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.

Does the Modality of Dental Treatment Affect the Treatment Prognosis and the Necessity of Re-Treatments?

BACKGROUND

The utilization of evidence-based approaches is crucial to achieving long-term positive outcomes for treatment performed chairside or under general anesthesia. The study aimed to evaluate if treatment modality (at the chairside or under general anesthesia) affects prognosis and the need for re-treatment.

METHODS

Oral-hygiene, gingival, and plaque indexes were recorded during the control appointment. The success of all treatments was evaluated according to the scoring of particular evaluation criteria.

RESULTS

A total of 1066 dental procedures were performed on 92 children. Plaque index scores were higher for patients treated under general anesthesia. The success rate of restorative procedures was 82.5% under general anesthesia and 80.6% at the chairside. There was no statistically significant difference between the mean number of restorative treatments and the need for re-treatment between general anesthesia or chairside (p = 0.649, p = 0.311). The mean number of unsuccessful endodontic treatments performed under general anesthesia was higher than performed chairside. Only two out of thirty stainless-steel crowns were decemented, all performed under general anesthesia.

CONCLUSIONS

The high volume of restoration failure due to secondary caries has highlighted the need for alternative approaches to caries management, especially given the risks associated with repeat general anesthetic.

Evaluation of the Shear Bond Strength of Immediate and Delayed Restorations of Various Calcium Silicate-Based Materials with Fiber-Reinforced Composite Resin Materials

Due to significant tissue loss in teeth requiring pulp treatments, hermetic restoration of the remaining dental tissues is one of the most crucial factors in determining the treatment's success. The adhesion of composite resins to calcium silicate cements (CSCs) is considered challenging. Consequently, it is crucial to identify the optimal method for obtaining optimal adhesion. The aim of the present study is to evaluate the shear bond strength (SBS) values of immediate and delayed restorations with fiber-reinforced composites on powder-liquid, premixed, and resin-containing flowable CSCs. In the present study, the SBS values obtained after immediate (14 min) and delayed (7 days) restorations of three different CSCs (NeoMTA2, NeoPutty, and TheraCal PT) with three different resin composite materials (EverX FlowTM, EverX PosteriorTM, and Filtek Z550) were compared. The fracture types were evaluated using a stereomicroscope and SEM. TheraCal PT had the highest SBS values for both immediate and delayed restorations, and the comparison with other materials showed a statistically significant difference (p = 0.001). In contrast, there was no statistically significant difference between the SBS values of NeoMTA and NeoPutty (p > 0.05). In both immediate and delayed restorations, there was no statistically significant difference between nanohybrid and fiber-reinforced composites (p > 0.05). The simple use and strong bonding ability of TheraCal PT with composite resins may provide support for the idea that it is suitable for pulpal interventions. Nevertheless, due to the in vitro nature of this study, additional in vitro and clinical studies are required to investigate the material's physical, mechanical, and biological properties for use in clinical applications.

Predictors of Parental Acceptance towards Contemporary Behavior Management Techniques Used in Pediatric Dentistry: A Preliminary Study on Turkish Population

BACKGROUND

Parents, who make the final decision regarding their child's treatment, play a significant role in their dental care. Parental approval is important for each stage of treatment and may affect the physician's approach to the treatment. Therefore, it is essential for pediatric dentists to comprehend which behavior management techniques (BMTs) are acceptable to parents and to identify the factors that influence their acceptability.

METHODS

Parents who were bringing their children for dental treatment answered a survey on the acceptance of twenty contemporary BMTs. The sociodemographic data of the parents and the age, gender, and Frankl behavior rating scale (Frankl) scores of their children were recorded. Parents were asked to indicate their level of acceptance of each BMT. Binary logistic regression analysis was designed to see the predictors of "accepted" and "declined" answers.

RESULTS

According to acceptance frequencies, the most accepted technique was communication and communicative guidance. The most declined technique was parental absence. The child's age, gender, Frankl score, parental educational status, and parent type predict the acceptability of some BMTs.

CONCLUSION

This study revealed that pediatric dentists must consider parent and child factors when selecting BMTs for children. We believe that this study can provide a basis for determining which factors pediatric dentists should consider when selecting individualized BMTs.

AB1322 APPENDICITIS STILL A MISDIAGNOSIS FOR FMF PATIENTS

Background

Familial Mediterranean Fever(FMF) is an autoinflammatory disease characterized by recurrent polyserositis attacks. Attacks typically consist of fever and/or abdominal pain and/or chest pain and/or arthritis. The disease is caused by mutations in the MEFV gene. Abdominal pain during the attacks is frequently misdiagnosed as acute abdomen and these patients go undersurgical intervention is not uncommon [1].

Objectives

Severe abdominal pain during FMF attacks is frequently misdiagnosed as acute abdomen and patients receive surgical intervention. In this study, we aim to compare the clinical and genetic characteristics of FMF patients with appendectomies to those without appendectomies.

Methods

We reviewed 176 patients with FMF who went under appendectomy. We randomly matched these patients with 176 FMF patients without appendectomy for comparison. We compared clinical manifestations, MEFV mutations, and treatment modalities.

Results

In this study, 176 patients with FMF went under appendectomy. Only 2 of these appendectomies were performed after FMF diagnosis. In the appendectomy group fever(84% vs 68%), abdominal pain(91% vs 79%), pathogenic exon 10 mutations(65% vs 59%), lower leg pain(0.5% vs 0%) and orchitis(0.5% vs 0%) were more common but only the abdominal pain and fever was statistically significant. In the control group chest pain(18% vs 19%), arthralgia(46% vs 53%), arthritis(29% vs 37%), anti IL-1 usage(3% vs 5%), amyloidosis (0% vs 3%) and erysipelas(1% vs 3%) were more common but none of them were statistically significant. Myalgia(3%) was the same in both groups[Table 1]. Median diagnostic delay was 8(IQR 2-15) years in the appendectomy group and 3.5(IQR1-10) years in the control group.

Table 1.

Characteristics of the patients

No Of Patients(%)AppendicitisNo Of Patients(%)P valueControl GroupPatients176(100)176(100)Fever148(84)120(68)0.0007Abdominal Pain160(91)139(79)0.0029Chest Pain32(18)33(19)1Arthralgia81(46)94(53)0.20Arthritis51(29)65(37)0.12Myalgia5(3)5(3)1Erysipelas2(1)5(3)0.45Lower Leg Pain1(0.5)0(0)-Orchitis1(0.5)0(0)-Anti IL-1 usage6(3)9(5)0.6Amyloidosis0(0)6(3)-Diagnostic Delay8.5(IQR2-15) years3.5(IQR1-10) years0.0002Pathogenic Exon 10 Mutations114(65)103(59)0.27Appendectomy Before FMF diagnosis174(99)0(0)

Conclusion

Even after the discovery of colchicine and identification of the MEFV gene diagnosis of FMF remains a challenge. Previous studies reported a median diagnostic delay of 8.2-11 years. In these studies, 28%-32% of the patients went under abdominal surgical intervention before the diagnosis of the FMF[2,3]. The most common symptoms of FMF(fever and abdominal pain) are also the most common symptoms of acute abdomen. Thus distinguishing between FMF and acute abdomen in undiagnosed FMF patients represents an understated problem. These patients have a longer diagnostic delay[8(IQR 2-15) vs 3.5(IQR1-10) years], worse control of attacks, poorer quality of life. In our study, most of the appendectomies were unnecessary in the FMF patients. Thus we recommend investigating the patient for FMF if the evidence of the acute abdomen does not expand beyond the symptoms.

References

[1]Ozdogan H, Ugurlu S. Familial Mediterranean Fever. Presse Med. 2019 Feb;48(1 Pt 2):e61-e76.

[2]Erdogan M, Ugurlu S, Ozdogan H, Seyahi E. Familial Mediterranean fever: misdiagnosis and diagnostic delay in Turkey. Clin Exp Rheumatol. 2019 Nov-Dec;37 Suppl 121(6):119-124.

[3]Hageman IMG, Visser H, Veenstra J, Baas F, Siegert CEH. Familial Mediterranean Fever (FMF): a single centre retrospective study in Amsterdam.

Disclosure of Interests

None declared

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.

Vulpinic acid, a lichen metabolite, emerges as a potential drug candidate in the therapy of oxidative stress–related diseases, such as atherosclerosis

Vulpinic acid, a lichen compound, has been shown to have many beneficial effects and its medicinal value increases day by day. As in atherosclerosis, endothelial damage is the basis of many diseases. The aim of this study is to investigate the effects of vulpinic acid against oxidative stress damage induced by hydrogen peroxide (H2O2) in endothelial cells. In order to find the IC50 of H2O2 and the protective dose of vulpinic acid, methyl thiazolyldiphenyl tetrazolium bromide (MTT) assays were performed. The amount of reactive oxygen species (ROS) induced by H2O2 and the protective effects of vulpinic acid against ROS were examined by fluorometric DCF-DA kit. The effects of H2O2 and vulpinic acid on actin filaments were determined by tetramethyl rhodamine (TRITC)-phalloidin fluorescence staining. Expression of Tie2 proteins was immunocytochemically analyzed in H2O2- and vulpinic acid-treated cells. After 24 h, the IC50 was found to be 215 μM in HUVECs treated with H2O2. The most effective dose of vulpinic acid against H2O2-associated damage was found to be 15 μM. Vulpinic acid pretreatment was shown to reduce H2O2-induced ROS production significantly ( p < 0.05). It was shown that 215 μM of H2O2 caused actin fragmentation, cell shrinkage, and decrease in actin florescence intensity while vulpinic acid protected the cells from these damages. It was found that Tie2 immunoreactivity was decreased in H2O2-treated groups and vulpinic acid pretreatment reduced the expression of this protein. In conclusion, vulpinic acid decreases H2O2-induced oxidative stress and oxidative stress–related damages in HUVECs. It may be drug candidate in the therapy of atherosclerosis.