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Stiklaru I, Lalum E, Hamoud S, Paz M, Levin A, Ben Itzhak J, Yavnai N, Gorenbein P, Solomonov M. The ability of different compositions of calcium silicate and epoxy sealers to withstand gutta percha removal via in vitro pull-out testing. BDJ Open 2024; 10:31. [PMID: 38589349 PMCID: PMC11001859 DOI: 10.1038/s41405-024-00212-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVE examination of the influence of chemical composition changes on the ability of sealers to withstand a pull-out test. MATERIALS AND METHODS Fifty distal or palatal canals of extracted teeth were prepared by Dc Taper files. The teeth were divided into five groups: AH Plus, BJM RCS, Total Fill BC,AH Plus Bioceramic and a group with Gutta Percha with no sealer added. Ten days after obturation, each cone was subjected to the "pull-out test" with the Shimadzo Universal Testing Machine until it was torn or removed from the canal. A force to Stroke graph was generated and the maximum vertex of this graph was recorded. The number of times the cone was torn or removed was recorded. RESULTS The amount of force needed to remove or rupture the cone was significantly higher in all sealer groups compared to the AH Plus Bioceramic group. The force needed for the AH Plus group was double that needed for the AH Plus Bioceramic group 4 (1.87 ± 0.53 N vs 0.93 ± 0.48 N, respectively, P < 0.001). All of the cones (n = 10) in the AH Plus Bio Ceramic Sealer group were removed in their entirety (P = 0.01 compared to each of the other groups). CONCLUSIONS The addition of macromolecules to epoxy sealer does not change the material's ability to withstand the pull-out test. Decreasing the amount of tri- and di-calcium silicate compounds combined with increasing amounts of zirconium oxide in a Bioceramic sealer significantly decreased the material's ability to withstand the pull-out test.
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Affiliation(s)
- Idan Stiklaru
- Department of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer, Shiba Road 2, Ramat- gan, Israel.
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel.
| | - Ella Lalum
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel
| | - Sobhi Hamoud
- Department of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer, Shiba Road 2, Ramat- gan, Israel
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel
| | - Maayan Paz
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel
| | - Avi Levin
- Department of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer, Shiba Road 2, Ramat- gan, Israel
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel
| | - Joe Ben Itzhak
- Department of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer, Shiba Road 2, Ramat- gan, Israel
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel
| | - Nirit Yavnai
- Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University, Hadassah Ein Kerem Campus, 12271, Jerusalem, Israel
| | - Pavel Gorenbein
- Medical Supplies, Pharmacy, and Biomedical Engineering Branch, Israel Defense Forces (IDF), Medical Corps, Tel Aviv, Israel
| | - Michael Solomonov
- Department of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer, Shiba Road 2, Ramat- gan, Israel
- "Bina" Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, 12271, Jerusalem, Israel
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Zur M, Gorenbein P, Nachshon A, Radomislensky I, Tsur AM, Benov A, Wagnert-Avraham L, Glassberg E. Post-expiry stability of freeze-dried plasma under field conditions - Can shelf life be extended? Transfusion 2021; 61:1570-1577. [PMID: 33594694 DOI: 10.1111/trf.16319] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/15/2020] [Accepted: 01/11/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND This prospective study evaluated the effect of routine, uncontrolled, Israeli field storage conditions on the safety and efficacy of Lyo-Plas N Freeze-Dried Plasma (FDP) at the end of the manufacturer's shelf life, and up to 24 months post expiry. Clotting factors V, VIII and XI, proteins S, C, fibrinogen, PTT, ATIII, VWF, and INR as well as TEG, DDM, residual moisture, pH, and sterility of FDP returned from field units after uncontrolled storage were evaluated. STUDY DESIGN AND METHODS Parameters measured at the end of manufacturer shelf life, as well as 6, 12, 18, and 24 months after expiry, were compared to those of freshly supplied FDP doses. RESULTS Changes were found when comparing freshly supplied FDP to all field-stored groups in INR, PT, PTT, pH, fibrinogen, and factor VIII. A significant change was also seen in Factor XI in the 12, 18, and 24 months post-expiry samples, Factor V and R in the 24 months post-expiry samples, MA in the 12, 24 months post-expiry group, and Protein C in the 18 months post-expiry group. An increase in the residual moisture from 0.90% in freshly supplied FDP to 1.35% in 24 months post-expiry FDP.; all p < .05. No growth was found in sterility analysis. CONCLUSION Despite uncontrolled field storage conditions, the findings demonstrate that the safety and efficacy of FDP units, stored in uncontrolled conditions are only slightly affected, even beyond their expiration date. This information allows consideration of possibly extending the shelf life.
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Affiliation(s)
- Meital Zur
- Israel Defense Forces (IDF) Medical Corps, Tel Aviv, Israel
| | | | | | - Irina Radomislensky
- Israel Defense Forces (IDF) Medical Corps, Tel Aviv, Israel.,Israel National Center for Trauma and Emergency Medicine Research, Sheba Medical Center, Gertner Institute for Epidemiology and Public Health Policy Research, Ramat Gan, Israel
| | - Avishai M Tsur
- Israel Defense Forces (IDF) Medical Corps, Tel Aviv, Israel
| | - Avi Benov
- Israel Defense Forces (IDF) Medical Corps, Tel Aviv, Israel
| | - Linn Wagnert-Avraham
- Institute for Research in Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Elon Glassberg
- Israel Defense Forces (IDF) Medical Corps, Tel Aviv, Israel.,Institute for Research in Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.,Faculty of Medicine, Bar Ilan University, Safed, Israel.,Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Itin C, Liani M, Zur M, Gorenbein P. Stability of Diazepam Solution for Injection Following Long-Term Storage in an Ambient Temperature of the Mediterranean Climate. Pharm Res 2021; 38:361-367. [PMID: 33404991 DOI: 10.1007/s11095-020-02984-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Diazepam is utilized as a convulsion antidote following nerve gas attacks. As an emergency medicine, it requires storage at ambient temperatures which often doesn't meet manufacturers' requirements, leading to an early invalidation of the product. Current work investigated this issue. METHODS Long-term stability of diazepam ampoules for injection stored in an ambient temperature of the Mediterranean climate for ~10 years vs storage at room temperature was studied. RESULTS Diazepam assay and pH remained within pharmacopeial specifications irrespective of storage conditions. A major degradation product 2-methylamino-5-chlorobenzophenone (MACB) showed a clear trend of accumulation as a function of storage time, exceeding the permitted limit at ~2 years, irrespective of storage conditions. A strong correlation between the discoloration of the solutions and the concentration of MACB was obtained. Intravenous administration of MACB to rats at doses ~2200-fold higher than permissible specification levels caused neither mortality nor any toxicological nor post-mortem findings. CONCLUSIONS Regarding the parameters tested: diazepam assay, MACB assay, and pH, storing ampoules of diazepam solution for injection in field conditions of high temperatures of the Mediterranean climate did not cause accelerated degradation as compared to room temperature. These findings open an option for the usage of expired ampoules in special scenarios.
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Affiliation(s)
- Constantin Itin
- Pharmacy, Biomedical Engineering & Medical Supplies Branch, Israel Defense Forces (IDF) Medical Corps, Ramat Gan, Israel.
| | - Maor Liani
- Pharmacy, Biomedical Engineering & Medical Supplies Branch, Israel Defense Forces (IDF) Medical Corps, Ramat Gan, Israel
| | - Meital Zur
- Pharmacy, Biomedical Engineering & Medical Supplies Branch, Israel Defense Forces (IDF) Medical Corps, Ramat Gan, Israel
| | - Pavel Gorenbein
- Pharmacy, Biomedical Engineering & Medical Supplies Branch, Israel Defense Forces (IDF) Medical Corps, Ramat Gan, Israel
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Zur M, Glassberg E, Gorenbein P, Epstein E, Eisenkraft A, Misgav M, Avramovich E. Freeze‐dried plasma stability under prehospital field conditions. Transfusion 2019; 59:3485-3490. [DOI: 10.1111/trf.15533] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/08/2019] [Accepted: 08/13/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Meital Zur
- Israel Defense Forces (IDF) Medical Corps Ramat Gan Israel
| | - Elon Glassberg
- Israel Defense Forces (IDF) Medical Corps Ramat Gan Israel
| | | | | | - Arik Eisenkraft
- Faculty of Medicine, The Institute for Research in Military Medicine The Hebrew University of Jerusalem Jerusalem Israel
| | - Mudi Misgav
- The National Hemophilia Center and Thrombosis Unit Sheba Medical Center Ramat Gan Israel
| | - Eva Avramovich
- Israel Defense Forces (IDF) Medical Corps Ramat Gan Israel
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Stepensky D, Gorenbein P. Epinephrine Concentrations in EpiPens After the Expiration Date. Ann Intern Med 2018; 168:81-82. [PMID: 29297028 DOI: 10.7326/l17-0494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- David Stepensky
- From Ben-Gurion University of the Negev, Beer-Sheva, and Israeli Defense Forces, Rishon LeZion, Israel
| | - Pavel Gorenbein
- From Ben-Gurion University of the Negev, Beer-Sheva, and Israeli Defense Forces, Rishon LeZion, Israel
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Dakwar GR, Kaplun V, Kojukarov L, Gorenbein P, Schumacher I, Kontorovich D, Förster C, Beit-Yannai E, Stepensky D. Toxicity assessment of extracts from infusion sets in cEND brain endothelial cells. Int J Pharm 2012; 434:20-7. [DOI: 10.1016/j.ijpharm.2012.05.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 05/08/2012] [Accepted: 05/11/2012] [Indexed: 10/28/2022]
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