Push-out bond strength of root fillings made with C-Point and BC sealer versus gutta-percha and AH Plus after the instrumentation of oval canals with the Self-Adjusting File versus WaveOne.

AIM: To compare the push-out bond strength exhibited by root fillings performed with either C-Point and Endosequence® BC sealer™ (BC Sealer) or gutta-percha and AH Plus® after the instrumentation of oval canals with either the Self-Adjusting File (SAF) System or WaveOne (WO) reciprocating file. METHODOLOGY: Eighty extracted premolars were selected and divided randomly into the following four groups (n = 20): group 1, SAF instrumentation and filling using gutta-percha and AH Plus sealer; group 2, SAF instrumentation and C-Point and BC sealer filling; group 3, WO instrumentation and filling using gutta-percha and AH Plus sealer; and group 4, WO instrumentation and filling with C-Point and BC sealer. Sodium hypochlorite (5.25%) and EDTA (17%) were used as irrigants for all groups. After the sealer was set completely, the teeth were prepared for micro push-out assessment using 1.0-mm-thick root slices. Loading was performed with a universal testing machine at a speed of 0.5 mm min(-1) . Two-way anova and Student's t-test for pairwise comparisons were used to compare groups. RESULTS: All specimens filled with C-Point and BC sealer were associated with significantly higher push-out bond strength compared with gutta-percha and AH Plus sealer (P < 0.001). The bond strength was higher for the coronal and apical samples of the C-Point/BC sealer/SAF group (6.6 ± 0.3 and 3.2 ± 0.3 MPa) versus those of the gutta-percha/AH Plus/WO group (4.8 ± 0.3 and 1.8 ± 0.3 MPa), by 38% and by 80% in the coronal and apical parts, respectively (P < 0.001, P < 0.0001). Adhesive bond failure was more common in the WaveOne-instrumented group in general and in the buccal and lingual recesses in this group in particular. CONCLUSIONS: In oval canals, the instrument used and the root filling material significantly affected the push-out values of root fillings. The highest value was recorded in oval root canals instrumented with the SAF System and filled with C-Point and BC sealer, whereas the lowest strength was noted in oval canals instrumented with WaveOne and filled with gutta-percha and AH Plus sealer.

Pharmacy diabetes screening trial (PDST): Outcomes of a national clustered RCT comparing three screening methods for undiagnosed type 2 diabetes (T2DM) in community pharmacy.

AIMS: To compare the effectiveness of three pharmacy-based screening methods for type 2 diabetes (T2DM): (1) risk assessment (AUSDRISK) alone (Group A); AUSDRISK followed by a point of care test if AUSDRISK ≥12; either (2) HbA1c (Group B); or (3) small capillary blood glucose test (Group C). METHODS: A cluster RCT with a nationally representative sample of Australian pharmacies was implemented with random allocation of eligible pharmacies to Groups A, B or C. GP referral was based on prespecified cut offs. Diagnoses were considered positive if confirmed by a GP, pathology laboratory, or national diabetes register. RESULTS: Of the 14,093 people screened in 339 pharmacies, 3059 participants met group-specific referral criteria: 1775 (45%) (Group A); 893 (17%) (Group B); and 391 (8%) (Group C). For the total screened population rates of T2DM diagnoses were significantly higher in Group B (1.5%), compared with Groups A (< 0.8%) and C (< 0.6%) with the odds of detection in Group B compared with Group A (1.8 [1.0;3.0]), and no difference between Groups A and C. CONCLUSIONS: In community pharmacy, the most effective method to uncover undiagnosed T2DM was a stepwise approach; initial risk assessment; and if appropriate an HbA1C POC test and referral.

S645C Point Mutation Suppresses Degradation of EGFR to Promote Progression of Glioblastoma.

Background: The tightly controlled activity of EGFR is important for the homeostasis of self-renewal of human tissue. Mutations in the extracellular domain of EGFR are frequent and function as a novel mechanism for oncogenic EGFR activation in GBM, and impact the response of patients to small-molecule inhibitors. Methods: We constructed glioblastoma cell lines stably expressing wild-type EGFR and the mutant of EGFR S645C. We detected cell growth in vitro and in vivo. We evaluated the anti-tumor activity and effectiveness of gefitinib and osimertinib in cells. Results: In the present study, we identified an oncogenic substituted mutation of EGFR-S645C. The mutation can promote the proliferation and colony formation of glioblastoma in vitro and in vivo. Mechanistically, the EGFR S645C mutation potentially changes the formation of hydrogen bonds within dimerized EGFR and inhibits the degradation of EGFR to prolong downstream signaling. The mutation induces resistance to gefitinib but presents an opportunity for osimertinib treatment. Conclusion: The study indicated a novel oncogenic mutation and advises on the precise treatment of individual patients with the EGFR S645C mutation.

An In vitro Comparison and Evaluation of Sealing Ability of Newly Introduced C-point System, Cold Lateral Condensation, and Thermoplasticized Gutta-Percha Obturating Technique: A Dye Extraction Study.

AIM: The aim of this study is to compare and to evaluate sealing ability of newly introduced C-point system, cold lateral condensation, and thermoplasticized gutta-percha obturating technique using a dye extraction method. MATERIALS AND METHODOLOGY: Sixty extracted maxillary central incisors were decoronated below the cementoenamel junction. Working length was established, and biomechanical preparation was done using K3 rotary files with standard irrigation protocol. Teeth were divided into three groups according to the obturation protocol; Group I-Cold lateral condensation, Group II-Thermoplasticized gutta-percha, and Group III-C-Point obturating system. After obturation all samples were subjected to microleakage assessment using dye extraction method. Obtained scores will be statistical analyzed using ANOVA test and post hoc Tukey's test. RESULTS: One-way analysis of variance revealed that there is significant difference among the three groups with P value (0.000 < 0.05). Tukey's HSD post hoc tests for multiple comparisons test shows that the Group II and III perform significantly better than Group I. Group III performs better than Group II with no significant difference. CONCLUSION: All the obturating technique showed some degree of microleakage. Root canals filled with C-point system showed least microleakage followed by thermoplasticized obturating technique with no significant difference among them. C-point obturation system could be an alternative to the cold lateral condensation technique.

Microgap Evaluation of Novel Hydrophilic and Hydrophobic Obturating System: A Scanning Electron Microscope Study.

INTRODUCTION: The purpose of an endodontic obturation is to obtain a fluid tight hermetic seal of the entire root canal system. There has been an evolution of different materials and techniques to achieve this desired gap free fluid tight seal due to presence of anatomic complexity of the root canal system. AIM: To compare the microgap occurring in root canals obturated with hydrophilic versus hydrophobic systems using scanning electron microscope. MATERIALS AND METHODS: Sixty extracted human single-rooted premolars were decoronated, instrumented using NiTi rotary instruments. The samples (n=20) were divided into three groups and obturated with Group A - (control group) gutta-percha with AH Plus, Group B - C-point with Smartpaste Bio and Group C - gutta-percha with guttaflow 2. The samples were split longitudinally into two halves and microgap was observed under scanning electron microscope in the apical 3 mm of the root canal. RESULTS: Group A (control) showed a mean difference of 8.54 as compared to 5.76 in group C. Group B showed the lowest mean difference of 0.83 suggesting that the hydrophilic system (C-point/Smartpaste Bio) produced least microgap as compared to the hydrophobic groups. CONCLUSION: Novel hydrophilic obturating system (C-points/ Smart-paste Bio) showed better seal and least microgap as compared to gutta-percha/guttaflow 2 and gutta-percha/ AH plus which showed gap at the sealer dentin interface due to less penetration and bonding of these hydrophobic obturating system.