Evaluation of the Canal Transportation Following Glide Path Preparation with Different Rotary Systems: A Comparative Study.

Objectives: Ideal root canal shaping might be more challenging particularly in cases with severely curved canals or complex anatomical variations. Glide path preparation is suggested as a critical step to achieve ideal canal preparation. The present study is aimed at evaluating transportation at different levels of the canal following glide path preparation by five different path finders. Materials and Methods: The study was conducted on 100 S-shaped canal simulator blocks. Glide path was prepared in five groups including (1) Scout RaCe (#10 and #15, 0.02), (2) One G (#14, 0.03), (3) PathFile (#13 and #16, 0.02), (4) GPS (#15, 0.03), and (5) K file (#15, 0.02) (Control group). The first four groups were NiTi rotary instruments, while the last group was a stainless steel hand file. The aforementioned files were used after canal negotiation by a #10 stainless steel hand file. Before- and after-preparation photos were taken and were superimposed in Adobe PhotoShop CC 2019. Transportation measurements were conducted in Digimizer. Absolute canal transportation was calculated at 10 cross-sections. Intergroup and intragroup data analysis were conducted using one-way and repeated measures ANOVA tests, respectively, in SPSS 26.0. The significance level was set to 0.05. Results: Although K file led to significantly more transportation in the apical and middle thirds (p < 0.001), rotary groups were not statistically different. In the coronal third, K files led to significantly more transportation compared to Scout RaCe and PathFile (p < 0.05). Conclusion: Within the limitations of the present study, regardless of the recruited rotary system, glide path preparation using NiTi rotary instruments leads to less canal transportation compared to stainless steel hand files.

Long-Term Outcomes of 6-Week Treatment of Lotilaner Ophthalmic Solution, 0.25%, for Demodex Blepharitis: A Noninterventional Extension Study.

PURPOSE: The aim of this study was to evaluate the long-term outcomes of lotilaner ophthalmic solution, 0.25%, in the treatment of Demodex blepharitis. METHODS: This observational, extension study included patients with Demodex blepharitis (N = 239) who completed the Saturn-1 study and presented for the day 180 visit. All participants were assessed at days 180 and 365 after the initiation of 6-week treatment with the study drug or its vehicle. RESULTS: The proportion of patients with 0 to 2 collarettes (grade 0) was significantly higher in the study group (N = 128 patients) than in the control group (N = 111 patients) (39.8% vs. 2.7% at day 180 and 23.5% vs. 2.9% at day 365; P < 0.0001). Similarly, the proportion of patients with ≤10 collarettes (collarette grade 0-1) in the study group was significantly higher than in the control group (70.3% vs. 18.0% at day 180 and 62.6% vs. 21.9% at day 365; P < 0.0001). In the study group, erythema continued to improve even after completion of the 6-week lotilaner treatment. No serious ocular adverse events were observed in the study group, and there was 1 treatment-related ocular adverse event in the study group, which was considered mild. CONCLUSIONS: After 6-week treatment with lotilaner ophthalmic solution, 0.25%, for Demodex blepharitis, no long-term concerns were observed during 1 year of follow-up. A high proportion of patients with 0 to 2 collarettes (grade 0) or ≤10 collarettes (collarette grade of 0 or 1) was observed throughout 1 year of follow-up, indicating that the efficacy of lotilaner ophthalmic solution, 0.25%, against Demodex blepharitis may last well after completion of therapy.

Cyclic Fatigue Resistance of Five Different Glidepath Files in a Double Curved Artificial Canal.

Introduction: The aim of this study was to examine the cyclic fatigue resistances #16 ProGlider, #15.02 Scout RaCe, #15.03 NeoNiTi GPS, One G and Path-File NiTi glide path files in S-shaped artificial canals. Materials and Methods: Twenty files from each group were tested. An artificial groove simulating double (S-shaped) curved canal measuring 1.5 mm in width at the top level decreasing towards the apical reaching 0.3 mm at the tip having a 0.06 taper, 18 mm in length, and 1.5 in depth machined in a stainless steel block was used in this study. Resistance to cyclic fatigue was determined by counting the numbers of cycles to failure (NCF). Furthermore, the fragment length of the fractured tips and angle and radius of curvature formed by each file in each trajectory were evaluated. The data were analyzed using the one-way analysis of variance and Tukey's HSD test and the level of significance was set at 5%. Results: NeoNiti GPS and Scout RaCe glide path files showed significantly higher NCF values compared to other evaluated glide path files (P<0.001) but no significant difference when compared with each other (P=0.67). Conclusion: Based on this in vitro study NeoNiti GPS and Scout RaCe glide path files had the highest cyclic fatigue resistance in simulated double (S-shaped) curved artificial canals among the evaluated path finding files. Therefore, it seems that they can be used with more confidence in endodontic treatment of S-shaped canals clinically.

The Prevalence of Demodex Blepharitis in US Eye Care Clinic Patients as Determined by Collarettes: A Pathognomonic Sign.

Purpose: To evaluate the prevalence of Demodex blepharitis by its pathognomonic sign, collarettes, in patients presenting for any reason to eye care clinics in the United States. Patients and Methods: In this retrospective study by 7 investigators at 6 eye care clinics, case records of consecutive patients who underwent a slit-lamp examination, regardless of chief complaint, were reviewed for Demodex blepharitis, as identified by the presence of collarettes. Patient characteristics, including age, gender, race, relevant ocular and systemic diagnoses, ocular medications, lid hygiene practices and contact lens wear, were also recorded. Results: Of 1032 patients (mean age: 60.2 ± 17.8 years), 57.7% had Demodex blepharitis. While the prevalence of Demodex blepharitis in patients with dry eye disease (DED) (58.9%) and cataract (55.7%) was similar to the overall prevalence of Demodex blepharitis, it was higher in patients with blepharitis (69.1%) and glaucoma (64.8%). Among patients with collarettes, 44.0% had never been diagnosed with blepharitis. Among those on anti-inflammatory DED treatment, 60.0% had Demodex blepharitis. Demodex blepharitis prevalence was significantly higher among those using topical tea tree oil versus those who were not (74.5% versus 56.7% p = 0.014); prevalence was comparable among those using/not using lid wipes (56.9% versus 55.5%). Conclusion: Demodex blepharitis, based on the pathognomonic finding of collarettes, is common and likely underdiagnosed among patients seeking eye care. These collarettes are still found in patients using over-the-counter treatments for blepharitis. The present study highlights the importance of screening patients for collarettes and Demodex blepharitis as part of every slit-lamp examination.

Evaluation of the Fractured Surface of Five Endodontic Rotary Instruments: A Metallurgical Study.

INTRODUCTION: The aim of this study was to compare several metallurgic properties of Neoniti instrument with four other commonly used endodontic rotary files. METHODS AND MATERIALS: Neoniti A1 (25/0.08), RaCe (25/0.06), Mtwo (25/0.06), Twisted file (25/0.06) and ProTaper Next X2 (25/0.06) were examined by differential scanning calorimetry (DSC) before and after heat treatment at 500°C. X-ray diffraction (XRD) was also performed on the specimens. Furthermore, scanning electron microscopy (SEM) and x-ray energy-dispersive spectrometric (EDS) analyses were carried out on randomly selected fractured files. RESULTS: In SEM tests, dimpled ruptures, characteristic of ductile fracture, were seen in all evaluated cross sections of all files. The SEM results of all evaluated files were alike. EDS results revealed higher proportions of Nickel (Ni) rich intermetallic compounds in Neoniti; whereas, in all the other files the proportion of Titanium (Ti) rich precipitates was higher. DSC results indicated that the temperature present in the oral environment, the austenite phase existed in all files. Mtwo and RaCe files did not show austenite transformation in the temperature range evaluated in this study. Only Neoniti revealed rhombohedal phase (R-phase) transformation. After heat treatment. No significant difference was seen in the transformation temperatures of all evaluated files. XRD evaluations revealed that Neoniti contained both Ni-rich and Ti-rich precipitates. The amount of the martensite phase was higher in ProTaper Next. CONCLUSION: The metallurgic properties of Neoniti files were different from other evaluated rotary files. This file contained higher proportions of Ni-rich precipitates.

Comparison of Cyclic Fatigue Resistance of Five Nickel Titanium Rotary File Systems with Different Manufacturing Techniques.

OBJECTIVES: The purpose of this study was to evaluate the resistance to fatigue failure of five different nickel-titanium rotary files in three different curved trajectories. MATERIALS AND METHODS: A total of 150 Neoniti A1, RaCe 25.06, Mtwo 25.06, Twisted file 25.06 and ProTaper Next X2 files with the tip size of 25 were tested (n=30 for each group). Three groove types simulating curved canals were used differing in radius, arc length and position of the arc, each measuring 1.5 mm in width, 20 mm in total length and 2.5 in depth. Resistance to cyclic fatigue was determined by counting the numbers of cycles to failure. Furthermore, the fragment length of the fractured tips and angle and radius of curvature formed by each file in each trajectory were evaluated. The data were analyzed by t-test, one way ANOVA and Tukey's HSD test. RESULTS: Neoniti showed the highest and RaCe showed the lowest number of cycles to fracture (NCF) values (P<0.05), indicating the highest and lowest fatigue resistance, respectively. The highest and lowest curvature angles were seen in RaCe and Neoniti, respectively. Regarding the radius of curvature, Twisted file had the lowest and Neoniti had the highest values. The mean NCF of all rotary files was lower in the more coronally curved trajectory. CONCLUSION: The fatigue resistance of the evaluated rotary files was lower in more coronally located curvatures. Neoniti exhibited the highest and RaCe exhibited the lowest fatigue resistance compared to other evaluated files.

Once daily dosing of bromfenac ophthalmic solution 0.09% for postoperative ocular inflammation and pain.

OBJECTIVE: To evaluate the efficacy and ocular safety of bromfenac ophthalmic solution 0.09% dosed once daily for the treatment of ocular inflammation and pain following cataract extraction with posterior chamber intraocular lens implantation. METHODS: A total of 455 subjects (455 study eyes: 230 bromfenac, 225 placebo) were enrolled in two randomized double-masked, placebo-controlled, clinical trials at 64 ophthalmology clinics in the United States. Subjects were randomized to receive either bromfenac 0.09% or placebo dosed once daily. Dosing began 1 day before cataract surgery (Day -1), continued on day of surgery (Day 0), and for 14 days following surgery. Evaluations were completed on Days 1, 3, 8, 15 and 22. The primary efficacy endpoint was cleared summed ocular inflammation score (SOIS) by Day 15. The secondary efficacy endpoint was the number of subjects who were pain-free at Day 1. RESULTS: The bromfenac 0.09% group was significantly higher compared to the placebo group in the primary endpoint of the proportion of subjects who had cleared ocular inflammation by Day 15 (P < 0.0001). The mean SOIS for the bromfenac 0.09% group was lower than the placebo group at Days 3, 8, 15, and 22 (P < 0.0001). More bromfenac 0.09% subjects were pain free at Days 1, 3, 8, and 15 (P < 0.0001). Fewer subjects in the bromfenac 0.09% group withdrew from the clinical trials due to lack of efficacy at Day 15 (P < 0.0001). Fewer adverse events were reported in the bromfenac 0.09% group than the placebo group. Limitations included advanced age, female predominance, and surgical nuances among cataract surgeons, making cross-trial comparisons difficult. CONCLUSIONS: Bromfenac ophthalmic solution 0.09% dosed once daily is clinically safe and effective for the treatment of ocular inflammation and the reduction of ocular pain associated with cataract surgery.