Creep Behavior of Resin Composite Interface Between Orthodontic Brackets and Enamel.

PURPOSE: The present study investigated the creep of adhesive resin under constant loading at the orthodontic bracket/enamel interface with an orthodontic bracket-tooth model (shear creep) and three-point bending test (bending creep). MATERIALS AND METHODS: For the bracket-tooth model, sixty premolars were assigned to 4 groups (n = 15). Orthodontic brackets were bonded onto the enamel surface using four different bonding agents: conventional, homogeneous Transbond XT orthodontic composite (group 1/TBC); Transbond XT composite reinforced with photopolymerized glass-fiber-reinforced composite (FRC with bidirectional fibers) (group 2/TBE); Transbond XT reinforced with FRC of vertically oriented unidirectional fibers (group 3/TBV); and Transbond XT reinforced with FRC of horizontally oriented fibers (group 4/TBH). Load was applied at the bracket/tooth interface and from the bracket wire slot. In the three-point bending test, the creep and recovery of the rectangular interface materials were tested by a dynamic mechanical analyzer. The data obtained were statistically analyzed with ANOVA and a post-hoc test using SPSS v20 statistical software. RESULTS: The groups exhibited significant differences in strain % and time for bracket deflection at the interface (p < 0.05). The interface loading with unidirectional fibers (groups TBV and TBH) were statistically significantly different compared to the interface with bidirectional fibers and control group (groups TBE and TBC). The three-point test showed the least creep compliance (ie, creep deformation occurring at each time point [J]) with group TBC, followed by groups TBV and TBE. Group TBC showed the highest nanohardness and elastic modulus; the lowest values were seen in group TBE, reflecting differences in polymer matrix composition. CONCLUSION: The creep and time for debonding the bracket increased with incorporation of glass fibers at the interface between bracket and enamel.

From Drug Discovery to Drug Approval: A Comprehensive Review of the Pharmacogenomics Status Quo with a Special Focus on Egypt.

Pharmacogenomics (PGx) is the hope for the full optimization of drug therapy while minimizing the accompanying adverse drug events that cost billions of dollars annually. Since years before the century, it has been known that inter-individual variations contribute to differences in specific drug responses. It is the bridge to what is well-known today as "personalized medicine". Addressing the drug's pharmacokinetics and pharmacodynamics is one of the features of this science, owing to patient characteristics that vary on so many occasions. Mainly in the liver parenchymal cells, intricate interactions between the drug molecules and enzymes family of so-called "Cytochrome P450" occur which hugely affects how the body will react to the drug in terms of metabolism, efficacy, and safety. Single nucleotide polymorphisms, once validated for a transparent and credible clinical utility, can be used to guide and ensure the succession of the pharmacotherapy plan. Novel tools of pharmacoeconomics science are utilized extensively to assess cost-effective pharmacogenes preceding the translation to the bedside. Drug development and discovery incorporate a drug-gene perspective and save more resources. Regulations and laws shaping the clinical PGx practice can be misconceived; however, these pre-/post approval processes ensure the product's safety and efficacy. National and international regulatory agencies seek guidance on maintaining conduct in PGx practice. In this patient-centric era, social and legal considerations manifest in a way that makes them unavoidable, involving patients and other stakeholders in a deliberate journey toward utmost patient well-being. In this comprehensive review, we contemporarily addressed the scientific leaps in PGx, along with various challenges that face the proper implementation of personalized medicine in Egypt. These informative insights were drawn to serve what the Egyptian population, in particular, would benefit from in terms of knowledge and know-how while maintaining the latest global trends. Moreover, this review is the first to discuss various modalities and challenges faced in Egypt regarding PGx, which we believe could be used as a pilot piece of literature for future studies locally, regionally, and internationally.