To show the effect of intermittent fasting during ramadan on endothelial dysfunction via TIMI frame count.

BACKGROUND: Fasting and coronary functions are prestige fields for the study. There are a limited number of studies on these topics. The effect of Ramadan fasting on endothelial dysfunction, which can be manifested by loss of nitric oxide bioavailability, has been demonstrated via flow-mediated vasomotion in patients with the slow coronary flow in a small number of studies. To our knowledge, there is no study showing the relationship between TIMI frame count and Ramadan fasting. AIMS: We aimed to prove that Ramadan fasting can improve endothelial dysfunction which can be documented via the TIMI frame count method in angiography. METHOD: This retrospective study included 67 patients diagnosed with the coronary slow flow by coronary angiographic before Ramadan. All of them were evaluated again via TIMI frame count within a period of 1 to 3 months after Ramadan. We tested our hypothesis that fasting may improve endothelial dysfunction and it was proved by the TIMI frame count method in our study. RESULTS: TIMI frame counts measured angiographically from LAD, Cx, and RCA and they were significantly lower than the counts before fasting. All coronary frame count parameters showed significant improvement after Ramadan compared with the baseline values before the Ramadan fasting period (P < 0.001). CONCLUSION: Our results revealed that fasting and lifestyle changes during Ramadan may be beneficial for the improvement of endothelial dysfunctions in patients with the slow coronary flow and this can be showed easily using TIMI frame count. This is a practical and easy method for showing coronary functions.

X-ray diffraction analysis of MTA mixed and placed with various techniques.

OBJECTIVES: The aim of this study was to evaluate the effect of various mixing techniques as well as the effect of ultrasonic placement on hydration of mineral trioxide aggregate (MTA) using X-ray diffraction (XRD) analysis. MATERIALS AND METHODS: One gram of ProRoot MTA and MTA Angelus powder was mixed with a 0.34-g of distilled water. Specimens were mixed either by mechanical mixing of capsules for 30 s at 4500 rpm or by manual mixing followed by application of a compaction pressure of 3.22 MPa for 1 min. The mixtures were transferred into the XRD sample holder with minimum pressure. Indirect ultrasonic activation was applied to half of the specimens. All specimens were incubated at 37 °C and 100% humidity for 4 days. Samples were analyzed by XRD. Phase identification was accomplished by use of search-match software utilizing International Centre for Diffraction Data (ICDD). RESULTS: All specimens comprised tricalcium silicate, calcium carbonate, and bismuth oxide. A calcium hydroxide phase was formed in all ProRoot specimens whereas among MTA Angelus groups, it was found only in the sample mixed mechanically and placed by ultrasonication. CONCLUSIONS: Mechanical mixing followed by ultrasonication did not confer a significant disadvantage in terms of hydration characteristics of MTA. CLINICAL RELEVANCE: Clinicians vary in the way they mix and place MTA. These variations might affect their physical characteristics and clinical performance. For ProRoot MTA, the mixing and placement methods did not affect its rheological properties, whereas for MTA Angelus, mechanical mixing combined with ultrasonic placement enhanced the calcium hydroxide phase formation.

Renal Frame Count and High Blood Pressure.

OBJECTIVE: The aim of the present study was to demonstrate the relationship between hypertension stages according to JNC-8 classification and mean renal frame count (RFC), which is an indicator of renal perfusion. METHODS: In this retrospective study, 100 hypertensive patients without obstructive renal artery disease, who had been evaluated with renal artery angiography for hypertension, were allocated into 2 groups (Stage 1 and Stage 2 hypertension). During coronary angiography, the patients were evaluated by selective renal angiography using 6F Judkins catheter. Cineangiographic images were evaluated by the same clinician and mean RFC was estimated for both renal arteries. Injections during renal angiography were performed with power injector and same amount of radiopaque media with same speed was used for all patients. RESULTS: There was no significant difference between the groups in terms of age, sex, duration of hypertension, and laboratory markers. Stage 2 hypertensive patients (Group 2) had a significantly higher mean RFC than Stage 1 hypertensive patients (Group 1) (p<0.001). The mean RFC of both kidneys in Group 2 was significantly higher than that of Group 1 (p<0.001 and p=0.023, respectively). CONCLUSIONS: This study showed that the mean RFC increased with increases in hypertension levels and it could be used as an indicator of renal perfusion, which is an indirect marker of renal function. If renal artery flow gets slower, blood pressure levels increase and there is a proportional relationship between these two variables (mean RFC and blood pressure levels). This study also demonstrated that there was a statistically significant correlation between mean RFC and JNC-8 hypertension stages.

A new method for left carotid angiography: use right judkins 4 guiding (6f) catheter with 2 side holes.

OBJECTIVE: To introduce a rapid and simple technique to engage and localize through left common carotid (LCCA) artery during selective carotid angiography using the same type of catheter (6F Medtronic™/launcher Judkins Right Guide Catheter, 4.0 Tip,2 Side holes, U.S.A.). METHODS: Patients were divided into two groups as new method and conventional method group including 295 and 292 prior to carotid angiography, respectively. The primary endpoints of this study included an analysis of total procedure time, time required for cannulation of left common carotid artery, fluoroscopy time and selective imaging success for left common carotid artery, feasibility, safety, amount of radio opaque agent and radiation exposure. RESULTS: Our novel method applied using a single catheter shortened total procedure time (5.41 ± 1.56 min. vs. 7.52 ± 2.48 min., respectively, p<0.001), fluoroscopy time (98 ± 9 sec. vs. 210 ± 19 sec., respectively, p<0.001), duration of left carotid artery cannulation (15 ± 1.2 sec vs. 42 ± 1.9 sec, respectively, p< 0.001). Use of our method reduced radiation exposure (120 ± 17 mGy vs. 217 ± 11 mGy, respectively, p<0.001), amount of contrast agent (44.99 ± 12.84 ml vs. 59.89 ± 18.93 ml, respectively, p<0.001). Aortic arch angiography was not needed in the first group compared with the conventional method group (0% vs. 29%, respectively, p<0.001). Also a higher success was achieved in cannulation of left common carotid artery using an identical catheter compared with application of conventional methods requiring use of different types of catheter (100% vs. 60%, respectively, p<0.001). No major complication and mortality was found due to use of both methods. However, a statistically insignificant elevation in minor complication was encountered in the patient group who underwent coronary angiography by the conventional method (3% vs. 7%, respectively, p<0.064). CONCLUSIONS: This new method is more easily applicable with a shorter duration for cannulation and localization of LCCA, safer for the patients with use of a limited amount of radio-opaque agent and finally cost-effective by requiring only one type of catheter and a limited.

Plasma galectin-3 as a biomarker for clinical staging of heart failure: a cross-sectional evaluation of 100 cases.

OBJECTIVES: To evaluate the plasma galectin-3 concentration associated with the severity of HF and its use as a biomarker for clinical staging of heart failure (HF). METHODS: This was a cross-sectional study, in which 100 HF cases diagnosed by clinical parameters and echocardiography were included and subgrouped into NYHA classes (I-IV) based on clinical severity and functional limitations. Plasma galectin-3 was measured with respect to these subgroups. RESULTS: The median plasma galectin-3 concentration in pg/mL was 82.7 (95% confidence interval: 64.5-112.7), 267.2 (214.3-293.5), 694.8 (626.4-902.4), and 1530.4 (1443.1-2384.4) in NYHA class I, II, III, and IV subgroups, respectively (p <0.05). The proposed galectin-3 concentrations in mild, moderate, and severe HF were 100-460, 460-1170, and >1170 pg/mL, respectively. Galectin-3 was negatively correlated with LV Ejection fraction (EF) by Simpson's biplane method (r=-0.634, p<0.001). Pro BNP showed that the level of plasma galectin-3 was positively correlated with the level of plasma NT pro BNP (r = 0.878, p <0.001). CONCLUSIONS: The plasma galectin-3 concentration showed progressive increase with increasing severity of HF; therefore, it may be used in clinical staging of the disease.

Dentinal wall adaptation of thermoplasticized gutta-percha in the absence or presence of smear layer: a scanning electron microscopic study.

The dentinal adaptation of injected thermoplasticized gutta-percha and thermoplasticized gutta-percha resulting from Ultrafil and Thermafil systems was evaluated by scanning electron microscopy and compared with adaptation obtained with the lateral condensation of gutta-percha. Each method was evaluated with and without the smear layer removed. Scanning electron microscopic observations showed the thermoplasticized gutta-percha resulting from either system to have better dentinal wall adaptation than lateral condensation of gutta-percha in either the absence or presence of the smear layer. In the absence of smear layer, the adaptation of gutta-percha was improved in all groups. Although sealer was used, removing the smear layer was found to enhance the ability of the thermoplasticized gutta-percha to enter the patent tubules.

Evaluation of sealing properties of Thermafil and Ultrafil techniques in the absence or presence of smear layer.

The apical sealing abilities of two thermoplasticized gutta-percha techniques were evaluated. A total of 128 single-rooted teeth were divided into six groups in which Ultrafil, Thermafil, and lateral condensation techniques, with and without the smear layer, were used to obturate 20 roots in each group. The roots were implanted subcutaneously in rats for 90 days to expose the materials to vital tissue and tissue fluids. The roots were recovered, immersed in 1% methylene blue for 2 wk, cleared, and the dye penetration was measured using a dissecting microscope. Thermafil showed the least leakage with smear layer present and Ultrafil the least with it absent. The two thermoplasticized gutta-percha techniques both showed significantly less leakage than lateral condensation with and without the smear layer. Removing the smear layer reduced the leakage significantly in all groups.

Effect of calcium hydroxide and combinations of Ledermix and calcium hydroxide on inflamed pulp in dog teeth.

The effects of Ledermix+calcium hydroxide (Ca(OH)2) or Ca(OH)2 alone on inflamed pulp tissues of dogs were studied. Fifty-nine upper incisor teeth of 10 dogs were used. Class V cavities were prepared and filled with amalgam after placement of decayed dentin particles. After 7 days, the decayed dentin and alloy were removed, and the pulps of the teeth were exposed. Ledermix and Ca(OH)2 mixtures or Ca(OH)2 alone were applied to the cavities. At the end of 7, 30, and 90 days, the teeth were extracted and examined histopathologically. Inflammation was found to be more prevalent in the 7- and 30-day groups that were treated with the Ledermix+Ca(OH)2 combination, whereas fibrosis and necrosis were nearly similar in both groups. In the 90-day groups, no inflammation was seen. No difference between the two 90-day groups with regard to reparative dentin was found.

A scanning electron microscopic study of external root resorption in replanted dog teeth.

Root resorption after replantation of mature permanent dog incisors was examined by scanning electron microscopy. Three groups consisting of three extracted teeth each were kept in a saline solution for 5, 30, and 120 min before replantation. The first group was replanted with the pulp intact. The second and third groups were replanted after root canal filling by Calciobiotic Root Canal Sealer. After 90 days, the teeth were extracted and the apical root surfaces were examined. Severe inflammatory root resorption was observed in the first (intact pulp) group. For the root canal filled teeth, the degree of root resorption was observed to be much less in those kept in saline for 30 min than in those kept for 120 min.

Effect of CO2, Nd:YAG, and ArF excimer lasers on dentin morphology and pulp chamber temperature: an in vitro study.

This study compared the effect of three laser systems: CO2 (10.600 nm), Nd:YAG (1.064 nm), and ArF excimer (193 nm) lasers on dentin hard tissue and on temperature increases of the pulp chamber. Sixty-six third molar teeth were used and randomly divided into three groups. A class I cavity was made to expose the dentin, and the pulp in the pulp chamber was removed via a hole bored in the cervical area. The pulp chamber was subsequently refilled with silicon grease, and a NiCr/NiSi thermocouple was inserted through the hole into the pulp chamber. The dentin surface was then lased for 30 s at the same settings (3 W, 2 mm spot size, 20 pps) with each laser. The average internal temperature increases were as follows: CO2, 37 degrees C; Nd: YAG, 28 degrees C; and ArF excimer, 1 degrees C. Scanning electron microscopy of the dentin in the occlusal cavity revealed extensive carbonization, isolated balls of recrystallized material, and the presence of smear layer at some dentinal tubule orifices for the CO2 and Nd:YAG lased teeth. Smear layer was also observed for the ArF excimer samples; however, they exhibited far less surface cavities than the others and seemed to undergo little morphological change on the dentin.

Effects of Nd: YAG laser, air-abrasion and acid-etching on human enamel and dentin.

The effects of the Nd:YAG laser, air-abrasion and acid-etching systems on mineral content and surface morphology of cut dentin and enamel were examined in 10 extracted human teeth. Enamel specimens were lased for two seconds at a fluence of 0.75 J and a frequency of 15 Hz, air-abraded for two seconds with 50 micron Al-oxide and etched for 60 seconds with 37% ortho-phosphoric acid. Dentinal specimens were subjected to the same procedure for half the time. Untreated areas of the same specimens served as the control. Morphologically, the lased dentin showed an apparently melted surface with partial obstruction of the dentin tubules, as well as cracks along the lased surface. Air-abrasion created very irregular surfaces on enamel and dentin. Dentin tubules were observed on the acid-etched dentin samples but not the air-abraded surfaces. The Nd:YAG laser created the most surface irregularity on both enamel and dentin. Laser treatment appeared to alter the chemical structure and surface morphology of the dentin and enamel.

An investigation of the effect of a desensitizing dentifrice on dentinal tubules in vitro and in vivo.

The effect of Sensodyne dentifrice, which contains strontium chloride hexahydrate, on the occlusion of dentinal tubules was studied in vivo and in vitro. Eight premolar teeth scheduled for extraction for orthodontic purposes were used. Four of the teeth were extracted before Sensodyne application (in vitro). The other four teeth were treated in vivo and then extracted. A patch of enamel was removed from all the teeth to expose the dentinal surfaces, and the smear layer over the exposed area was removed. In the in vivo test, the patients were instructed to brush their teeth for 1 minute, twice a day, for 2 weeks. The teeth were then extracted and kept in distilled water until examined by scanning electron microscope. The in vitro teeth were brushed in the same manner and kept in distilled water between brushings. Most of the in vitro dentinal tubules were found to be open, whereas most of the in vivo dentinal tubules were occluded.

Early tensile bond strength between dentin and composite resin mediated by bonding agents.

The aim of this study was to evaluate, in vitro, the early tensile bond strength values of three dentin bonding agents (Scotchbond, Tenure and Gluma) to dentin. Fifteen non-carious, extracted, human third molars were used in this study. The bond strengths were calculated in an Instron test machine and expressed in MN/m2. The results were evaluated statistically using the Student-test. The in vitro tensile bond strengths of the three bonding agents to dentin showed higher values than the tensile bond strength of composite resin alone and differences among the bond strengths were significant (P < 0.05). Greater bond strength values were obtained with the Gluma bonding system than with Scotchbond or Tenure systems.

Two-dimensional photoelastic stress analysis of traumatized incisor.

In this study, stress of traumatized incisor and the effect of stress on tooth and alveolar bone was studied with two-dimensional photoelasticity. Two homogeneous two-dimensional maxillary central incisor models were prepared. Loads were applied to the labial side of incisal edge and middle third of the crown at angles of 45 degrees and 90 degrees. It was observed that stress was increased on teeth and alveolar bone when load was applied 90 degrees on labial side of incisal edge.

Effects of the Nd:YAG laser, air-abrasion, and acid-etchant on filling materials.

The purpose of this study was to determine any inadvertent effects of the neodymium: yttrium-aluminium-garnet (Nd:YAG) laser, air-abrasion, and ortho-phosphoric acid on some conventionally used dental filling materials [amalgam, composite resin, compomer, glass-ionomer cement (GIC), and ceromer], when they were used for purposes of margin etching and assessed according to standard enamel etching parameters using a total of five fillings. The surfaces of the filling materials were polished. One sample from each material group was exposed to laser (at 0.75 J, 15 pps) and air abrasion (with Al-oxide powder, 60 psi) for 2 s and to the 37% ortho-phosphoric acid for 60 s. The exposed materials were examined under Scanning Electron Microscopy (SEM). After laser treatment most specimens showed recrystallized areas, the GIC surface being the most affected. There were some pores and cavities on the amalgam surface following laser treatment. The abraded surfaces showed mechanical abrasions. The acid etchant showed the least effect. During the application of laser or air-abrasion, the adjacent tooth or filling surface must be protected or the dentist must be careful.

The effects of acid application on the dentine surface smear layer: an S.E.M. study.

In this study, the effect of citric acid and LIV CENERA Liquid (40% poly-acrylic acid) on the smear layer of the dentine surface was investigated. Twelve freshly extracted, non-carious human molar teeth were used and approximately 25 mm2 flat occlusal dentine surfaces were prepared. Citric acid and LIV CENERA Liquid were applied for 10 and 30 seconds to the dentine surfaces. The results of our study indicated that: 1. Conditioning with LIV CENERA Liquid for 10 seconds was not effective in removing the smear layer on the dentinal tubules but application for 30 seconds was partially effective. 2. Although 10 seconds application of citric acid was not effective in removing the smear layer, 30 seconds application removed it completely, but harmful effects were observed on the dentinal tubules. 3. Conditioning with citric acid is more effective than the application of LIV CENERA Liquid in removing the smear layer, but LIV CENERA Liquid in contrast to citric acid application, did not enlarge the dentinal tubules.

Investigation of surface corrosion in amalgam.

In this study, surface corrosion of carved and polished specimens of conventional and high-copper amalgams was investigated. The specimens were studied to detect surface corrosion after immersion in artificial saliva for 48 h or 1 year, and later investigated by SEM. Corrosion was greatest in 1-year-immersed carved conventional amalgam specimens. The surface was very rough with the contours of the particles visible and deep holes opening at the surface. High-copper amalgam specimens showed less corrosion than conventional amalgam specimens.

The use of computed tomography when comparing nickel-titanium and stainless steel files during preparation of simulated curved canals.

AIM: The aim of this study was to compare canal preparations completed with Hedstrom and K-files of ISO size 15 - 40, made of nickel-titanium (Ni-Ti) and stainless steel (SS). METHODOLOGY: Eighty simulated canals with 200 and 30 degrees C curvatures were prepared using the step-back technique and quarter turn/pull instrument manipulation. Middle and apical level canal sections were taken using computed tomography. RESULTS: No significant difference was found between any of the file types at either level with respect to canal curvature (20 degrees or 30 degrees). At the middle level, the stainless steel files caused more enlargement toward the inner part, compared to nickel-titanium files. At the apical level, nickel-titanium canal files caused more enlargement toward the inner part, whereas more outward enlargement was caused by stainless steel instruments. No significant difference could be observed at the middle level (P > 0.05) related to the enlargement toward the outer side of the canal curvature. Transportation at both levels was significantly less (P < 0.001) for the Ni-Ti files than the SS ones. Centring ratios of the file types at the middle level were low, but not significantly different (P > 0.05), whereas at the apical level the centring ratios were significantly higher for the Ni-Ti files (P < 0.001). CONCLUSIONS: Ni-Ti instruments produced preparations with adequate enlargement, less transportation, and a better centring ratio.

Pulp responses to three dentine bonding agents in dogs' teeth.

The purpose of this study was to evaluate pulp reactions to cavities treated with Scotchbond Dual Cure, Gluma and Tenure dentine bonding agents in four adult dogs, at intervals of 7, 30 and 90 days. The reactions were compared with the results from a control group in which the cavities were treated with zinc oxide/eugenol cement. The results indicated that Scotchbond Dual Cure dentine bonding agent caused less pulp reaction than Gluma and Tenure dentine bonding agents. However, long-term (90 days) specimens showed that none of these three bonding agents caused any severe reaction. The recovery of the pulp and a thick layer of reparative dentine formation were found quite significant.

A comparative study of the area of the canal space obturated by thermoplasticized gutta-percha techniques.

Two thermoplasticized gutta-percha techniques were evaluated for the percentage area of canal obturated by gutta-percha and compared with the lateral condensation of gutta-percha technique. All obturation systems were used in conjunction with Grossman's sealer. Single rooted teeth were obturated by either injected thermoplasticized gutta-percha (Ultrafil), thermoplasticized gutta-percha with metal carrier (Thermafil) or lateral condensation of gutta-percha. There were ten specimens in each group. The teeth were embedded in resin, sectioned at 1.5 mm, 3 mm and 4.5 mm from the root apex and examined with a stereomicroscope. Specimens filled by Ultrafil and Thermafil contained a significantly higher percentage of gutta-percha than specimens filled by the lateral condensation technique at every level. However no difference was found between Ultrafil and Thermafil. Three lateral condensation specimens showed voids at the 1.5 mm section; no voids were detected in specimens filled by Ultrafil or Thermafil at any level.