Real-World Safety and Effectiveness of Canagliflozin Treatment for Type 2 Diabetes Mellitus in Japan: SAPPHIRE, a Long-Term, Large-Scale Post-Marketing Surveillance.

INTRODUCTION: This long-term post-marketing surveillance (SAPPHIRE) collected information on the safety and effectiveness of canagliflozin (approved dose 100 mg) prescribed to patients with type 2 diabetes mellitus (T2DM) in real-world practice in Japan. METHODS: Patients with T2DM who were prescribed canagliflozin between December 2014 and September 2016 were registered and observed for up to 3 years. Safety was evaluated in terms of adverse drug reactions (ADRs). Effectiveness was assessed in terms of glycaemic control. Data were also analysed across age subgroups (< 65, ≥ 65 to < 75, and ≥ 75 years old) and the estimated glomerular filtration rate (eGFR) categories for chronic kidney disease (G1-G5 based on eGFR) at baseline. RESULTS: A total of 12,227 patients were included in the safety analyses and 11,675 in effectiveness analyses. Overall, 7104 patients were treated with canagliflozin for ≥ 3 years. The mean age, haemoglobin A1c (HbA1c), and eGFR at baseline were 58.4 ± 12.5 years, 8.01 ± 1.49%, and 80.04 ± 21.85 mL/min/1.73 m2, respectively. There were 1836 ADRs in 1312 patients (10.73%) and 268 serious ADRs in 225 patients (1.84%). The most common ADRs were those related to volume depletion (1.39%), genital infection (1.34%), polyuria/pollakiuria (1.23%), and urinary tract infection (1.19%). The frequencies of ADRs tended to increase with age and stage of chronic kidney disease. The reductions in mean HbA1c after starting canagliflozin were maintained for up to 3 years with a mean change of - 0.68% (n = 6345 at 3 years). Maintained reductions in mean HbA1c were observed in each age subgroup and in patients with G1-G3b renal function. CONCLUSION: This surveillance in real-world clinical practice showed that canagliflozin provides sustained glucose-lowering effects in patients with T2DM, including elderly patients and patients with moderate renal impairment, without new safety concerns beyond those already described in the Japanese package insert. TRIAL REGISTRATION: JapicCTI-153048.

Canagliflozin is a sodium­glucose cotransporter 2 (SGLT2) inhibitor that lowers blood glucose levels by increasing urinary glucose excretion. It was approved for the management of blood glucose levels in patients with type 2 diabetes mellitus following clinical trials. However, clinical trials may not fully represent the safety or effectiveness of a drug in real-world clinical practice. Therefore, a 3-year post-marketing surveillance was performed in Japan to obtain safety and effectiveness data for a large group of 12,227 patients with type 2 diabetes mellitus and various demographic/clinical characteristics. Safety and effectiveness data were collected for up to 3 years while patients were treated with canagliflozin. Adverse drug reactions occurred in 10.73% of patients. The most common types of adverse drug reactions were those related to volume depletion (body fluid decreased), followed by genital infection, polyuria/pollakiuria (increased urination), and urinary tract infection. Adverse drug reactions tended to be more common in elderly patients and in patients with renal impairment. As expected, canagliflozin was associated with improvements in haemoglobin A1c, a marker of blood glucose control, in patients with type 2 diabetes, including in elderly patients and patients with moderate renal impairment. In this surveillance in real-world clinical practice, long-term treatment with canagliflozin raised no new safety concerns beyond the information already included in the Japanese package insert. Canagliflozin provides sustained glucose-lowering effects.

Rationale, design, demographics and baseline characteristics of the randomized, controlled, Phase 2b SAPPHIRE study of verinurad plus allopurinol in patients with chronic kidney disease and hyperuricaemia.

BACKGROUND: Verinurad is a human uric acid (UA) transporter (URAT1) inhibitor known to decrease serum UA (sUA) levels and that may reduce albuminuria. In a Phase 2a study (NCT03118739), treatment with verinurad + febuxostat lowered urine albumin-to-creatinine ratio (UACR) at 12 weeks by 39% (90% confidence interval 4-62%) among patients with Type 2 diabetes mellitus, hyperuricaemia and albuminuria. The Phase 2b, randomized, placebo-controlled Study of verinurAd and alloPurinol in Patients with cHronic kIdney disease and hyperuRicaEmia (SAPPHIRE; NCT03990363) will examine the effect of verinurad + allopurinol on albuminuria and estimated glomerular filtration rate (eGFR) slope among patients with chronic kidney disease (CKD) and hyperuricaemia. METHODS: Adults (≥18 years of age) with CKD, eGFR ≥25 mL/min/1.73 m2, UACR 30-5000 mg/g and sUA ≥6.0 mg/dL will be enrolled. Approximately 725 patients will be randomized 1:1:1:1:1 to 12, 7.5 or 3 mg verinurad + allopurinol, allopurinol or placebo. An 8-week dose-titration period will precede a 12-month treatment period; verinurad dose will be increased to 24 mg at Month 9 in a subset of patients in the 3 mg verinurad + allopurinol arm. The primary efficacy endpoint the is change from baseline in UACR at 6 months. Secondary efficacy endpoints include changes in UACR, eGFR and sUA from baseline at 6 and 12 months. CONCLUSIONS: This study will assess the combined clinical effect of verinurad + allopurinol on kidney function in patients with CKD, hyperuricaemia and albuminuria, and whether this combination confers renoprotection beyond standard-of-care.

Therapeutic potential of topically administered γ-AlOOH on 2,4-dinitrochlorobenzene-induced atopic dermatitis-like lesions in Balb/c mice.

Boehmite (γ-AlOOH) has a wide range of applications in a variety of industrial and biological fields. However, little is known about its potential roles in skin diseases. The current study investigated its effect on atopic dermatitis (AD). Following characterization, cytotoxicity, pro-inflammatory response and oxidative stress associated with boehmite were assessed, using TNF-α-induced keratinocytes and mast cells. In addition, therapeutic effects of boehmite, topically administered to Balb/c mice induced by 2,4-dinitrochlorobenzene (DNCB), were evaluated. Expression of cytokines (TLSP, IL-25 and IL-33) and the generation of ROS from keratinocytes induced by TNF-α were significantly inhibited by boehmite without affecting cell viability. MAPKs (ERK, JNK and p38) required for cytokine expression were suppressed by boehmite treatment. Up-regulation of cytokines (TSLP, IL-4, IL-5, IL-13, RANTES) in human mast cells treated with phorbol 12-myristate 13-acetate and calcium ionophore was also suppressed by boehmite. Boehmite improved the AD severity score, epidermal hyperplasia and transepidermal water loss in DNCB-induced AD-like lesions. Moreover, Th2-mediated cytokine expression, mast cell hyperplasia and destruction of the skin barrier were improved by boehmite treatment. Overall, we demonstrated that boehmite may potentially protect against AD.

Effect of Resin Luting Systems and Alumina Particle Air Abrasion on Bond Strength to Zirconia.

This study aimed to evaluate the effect of different primer/resin luting agent combinations and alumina air abrasion on the adhesion to zirconia. Eighty blocks (4×4×3 mm) of Lava Frame Zirconia (3M ESPE) were produced and randomly assigned into eight groups (n=10) according to two zirconia surface treatments (untreated or air abrasion with 50-µm alumina particles) and four luting systems (SU: Scotchbond Universal/RelyX Unicem 2; ZP: Z-Prime Plus/Duo-link Universal; MB: Monobond Plus/Variolink II; and AP: Alloy Primer/ED Primer II/Panavia F 2.0). After the conditioning and primer applications, resin luting agents were manipulated and applied on the zirconia, using a matrix, to form a cylinder (2 mm in diameter×2 mm high), followed by photoactivation for 40 seconds. After that, the specimens were stored in distilled water (37 °C) for 120 days and then submitted to shear bond strength testing, followed by failure mode evaluation under an optical microscope (30×). A two-way analysis of variance and Tukey test (α=0.05) were used for data analysis. Alumina air abrasion (Al) promoted higher bond values for the three luting systems, except for SU, which showed the best results without air abrasion, while with air abrasion, Al-SU, Al-ZP, and Al-MB presented higher values compared to Al-AP. We concluded that the alumina air abrasion of zirconia surfaces seemed to be dispensable for the SU group, while air abrasion (topographical alterations) enhanced the adhesion of the ZP, MB, and AP groups.

Vx3-Functionalized Alumina Nanoparticles Assisted Enrichment of Ubiquitinated Proteins from Cancer Cells for Enhanced Cancer Immunotherapy.

A simple and effective strategy was developed to enrich ubiquitinated proteins (UPs) from cancer cell lysate using the α-Al2O3 nanoparticles covalently linked with ubiquitin binding protein (Vx3) (denoted as α-Al2O3-Vx3) via a chemical linker. The functionalized α-Al2O3-Vx3 showed long-term stability and high efficiency for the enrichment of UPs from cancer cell lysates. Flow cytometry analysis results indicated dendritic cells (DCs) could more effectively phagocytize the covalently linked α-Al2O3-Vx3-UPs than the physical mixture of α-Al2O3 and Vx3-UPs (α-Al2O3/Vx3-UPs). Laser confocal microscopy images revealed that α-Al2O3-Vx3-UPs localized within the autophagosome of DCs, which then cross-presented α-Al2O3-Vx3-UPs to CD8+ T cells in an autophagosome-related cross-presentation pathway. Furthermore, α-Al2O3-Vx3-UPs enhanced more potent antitumor immune response and antitumor efficacy than α-Al2O3/cell lysate or α-Al2O3/Vx3-UPs. This work highlights the potential of using the Vx3 covalently linked α-Al2O3 as a simple and effective platform to enrich UPs from cancer cells for the development of highly efficient therapeutic cancer vaccines.

Airborne particulate concentration during laser hair removal: A comparison between cold sapphire with aqueous gel and cryogen skin cooling.

BACKGROUND: High concentrations of sub-micron nanoparticles have been shown to be released during laser hair removal (LHR) procedures. These emissions pose a potential biohazard to healthcare workers that have prolonged exposure to LHR plume. OBJECTIVE: We sought to demonstrate that cold sapphire skin cooling done in contact mode might suppress plume dispersion during LHR. METHODS: A total of 11 patients were recruited for laser hair removal. They were treated on the legs and axilla with a 755 or 1064 nm millisecond-domain laser equipped with either (i) cryogen spray (CSC); (ii) refrigerated air (RA); or (iii) contact cooling with sapphire (CC). Concentration of ultrafine nanoparticles <1 µm were measured just before and during LHR with the three respective cooling methods. RESULTS: For contact cooling (CC), counts remained at baseline levels, below 3,500 parts per cubic centimeter (ppc) for all treatments. In contrast, the CSC system produced large levels of plume, peaking at times to over 400,000 ppc. The CA cooled system produced intermediate levels of plume, about 35,000 ppc (or about 10× baseline). CONCLUSIONS: Cold Sapphire Skin cooling with gel suppresses plume during laser hair removal, potentially eliminating the need for smoke evacuators, custom ventilation systems, and respirators during LHR. Lasers Surg. Med. 50:280-283, 2018. © 2017 Wiley Periodicals, Inc.

Results of Total Elbow Arthroplasty with Cementless Implantation of an Alumina Ceramic Elbow Prosthesis for Patients with Rheumatoid Arthritis.

We investigated the long-term clinical results of total elbow arthroplasty (TEA) by cementless fixation of alumina ceramic unlinked elbow prostheses (J-alumina ceramic elbows: JACE) for the reconstruction of elbow joints with rheumatoid arthritis (RA). Seventeen elbows in 17 patients (aged 44-72 years, average 54.8) replaced by JACE TEA without bone cement were investigated. The average follow-up period was 10.7 (range, 1.0-19.3) years. Clinical conditions of each elbow before and after surgery were assessed according to the Mayo Elbow Performance Index (MEPI). Radiographic loosening was defined as a progressive radiolucent line of more than 1 mm that was completely circumferential around the intramedullary stem. The average MEPI significantly improved from 46.8 points preoperatively to 66.8 points at final follow-up (p=0.0226). However, aseptic loosening was noted in 10 of 17 elbows (58.8%) and revision surgery was required in 7 (41.2%). Most loosening was observed on the humeral side. With radiographic loosening and revision surgery defined as the end points, the likelihoods of prosthesis survival were 41.2% and 51.8%, respectively, up to 15 years by Kaplan-Meier analysis. The clinical results of JACE implantation without bone cement were disappointing, with high revision and loosening rates of the humeral component.

A randomised clinical in situ study to evaluate the effects of novel low abrasivity anti-sensitivity dentifrices on dentine wear.

OBJECTIVES: To compare the abrasive wear on human dentine in an in situ model associated with use of an experimental low abrasivity anti-sensitivity dentifrice containing 1% alumina and 5% sodium tripolyphosphate (STP) with an experimental ultra-low abrasivity non-alumina 5% STP dentifrice, a higher abrasivity daily-use whitening dentifrice, and water as controls. METHODS: This was a single-centre, single-blind, randomised, split-mouth, four-treatment, two-period, crossover in situ study in 29 healthy subjects. Subjects wore bilateral lower buccal appliances, each fitted with four dentine specimens. Study treatments were applied ex vivo (three times daily). Dentine loss was measured by non-contact profilometry after 5, 10 and 15days' treatment. RESULTS: All 29 subjects were included in the efficacy analysis. Significantly less dentine loss was associated with brushing with the low and ultra-low abrasivity dentifrices than with the higher abrasivity dentifrice at all timepoints (p<0.01). Brushing with ultra-low abrasivity dentifrice or water resulted in statistically significantly less dentine loss compared with brushing with the low abrasivity dentifrice at all timepoints (p<0.05). Dentine loss after brushing with ultra-low abrasivity dentifrice was not significantly different from brushing with water. CONCLUSIONS: The degree of dentine loss observed in this in situ model reflected the abrasivity of the study dentifrices. Brushing with low or ultra-low abrasivity STP-containing anti-sensitivity dentifrices resulted in significantly less dentine loss (equating to dentine wear) than with a higher abrasivity daily-use whitening dentifrice.

Aza-Michael Mono-addition Using Acidic Alumina under Solventless Conditions.

Aza-Michael reactions between primary aliphatic and aromatic amines and various Michael acceptors have been performed under environmentally-friendly solventless conditions using acidic alumina as a heterogeneous catalyst to selectively obtain the corresponding mono-adducts in high yields. Ethyl acrylate was the main acceptor used, although others such as acrylonitrile, methyl acrylate and acrylamide were also utilized successfully. Bi-functional amines also gave the mono-adducts in good to excellent yields. Such compounds can serve as intermediates for the synthesis of anti-cancer and antibiotic drugs.

Effect of surface treatment and aging on bond strength of composite resin onlays.

STATEMENT OF PROBLEM: Additional polymerization of indirect composite resins enhances their physical properties but lessens the potential for chemical bonding. PURPOSE: The purpose of this in vitro study was to evaluate the influence of different surface treatments and 6-month water storage on the microtensile bond strength (µTBS) of composite resin onlays. MATERIAL AND METHODS: Composite resin onlays (Filtek Z250) randomly received 6 different surface treatments: (1) airborne-particle abrasion with 27-µm alumina particles+Adper Scotchbond 1XT adhesive application, (2) airborne-particle abrasion with alumina particles+silane application (ESPE SIL)+Adper Scotchbond 1XT, (3) airborne-particle abrasion with alumina particles+Scotchbond Universal adhesive, (4) tribochemical silica coating with 30-µm particles (CoJet Sand)+Adper Scotchbond 1XT adhesive, (5) tribochemical silica coating+silane application+Adper Scotchbond 1XT, and (6) tribochemical silica coating+Scotchbond Universal adhesive. Onlays were luted to fresh composite resin specimens with RelyX Ultimate resin cement. Bonded assemblies were stored in water for 24 hours or 6 months at 37°C and subjected to the µTBS test. Additional surface-treated composite resin onlays were analyzed with a contact profilometer to determine average roughness, and micromorphologic changes were analyzed with scanning electron microscopy. RESULTS: Airborne-particle abrasion with alumina followed by Adper Scotchbond 1XT or Scotchbond Universal adhesive application provided the highest bond strength values at 24 hours. Lower values were obtained after tribochemical silica coating. After 6 months of artificial aging, airborne-particle abrasion with alumina or silica-coated alumina particles followed by Scotchbond Universal application yielded the greatest bond strength results. Airborne-particle abrasion with alumina produced the highest roughness values and a more irregular surface. CONCLUSION: Adhesive selection seems to be relevant to the µTBS of luted composite resin onlays after 6 months of water aging, as specimens treated with Scotchbond Universal, after alumina airborne-particle abrasion or tribochemical silica coating, yielded the highest values and better aging stability.

Aluminum Oxide Sandblasting of Hexagonal Coping and Abutment: Influence on Retention and Marginal Leakage Using Temporary Cements.

PURPOSE: To compare the tensile strength and marginal leakage of prefabricated abutments/copings, with or without surface sandblasting with aluminum oxide, luted with a calcium hydroxide-based temporary cement (CH, Dycal; Dentsply, Petrópolis, RJ, Brazil) or a noneugenol zinc oxide cement (ZO, Temp Bond NE; Kerr, Orange, CA). MATERIALS AND METHODS: A total of 48 CeraOne abutment analogs and respective copings were divided into 6 groups (n = 8) according to the component that was sandblasted: the coping only, coping + abutment or no sandblasting and the temporary cement used: CH or ZO. After cementation, the samples underwent 500 thermal cycles (5°C ± 2°C and 55°C ± 2°C) and were subsequently immersed in an aqueous solution of 0.5% basic fuchsine dye for 24 hours. Next, the tensile test was performed, and microleakage was assessed qualitatively. Data were analyzed using Mann-Whitney, Kruskal-Wallis tests, followed by the Student-Newman-Keuls test (α = 0.05). RESULTS: CH cement showed a tensile strength (245.6 N) significantly higher than that of the ZO (18.1 N). Sandblasting both abutment and coping increased tensile strength by 1.7 times. Marginal leakage was not influenced by sandblasting; however, CH presented less microleakage. CONCLUSION: Aluminum oxide sandblasting of the coping and abutment favored the tensile strength of temporary cements and the CH showed a higher tensile strength and less microleakage than did the ZO cement.

Pit and Fissure Sealant Retention Following Air Abrasion Preparation with Bioactive Glass and Aluminum Oxide Particles.

PURPOSE: Alumina air abrasion is an alternative for acid-etch technique for tooth preparation before placement of a fissure sealant. The aim of this study was to compare the retention of sealants placed subsequent to air abrasion with alumina and bioactive glass (BAG) particles. METHODS: Sixty-two 6-12 year old children were included in this study. Using a halfmouth design, the fissures were prepared using air abrasion with alumina particles on randomly assigned permanent mandibular or/and maxillary first molars on one side of the mouth (Group 1) and air abrasion with BAG on the contralateral side of the mouth (Group 2). Sealants were applied on 180 teeth, and were scored as missing, partially retained, and completely retained after three, six, nine and 12 months. Data were analyzed using Friedman and Wilcoxon tests (α=0.05). RESULTS: Sealant retention rates in the alumina group were higher than those in the BAG group at all time periods (P<0.001). CONCLUSIONS: Sealant retention after air abrasion with alumina particles was higher than BAG over 12 months.

Porous Alumina as a Promising Biomaterial for Public Health.

Porous aluminum is a nanostructured material characterized by unique properties, such as chemical stability, regular uniformity, dense hexagonal porous lattice with high aspect ratio nanopores, excellent mechanical strength, and biocompatibility. This overview examines how the structure and properties of porous alumina can be exploited in the field of public health. Porous alumina can be employed for fabricating membranes and filters for bioremediation, water ultrafiltration, and microfiltration/nanofiltration, being a promising technique for having clean and fresh water, which is essential for human health. Porous alumina-based nanobiosensor coated with specific antibodies or peptides seem to be a useful tool to detect and remove pathogens both in food and in water, as well as for environmental monitoring. Further, these applications, being low-energy demanding and cost-effective, are particularly valuable in resource-limited settings and contexts, and can be employed as point of use devices in developing countries, where there is an urgent need of hygiene and safety assurance.

A Randomized Clinical Study Investigating the Stain-Removal Potential of Two Experimental Dentifrices.

OBJECTIVE: To evaluate the ability of two experimental desensitizing dentifrices, both containing a chemical cleaning agent, one with ultra-low abrasivity and one with low abrasivity, a standard fluoride dentifrice, and a daily-use whitening dentifrice to remove extrinsic tooth stain. METHODS: This was a single-center, examiner-blind, randomized, controlled, four-treatment, parallel-group study in healthy adults. Extrinsic stain was evaluated using the Macpherson modification of the Lobene Stain Index (MLSI). At baseline, eligible subjects with a total MLSI (area x intensity [A x I]) score of 15 for the facial surfaces of the 12 anterior teeth were stratified (based on total MLSI [A x I] score [< 45 = low; ≥ 45 = high] and smoking status) and randomized to treatment with one of four dentifrices: an experimental ultra-low abrasivity desensitizing dentifrice (relative dentin abrasion [RDA] -12); an experimental low abrasivity desensitizing dentifrice (RDA -40); a standard fluoride dentifrice with moderate abrasivity (RDA -80); and a whitening dentifrice with higher abrasivity (RDA -142). Both desensitizing dentifrices contained 5% potassium nitrate and 5% sodium tripolyphosphate (a chemical cleaning agent). Treatment effects were evaluated after four and eight weeks of twice-daily brushing. RESULTS: In total, 142 subjects were randomized and 133 subjects completed the study. All study dentifrices demonstrated statistically significant reductions in extrinsic tooth stain from baseline after four and eight weeks of twice-daily use (p < 0.01). There were no statistically significant between-treatment differences for the primary variable (mean MLSI [A x I] score across all assessed sites) at four or eight weeks, and no notable trends were observed. CONCLUSION: All study dentifrices reduced extrinsic tooth stain. The experimental ultra-low and low abrasivity desensitizing dentifrices containing 5% sodium tripolyphosphate performed similarly to both a moderate abrasivity standard fluoride dentifrice and a higher abrasivity whitening dentifrice.

Comparison of effectiveness of abrasive and enzymatic action of whitening toothpastes in removal of extrinsic stains - a clinical trial.

OBJECTIVE: To compare the effectiveness of abrasive component (perlite/calcium carbonate) and enzymatic component (papain and bromelain) of whitening toothpaste in removal of extrinsic stains. METHODS: This study is a randomized, triple blind and parallel group study in which 90 subjects aged 18-40 years were included. At baseline, stains scores were assessed by Macpherson's modification of Lobene Stain Index and subjects were randomly assigned to two groups with 45 subjects in each. Group 1 used whitening toothpaste with enzymatic action and group 2 with abrasive action. After 1 month, stain scores were assessed for the effectiveness of the two toothpastes and 2 months later to check the stain prevention efficacy. Wilcoxson's test was used to compare between baseline 1 and 2 months stain scores, and Mann-Witney U-test was applied for intragroup comparison. RESULTS: The mean baseline total stain score for the subjects allocated to the enzymatic toothpaste was 37.24 ± 2.11 which reduced to 30.77 ± 2.48 in 1 month, and for the abrasive paste, total stain reduced from 35.08 ± 2.96 to 32.89 ± 1.95. The reductions in total stain scores with both the pastes were significant compared with baseline stain scores (at 1 month Group 1, P = 0.0233 and Group 2, P = 0.0324; at 2 months, Group 1 P = 0.0356). Both the toothpastes proved to be equally good in removal of extrinsic stains; however, the enzymatic paste showed better results as compared to abrasive toothpaste. CONCLUSION: Whitening toothpaste with abrasive action and enzymatic action are equally effective in removal of extrinsic stains; however, whitening toothpaste with abrasive action needs to be used with caution.

Adaptação marginal em copings de dois sistemas cerâmicos livres de metal / Marginal fit in copings of two metal free ceramic systems

Este trabalhou avaliou a adaptação marginal de infraestruturas cerâmicas (copings em alumina) de dois sistemas cerâmicos livres de metal. Foram pesquisados os sistemas In-Ceram e Procera. Os valores de discrepância vertical presentes entre as margens de nove copings de cada sistema cerâmico e a margem de um modelo mestre metálico foram medidos com microscópio eletrônico de varredura em 5 pontos de cada infraestrutura. Esses valores foram medidos em micrômetros (pm). Os resultados foram analisados estatisticamente com o software SPSS (Statistical Package for the Social Sciences 11.0), através do teste t de Student, considerando-se significativos os valores de p<0(05. Os valores médios de discrepância marginal dos dois sistemas, medidos em microscópio eletrônico de varredura, mostraram diferença estatística entre si (p=0,001), sendo observadas desadaptações de 39±11pm (sistemas Procera) e 11 5±56pm (sistema In-Ceram). Conclui-se que os dois sistemas cerâmicos livres de metal avaliados apresentaram adaptação marginal dentro de limites aceitáveis clinicamente.

This work has evaluated the marginal fit of alumina copings of two metal free ceramic systems, namely Procera and In-Ceram systems. The marginal fit values of the margins in nine copings of each ceramic system and in a metal master model were assessed using electron- scanning microcopy in five points of the margin of each coping. Such values were measured in micrometers (pm). The results were analyzed statistically by the SPSS software (p<0.05). The marginal fit mean values for both systems have presented statistical difference (p=0.001), being of 39±11 pm and 115±56pm for the Procera and Inc-Ceram systems, respectively. Both systems have presented marginal fit according to the clinical acceptance.

Compatibility of Ce-TZP/Al2O3 nanocomposite frameworks and veneering porcelains.

The aim of this study was to examine the compatibility of Ce-TZP/Al2O3 nanocomposite (CTA) frameworks and veneering porcelains using the Schwickerath crack initiation test and clarify the effects on debonding/crack initiation strength (DIS) of both surface pretreatment (include heat treatment) of the frameworks, type of veneering porcelain varying the coefficient of thermal expansion (CTE), and surface roughness of the frameworks. The surfaces of Ce-TZP/Al2O3 plates were mechanically treated and followed by post-heat treatment. The liner and body porcelains were built up and fired according to the manufacturer's instructions. Surface analyses of the fractured plates showed compatibility with liner porcelains. Since no statistically difference in the DIS was found amongst the different surface treatments, post-heat treatments don't be mandatory. Whereas, since differences in DIS were found when different porcelains with different CTE were used, we concluded the matching of CTE of the porcelain with that of Ce-TZP/Al2O3 was important for successful all-ceramic restorations using Ce-TZP/Al2O3 frameworks.

Polyethylene wear and osteolysis after cementless total hip arthroplasty with alumina-on-highly cross-linked polyethylene bearings in patients younger than thirty years of age.

BACKGROUND: We asked whether cementless total hip arthroplasties that made use of alumina-on-highly cross-linked polyethylene bearings would improve hip score and functional activity and reduce the prevalence of polyethylene wear, osteolysis, and aseptic loosening. METHODS: Consecutive primary total hip arthroplasties were performed in fifty patients (a total of sixty hips among thirty-four men and sixteen women) who were younger than thirty years of age. The average age at the time of the index arthroplasty was 28.3 years (range, twenty-one to twenty-nine years). The average follow-up was 10.8 years (range, ten to twelve years). Osteolysis and polyethylene wear rates were evaluated with use of radiography and computed tomography. RESULTS: The mean Harris hip score, which was 38 points (range, 6 to 45 points) preoperatively, had improved to 95 points (range, 85 to 100 points) at a mean follow-up time of 10.8 years. The mean penetration (and standard error of the mean) of the polyethylene liner was 0.031 ± 0.004 mm per year. No hip had osteolysis or aseptic loosening. CONCLUSIONS: At a minimum of ten years and an average of 10.8 years postoperatively, the current generation of cementless acetabular and femoral components with alumina-on-highly cross-linked polyethylene bearings was functioning well and was not associated with the development of osteolysis in our group of patients younger than thirty years of age. While the long-term prevalence of polyethylene wear and osteolysis remains unknown, the midterm data are promising.

Cleaning, abrasion, and polishing effect of novel perlite toothpaste abrasive.

OBJECTIVE: This study was intended to optimize perlite particle size and morphology for better tooth cleaning and lower tooth abrasion, and to evaluate the performance of a whitening toothpaste containing the optimized perlite abrasive for tooth cleaning, abrasion, and polishing. METHODS: Perlite toothpaste abrasive samples were prepared by air classifying a commercial expanded perlite product. The tooth cleaning and abrasion properties for these classified perlite samples were reported via the pellicle cleaning ratio (PCR) and relative dentin abrasion (RDA). Performance of the whitening toothpaste containing the optimized perlite abrasive in tooth cleaning, polishing, and abrasion was evaluated against a widely used synthetic high-cleaning silica. RESULTS: Air classification removes large perlite particles and also physically changes perlite particle morphology from mostly three dimensional and angular particles to mainly two dimensional and platy particles. All the classified samples show good tooth cleaning effect, but tooth abrasion decreases significantly with decreasing particle size. Compared to high-cleaning silica whitening toothpaste, the whitening toothpaste containing the optimized perlite abrasive (PerlClean) is slightly better at tooth cleaning, lower in tooth abrasion, and significantly better at tooth polishing. CONCLUSIONS: Fine platy perlite particles are effective in tooth cleaning with low tooth abrasion. The enhanced performance of optimized perlite toothpaste abrasive compared to high-cleaning silica in a whitening toothpaste is attributed to the optimized particle size distribution and the unique platy particle geometry.