthma medications (IAMs) on the color change of dental restorative materials (DRMs).

METHODS

In total, 192 samples were taken from six different DRMs: [Filtek Z550 (nanohybrid composite), Fusio Liquid Dentin (Self-adhering flowable composite), Filtek Ultimate (nanofilled flowable composite), Dyract XP (compomer), Fuji II LC (resin-modified glass ionomer), Fuji IX Fast (self-cured-packable glass ionomer), (n = 32)]. After the initial color values (CIELab) of DRMs were measured by using a spectrophotometer, each sample was exposed to the same IAMs via nebulizer according to the four different inhaled therapies and measurements were repeated on the 7th & 21st days.

RESULTS

In all IAM groups, DRM with the least amount of ΔE was nanohybrid composite, while the highest ΔE was found in Fuji II LC. Among all experimental groups, only Fuji II LC which was administered the combined medication, exceeded the clinically unacceptable threshold (ΔE = 3.3) on 7th & 21st days.

CONCLUSIONS

Consequently, important factors affecting the susceptibility to color stability are the type of IAMs, the administration time-dosage, and the type of DRMs.

Analysis of the bond strength between conventional, putty or resin-modified calcium silicate cement and bulk fill composites

BACKGROUND

The aim of this study was to evaluate the shear bond strength of three different calcium silicate-based cements (CBCs) with two different bulk-fill composite resins (CRs).

METHODS

Plexiglas moulds with a diameter of 4 mm and a thickness of 2 mm were prepared (n = 60). The Biodentine, NeoPutty and MTA Cem LC samples were randomly divided into two subgroups containing 10 samples each. Surfaces of samples were air dried and Single Bond universal adhesive was applied. Cylindrical plastic capsules of 4 mm height and 2 mm inner diameter belonging to Filtek Bulk-fill and EverX Posterior CRs were centred on coating material and polymerized for 20 s. After shear bond strength (SBS) testing, all samples were examined by scanning electron microscopy (SEM) to identify failure patterns. Three samples, one from each group, were prepared to evaluate chemical composition of CBCs and examined with an energy dispersive X-ray spectroscopy for surface elemental analysis.

RESULTS

The values obtained from the tests were evaluated as statistically significant (P < 0.05). After SBS testing, the difference between all CBCs was statistically significant in both CRs.

CONCLUSION

According to the findings in this study, it was concluded that MTA Cem LC had highest SBS values in both CRs. © 2023 Australian Dental Association.

Chylothorax due to thrombosis of the jugular and subclavian veins in a patient with gastric cancer: a case report

BACKGROUND

Chylothorax is a rare condition due to leakage of chyle in the thoracic cavity. When large amounts of chyle leak into the thoracic cavity, it can lead to severe respiratory, immune, and metabolic complications. Chylothorax has many potential underlying etiologies, and the most common causes are traumatic chylothorax and lymphoma. Venous thrombosis of the upper extremities is a rare cause of a chylothorax.

CASE PRESENTATION

A 62-year-old Dutch man with a medical history of gastric cancer, treated with neoadjuvant chemotherapy and surgery 13 months prior, presented with dyspnea and a swollen left arm. Computed tomography thorax showed bilateral pleural effusion that was more prominent on the left side. The computed tomography scan further revealed thrombosis of the left jugular and subclavian veins and osseal masses suggesting cancer metastasis. Thoracentesis was performed to confirm the suspicion of gastric cancer metastasis. The obtained fluid was milky with a high level of triglycerides, but contained no malignant cells; hence, the diagnosis of the pleural effusion was chylothorax. Treatment with anticoagulation and a medium-chain-triglycerides diet was started. Furthermore, bone metastasis was confirmed with a bone biopsy.

CONCLUSION

Our case report demonstrates chylothorax as a rare cause of dyspnea in a patient with pleural effusion and a history of cancer. Therefore, this diagnosis should be considered in all patients with a history of cancer with new-onset pleural effusion and thrombosis of the upper extremities or clavicular/mediastinal lymphadenopathy.

Results of 301 Parotidectomies: A Twenty-Year Experience of One Single Institution

To evaluate demographic, clinical, surgical and histopathological results and complications of 301 parotidectomies performed in southern part of Turkey. The results of 297 patients undergoing 301 parotidectomies between 2000 and 2019 were retrospectively reviewed. Four patients underwent bilateral parotidectomy. Age, gender, side and size of lesion, postoperative facial nerve function (FNF) for benign tumors and types of surgery were evaluated. There were 172 male and 125 female patients. The mean age was 52.53 ± 16.67 years (range 11-90 years). Patients with malignant tumor had higher mean age than the patients with benign diseases (p < 0.001) and the mean age of Warthin tumor (WT) patients was significantly higher than pleomorphic adenoma (PA) (p < 0.001). There was a significant male dominancy in WTs than the PAs (p < 0.001). The mean size of the malignant tumors was significantly higher than the benign tumors (p = 0.012). The mean of cigarette smoking value (pack/year) was higher in WTs than the PAs (p < 0.001). WT incidence was slightly higher than PA in between years 2010 and 2019 (p = 0.272) compared to between years 2000 and 2009. Fine needle aspiration biopsy had a sensitivity of 96% and specificity of 78% for the benign tumors. Tumor location (p < 0.001) and tumor size (p = 0.034) had negative effect on the postoperative FNF. The incidence of WT had a significant rise in the last decade. Deep lobe tumors and increased tumor size had effect postoperative FNF. Experience of surgeon is more important than nerve monitoring to prevent facial paralysis. Partial superficial parotidectomy was available methods for small benign tumors in tail of the parotid gland.

Colour agreement between try-in paste and resin cement: effect of background on zirconia-reinforced lithium silicate

PURPOSE

To investigate colour agreement between different shades of Panavia V5 resin cement and their try-in pastes under zirconia-reinforced lithium silicate ceramics.

METHODS

Forty-four zirconia-reinforced lithium silicate ceramic specimens were prepared at 0.8 ± 0.01 mm thickness. Composite resin tooth-shaded background specimens were obtained in two shades. Resin cement specimens were fabricated at 0.1-mm thickness. Colour difference values (ΔE) between Aquagel and both the try-in paste and resin cement were calculated using the CIE-Lab system. The CIEDE2000 (ΔE00) colour formula was used to determine colour differences. The three-way ANOVA test and a multiple comparisons test were used for statistical analysis (α = 0.05).

RESULTS

A statistically significant difference was found between the ΔE00 values obtained from the cement shade colour measurements for all specimens (P < 0.05). According to the three-way ANOVA test, lower ΔE00 values were observed in the try-in paste group compared to the resin cement group. The ΔE00 values were significantly affected by the cement shade and tooth-shaded background (P < 0.05).

CONCLUSIONS

The colour agreement between the try-in pastes and the corresponding resin cement differed, and the try-in pastes could not mask the dark dental background as much as the corresponding resin cement.

Evaluation of the microhardness of different resin-based dental restorative materials treated with gastric acid: Scanning electron microscopy-energy dispersive X-ray spectroscopy analysis

The aim of this study is to evaluate the microhardness, relative surface roughness, and elemental changes of resin-based dental restorative materials (RDRMs) after gastric acid treatment. Five different RDRMs (Group 1 [Filtek Z550], Group 2 [Beautifil II], Group 3 [Vertise Flow], Group 4 [Dyract XP], Group 5 [Fuji II LC]) were used. Samples were formed by using plexiglass molds of 10 mm diameter and 2 mm thickness. A total of 50 samples (n = 10) for microhardness tests and a total of 15 samples (n = 3) for scanning electron microscopy (SEM)-energy dispersive X-ray spectroscopy (EDX) analysis were prepared. All samples of each group were treated to gastric acid, simultaneously. A Vickers microhardness tester was used to evaluate the microhardness of the upper surfaces of each sample. SEM-EDX system was used for microstructure and elemental composition detection. The SEM-EDX, microhardness and relative surface roughness analysis were made prior to treatment in gastric acid for 14 days and analysis were repeated on the 14th day. As the difference in the microhardness values of RDRMs was compared, the time-dependent variation in all RDRMs was found to be statistically significant. It was observed that a drastic decrease in microhardness values was in Beautifil II, Filtek Z550, Vertise Flow, Fuji II LC, and Dyract XP, respectively. Average decrease rate of microhardness values compared to the initial state can be listed from high to low as Beautifil II (%35.72), Vertise Flow (% 28.88), Fuji II LC (% 21.09), Dyract XP (%17.60), and Filtek Z550 (% 16.58). As a result, in in-vitro conditions gastric acid decreased microhardness while increasing the relative surface roughness of RDRMs.

The effect of various asthma medications on surface roughness of pediatric dental restorative materials: An atomic force microscopy and scanning electron microscopy study

The aim of the study is to examine and compare the effects of various inhaled asthma medications (IAMs) on the surface roughness of dental restorative materials (DRMs). In total, 192 samples were prepared including 32 samples for the each material group from six different DRMs [Nanohybrid composite (Filtek Z550), Nanofilled flowable composite (Filtek Ultimate), Compomer (Dyract XP), Conventional glass ionomer (Fuji IX Fast), Resin-modified glass ionomer (Fuji II LC), Self-adhering flowable composite (Fusio Liquid Dentin)]. Each group, were divided into four subgroups (n = 8) according to four different IAMs. Surface roughness values (Ra) were obtained by atomic force microscopy (AFM). After the initial roughness of DRMs was analyzed by using AFM and scanning electron microscopy (SEM), each samples were exposed to the same IAMs for 21 days and all analysis were repeated on the 7th and 21st day. Ras increased in all DRMs and higher Ras were recorded through the long-term IAMs administrations. For all IAMs, Fuji II LC had the highest Ra and Filtek Z550 had the lowest Ra. The combined IAM created the highest roughness change on the 7th and 21st day compared to other IAMs. As a result, in in vitro conditions IAMs significantly increased the surface roughness of DRMs.

Renal Frame Count and High Blood Pressure

OBJECTIVE

The aim of the present study was to demonstrate the relationship between hypertension stages according to JNC-8 classification and mean renal frame count (RFC), which is an indicator of renal perfusion.

METHODS

In this retrospective study, 100 hypertensive patients without obstructive renal artery disease, who had been evaluated with renal artery angiography for hypertension, were allocated into 2 groups (Stage 1 and Stage 2 hypertension). During coronary angiography, the patients were evaluated by selective renal angiography using 6F Judkins catheter. Cineangiographic images were evaluated by the same clinician and mean RFC was estimated for both renal arteries. Injections during renal angiography were performed with power injector and same amount of radiopaque media with same speed was used for all patients.

RESULTS

There was no significant difference between the groups in terms of age, sex, duration of hypertension, and laboratory markers. Stage 2 hypertensive patients (Group 2) had a significantly higher mean RFC than Stage 1 hypertensive patients (Group 1) (p<0.001). The mean RFC of both kidneys in Group 2 was significantly higher than that of Group 1 (p<0.001 and p=0.023, respectively).

CONCLUSIONS

This study showed that the mean RFC increased with increases in hypertension levels and it could be used as an indicator of renal perfusion, which is an indirect marker of renal function. If renal artery flow gets slower, blood pressure levels increase and there is a proportional relationship between these two variables (mean RFC and blood pressure levels). This study also demonstrated that there was a statistically significant correlation between mean RFC and JNC-8 hypertension stages.

Plasma galectin-3 as a biomarker for clinical staging of heart failure: a cross-sectional evaluation of 100 cases

OBJECTIVES

To evaluate the plasma galectin-3 concentration associated with the severity of HF and its use as a biomarker for clinical staging of heart failure (HF).

METHODS

This was a cross-sectional study, in which 100 HF cases diagnosed by clinical parameters and echocardiography were included and subgrouped into NYHA classes (I-IV) based on clinical severity and functional limitations. Plasma galectin-3 was measured with respect to these subgroups.

RESULTS

The median plasma galectin-3 concentration in pg/mL was 82.7 (95% confidence interval: 64.5-112.7), 267.2 (214.3-293.5), 694.8 (626.4-902.4), and 1530.4 (1443.1-2384.4) in NYHA class I, II, III, and IV subgroups, respectively (p <0.05). The proposed galectin-3 concentrations in mild, moderate, and severe HF were 100-460, 460-1170, and >1170 pg/mL, respectively. Galectin-3 was negatively correlated with LV Ejection fraction (EF) by Simpson's biplane method (r=-0.634, p<0.001). Pro BNP showed that the level of plasma galectin-3 was positively correlated with the level of plasma NT pro BNP (r = 0.878, p <0.001).

CONCLUSIONS

The plasma galectin-3 concentration showed progressive increase with increasing severity of HF; therefore, it may be used in clinical staging of the disease.

Comparison of microtensile bond strength and resin-dentin interfaces of two self-adhesive flowable composite resins by using different universal adhesives: Scanning electron microscope study

The aim of this in-vitro study was to evaluate microtensile bond strength (μTBS) of two different self-adhesive composites (SACs) on the permanent dentin by applying five different universal adhesive systems. In this study, two different SACs [Vertise Flow (VF), Fusio Liquid Dentin (FLD)] and five different bonding systems [Clearfil Universal Bond Quick (CUB), Single Bond Universal (SBU), All Bond Universal (ABU), Prime Bond Universal (PBU), Futurabond U (FBU)] were used. A total of 22 groups were created in which SACs were applied without adhesive and with five different universal bonding agents in total-etch (TE) and self-etch (SE) modes. Two hundred and forty test sticks were obtained using 48 healthy human molar teeth in total with groups having 10 samples each. The μTBS test was applied to each sample in the Universal test device and the data obtained were analyzed statistically by variance analysis and Tukey HSD test. In addition, the resin-dentin interface and fractures modes in the groups were examined by SEM. Upon examining the μTBS results, the highest values were seen in the use of SBU adhesive in TE mode in VF group, while the lowest values were seen in the FLD control group. The difference between the control and experimental groups was found statistically significant (p < .05). Upon comparing the control groups with each other, it was seen that VF group had higher μTBS values than FLD group and the difference between the groups was found statistically significant (p < .05). The μTBS results and SEM images of the study showed that the use of SACs with universal adhesive systems provides a more effective bond strength.

Supraclavicular Metastases from a Sex Cord Stromal Tumor of the Ovary

Metastases to the supraclavicular fossa usually originate from head and neck or infraclavicular tumors. Ovarian primaries of supraclavicular metastases are very rare. Sex cord stromal tumors of the ovary account for 5–8% of all ovarian malignancies and there have been only a few case reports on distant metastases from these tumors. A 46-year-old woman presented to us with a left supraclavicular mass. She had had a sex cord stromal tumor in the right ovary four years before. Comprehensive clinical investigation and fine-needle aspiration cytology were performed. The lesion had the characteristics of a sex cord stromal tumor. To our knowledge, this is the first report of such a case in the English literature. We discuss its pathological and clinical features in the light of the current knowledge.

The Role of Oxidative Stress and Inflammatory Mediators in Benign Paroxysmal Positional Vertigo

OBJECTIVE

Benign paroxysmal positional vertigo (BPPV) is the most common peripheral cause of vertigo. It can be defined as transient vertigo induced by rapid changes in head position associated with a characteristic paroxysmal positional nystagmus. The aim of this study was to search for the possible role of oxidative stress and inflammatory mediators in the pathogenesis of BPPV.

MATERIALS AND METHODS

Total antioxidant status as well as paraoxonase, tumor necrosis factor alpha, interleukin (IL) 6, and IL-1β levels were evaluated in peripheral venous serum samples of 30 BPPV and 30 control patients.

RESULTS

Total antioxidant status levels were lower in the BPPV group than in the control group (p=0.008). After Epley's repositioning maneuver in the vertigo group, there was a statistically significant decline in IL-1β levels at the first and third month visits (p=0.014 for first month and p=0.013 for third month).

CONCLUSION

Our findings suggested that IL-1β and oxidative stress contributed to the pathogenesis of BPPV.

Accessory Nostril: A Rare Congenital Nasal Anomaly

Accessory nostril is a very rare congenital anomaly with an unknown etiology also known as supernumerary nostril. A few accessory nostrils have been reported up to the present time, and extremely rare cases located on columella. A newborn infant with respiratory distress was referred to our hospital. The authors observed that accessory nasal nostril is not related to normal nasal cavity on the median line of columella. In this article, the authors reported accessory nostril case in newborn and review the literature.

Endoscopic Sphenopalatine Artery Ligation in Posterior Epistaxis: Retrospective Analysis of 30 Patients

Objective

Although posterior epistaxis is rarely seen, it is an important medical problem that both decreases the quality of life of the patient and causes difficulties in the management for otorhinolaryngologists. In this study, we aimed to present the results of 30 patients who underwent transnasal endoscopic sphenopalatine artery ligation (TESPAL) for posterior epistaxis in our department.

Methods

The records of 30 patients who underwent TESPAL from January 2014 to April 2016 were analyzed retrospectively, and the relationship between perioperative factors and need for revision surgery was assessed.

Results

The success rate of TESPAL in posterior epistaxis was 90%. There was no relationship between surgical failure and antiaggregant use (p=0.224), anticoagulant use (p=0.534), hypertension (p=0.564), previous nasal surgery (p=0.279), and bilateral TESPAL application (p=0.279). TESPAL was seen to be effective in cases with Osler-Weber-Rendu disease, pregnancy, and uncontrollable epistaxis after rhinoplasty surgery. Mortality was seen in one of our patients not related to endoscopic ligation in the follow-up period.

Conclusion

TESPAL is an effective method in the treatment of posterior epistaxis. Hypertension, antiaggregant or anticoagulant use, bilateral sphenopalatine artery ligation, and previous nasal surgery do not seem to be factors leading to surgical failure.

Clinical evaluation of apex locator and radiography in primary teeth

AIM

The aim of this in vivo study was to evaluate the accuracy and reliability of electronic apex locater and radiographic determination of root canal length in primary teeth.

METHODOLOGY

A total of 32 human primary molar teeth (96 roots) were selected. After endodontic access preparation, root canals were irrigated with physiological saline solution. The access cavities were dried with cotton pellets and, the roots were dried with paper points before performing the electronic measurement. The root canal length measurements were first taken with an apex locater (EndoMaster), and then, a size ♯ 15 K-file was inserted into the root canal, and radiography was taken to determine the working length measurements. The measurement data were recorded and compared by one-way anova and Kruskal-Wallis tests. P < 0.05 was accepted for the significance.

RESULTS

The mean values for radiography were 13.23 ± 1.92 mm and for EndoMaster were 13.08 ± 1.77 mm. The accuracy of EndoMaster was 80.2% in correct measurements ±1 mm (P < 0.001).

CONCLUSION

The electronic apex locators could be useful in determining working length and thereby decreasing the need for radiographs and exposure to ionizing radiation in pediatric dental patients.