Comparing nanoleakage between class II bulkfill and incremental composite restorations using snowplow technique.

Purpose: To compare the nanoleakage between bulkfill and incremental-fill resin composites in class II slot preparations for primary and permanent teeth restored by the snowplow technique. Materials and Methods: Class II slots were prepared in 32 M (16 exfoliated/extracted primary and 16 permanent molars). Optibond All-InOne self-etching adhesive was applied and cured. A flowable composite, Premise, was then injected into the gingival seat without curing using the snowplow technique. Cavities were restored using Sonicfill/bulkfill or microhybrid Herculite composites. Energy dispersive X-ray spectrometry was used to assess nanoleakage as silver deposition percentages along the axial and cervical walls. Multivariate analysis of variance was used to assess the effect of tooth type (primary and permanent teeth) and placement technique (bulkfill and incremental techniques) on nanoleakage at the axial and cervical walls. Results: Bulkfill restorations had significantly greater nanoleakage than incremental restorations at the cervical walls in primary and permanent molars (mean = 1.21 vs 0.49 in primary molars and 0.76 vs 0.24 in permanent molars). Equivalent results were observed at the axial walls of the restorations (mean = 0.66 vs 0.14 in primary molars and 0.28 vs 0.08 in permanent molars, with a P value of<0.001). Conclusions: Less nanoleakage was observed in class II slot/snowplow resin-composite restorations using the incremental technique compared to bulkfill in both dentitions. However, greater nanoleakage was detected on the cervical walls when compared with the axial walls.

Evaluation of salivary parameters and Streptococcus' Mutans count in children with cerebral palsy in Egypt: a case control study.

BACKGROUND: Children with cerebral palsy (CP) are at high risk for dental caries. Alteration of some salivary properties encountered among them compared to healthy children, could play a role in this elevated risk. OBJECTIVES: The aim of the present study was to assess salivary physicochemical properties; including total antioxidant (TAC), flow rate, viscosity, pH and buffering capacity, as well as Streptococcus mutans level among children with CP, also to correlate these variables to their caries experience. MATERIALS AND METHODS: This case control study included 80 children with CP, study group (SG) and matched number of healthy children for control group (CG). Interview-based questionnaire, clinical examination, salivary biochemical and microbiological investigations using MALDI-TOF were done. RESULTS: In SG, the caries experience in primary teeth dmft and S. mutans log value were significantly higher than CG (P = 0.039, P = 0.002) while unstimulated salivary flow rate, buffering capacity and salivary TAC were significantly lower (P < 0.0001). Multivariate linear regression showed that the presence of CP was significantly associated with the greatest variation in caries experience in the primary teeth and permanent teeth. Higher unstimulated salivary flow rate, or an increase in buffering capacity by 1 ml of acid/ml of saliva were associated with lower number of the affected primary and permanent teeth. On the other hand, One-unit increase in S. mutans log count and higher salivary TAC were associated with higher caries experience. CONCLUSION: Children with CP have higher caries experience (dmf) due to lower salivary protective factors and higher S. mutans counts.

Reliability of serum procalcitonin concentrations for the diagnosis of sepsis in neonates.

The evaluation of tests for neonatal sepsis is important because the infection may present a very serious threat to the baby. Extensive literature exists on single laboratory test or combinations of tests, as well as tests used together with risk factors and/or clinical signs, to diagnose neonatal sepsis. In many instances, the results of the evaluations have been conflicting. It has recently been suggested that serum procalcitonin (PCT) is of value: in the diagnosis of neonatal sepsis, with varying results. This study was designed to determine the reliability of PCT concentrations as a new marker for the diagnosis of early neonatal sepsis of vertical transmission comparing to the traditional inflammatory mediators, such as interleukin-6 (IL-6) and C-reactive protein (CRP) values. The current study included 69 newborn babies. After full history and clinical examination, they were classified into 2 groups: Group 1, included 27 of asymptomatic newborn infants admitted during the first 24 h of life to the neonatal unit because of prematurity, low birth weight. They had no clinical signs of sepsis during their first week of life and had a negative blood culture, and they did not receive antibiotic treatment. The second group: Group 2, included 42 symptomatic neonates who were admitted to the neonatal care unit and were evaluated for sepsis during the first 48 h of life, they were subclassified into twosubgroups: group 2A; included 22 neonates of confirmed vertical neonatal sepsis, defined as they had at least three clinical signs of infection with culture proven sepsis, and group 2B included 20 neonates of vertical clinical sepsis (they had at least three clinical signs of infection) with negative blood culture. Blood sampling for blood culture, complete blood count, blood gases and blood chemistry, additionally, CRP, serum IL-6 and PCT were measured. The microbial organisms isolated from the blood culture of group 2A; Escherichia coli was isolated from 9 cases, staphylococcus aureus from 6 cases, staphylococcus epidermidis from 2 cases, group B streptococci (GBS) from 2 cases, ureaplasma from 2 cases and one case was GBS positive mother. The comparison between the studied groups revealed that, white blood cell counts (WBCs) and CRP levels were significantly increased in group 2A more than in group 1 and group 2B. While in group 2B the WBCs not differed from group 1 but CRP differed from group 1. IL-6 and PCT values were significantly increased in group 2A more than in group 1 and group 2B. Furthermore in group 2B both were significantly increased as compared to group 1. For the diagnosis of neonatal infection, at cutoff >1.5 ng/ml, PCT give a sensitivity of 92.9%, specificity of 85.2%, positive predictive value (PPV) of 84.8%, and negative predictive value (NPV) of 76.7%. At a cutoff >140 ng/ml, IL-6 gives a sensitivity of 76.2%, speCificity of 70.4%, PPV of 64%, NPV of 63.3%. However, at a cutoff >12 mg/L, CRP gives a sensitivity of 88%, specificity of 77.8%, PPV of 77.1%, NPV of 70%. We conclude that the serum PCT concentration showed a good diagnostic value for the early detection of neonatal sepsis of vertical transmission comparing with the other traditional markers of inflammations, thus may facilitate early therapeutic intervention in those high risk group.