[Bracing in Adolescent Idiopathic Scoliosis].

Scoliosis is a common medical problem, with an incidence of between 0.47% and 5.2% in the general population globally. Adolescent idiopathic scoliosis (AIS) accounts for nearly 80% of all scoliosis. Young people with AIS often experience negative social consequences in association with their condition. Without proper and timely treatment, the potential resulting disabilities range from trunk deformity, pain, and neurological complications to compromised cardiopulmonary function, all of which may cause lifelong suffering. Scoliosis may be treated either conservatively or surgically, based on the severity of the disease. Bracing is the most widely adopted method of conservative treatment. However, the main goal of bracing is to inhibit the progression of the spinal curvature rather than to cure scoliosis. The clinical effectiveness of bracing in Taiwan has often been underutilized as a result of financial or other factors such as the availability of the treatment. The purpose of the present review is to clarify the effectiveness of bracing for AIS by elucidating the pathophysiology of scoliosis and examining the recent clinical evidence. The importance of preventative care and the unique contribution of nursing care to treatment has to date been under-recognized. The positive support that nurses provide to the families of the patients during the early phases of treatment as well as to the patients themselves, including helping them exercise appropriately and wear the brace correctly, is an essential component of effective treatment. Learning how to work with and to adapt to the brace being part of the body is an important part of the treatment as well as a way to avoid pain. Nurses are in an ideal position to facilitate this learning process and, overall, to provide health education.

Which Factors Influence the Shear Bond Strength of Sealant Materials?

PURPOSE: This study investigated the influence of several methodological details on the shear bond strength (SBS) testing of pit and fissure sealants. The following variables were considered: type of enamel surfaces, prismatic vs aprismatic enamel, etching time, and aging and shearing procedures. MATERIALS AND METHODS: The surfaces of 180 healthy human third molars were divided into 4 different sections (mesial, distal, buccal, and oral). After tooth separation, the specimens were randomly allocated to the following groups: 1) enamel preparation: prismatic vs aprismatic; 2) etching: 30 s vs 60 s; 3) aging: 1 day or 3 months vs 5000 thermocycles; 4) shearing: notched-edge method (ISO 29022:2013) vs knife-edge method. After following each protocol, SBS was determined using a universal testing machine, followed by failure mode analysis. Data were analysed using Mann-Whitney U-tests and regression analyses. RESULTS: In the aprismatic enamel group, the longer etching time resulted in slightly, not statistically significantly higher SBS. When aging sealants on aprismatic enamel with different procedures, significantly lower SBS was found for 5000 thermocycles. In the case of aprismatic enamel etched for 60 s and sheared with the notched-edge blade, there was no significant difference between the aging procedures. Failure mode analysis showed adhesive failures to be predominant. Simple linear regression revealed that all of the included factors significantly influenced SBS. In a multiple linear regression model, the variables "aprismatic enamel" and "distal surface" were associated with a higher SBS; "5000 thermocycles" reduced SBS significantly. CONCLUSION: Enamel grinding, aging method, and type of enamel surface significantly influenced the SBS.

Does etching time affect the in vitro performance of a sealant material?

This in vitro study evaluated the shear bond strength (SBS), failure mode and microleakage of fissure sealing materials in relation to different etching times on aprismatic and prismatic enamel. Ninety-six healthy human third molars were randomly allocated to the following groups: 1) prismatic or aprismatic enamel; 2) etching: 15, 30, 45, 60 s. After 5,000-fold thermocycling SBS, failure mode and microleakage were measured. Statistical evaluation included Mann-Whitney-U-test and linear regression analysis. In the aprismatic enamel group, an increasing etching time resulted in higher SBS. The linear regression model revealed that 60 s of etching time led to a significant increase in SBS. Microleakage was found to be low in all test groups. This study indicated that 60 s of etching time showed to a significantly better SBS. When considering the small differences of SBS, failure modes and microleakage between 30 and 60 s etching time, 30 s acid etching seems to also be justifiable.

Meta-analysis of the longevity of commonly used pit and fissure sealant materials.

OBJECTIVE: This systematic literature review and meta-analysis compared the clinical retention of primed or adhesively bonded sealants to that of conventional sealant materials. METHODS: A search of the MEDLINE, EMBASE and CENTRAL databases identified 3707 abstracts published prior to 12/31/2017, of which 335 clinical publications were analysed in detail. A total of 67 studies included information about sealant retention after 24, 36, or 60 months of follow-up. A meta-analysis using a random effects model was conducted to calculate the pooled estimate of the retention rates for the five groups of sealants. Subgroup moderator analysis was performed to compare the pooled retention rate estimate (RRE) of primed sealants against those of the other groups. RESULTS: Primed sealants had a 2-year pooled RRE of 43.2% (95% CI: 30.5-55.8), which was significantly inferior to those of auto-polymerizing (80.8%, 95% CI: 72.2-89) and light-polymerizing sealants (68.4%, 95% CI: 60.2-76.7). Fluoride-releasing and light-polymerizing sealants had the highest 3-year pooled RREs (86.4%, 95% CI: 73.4-99.3 and 83.1%, 95% CI: 75.6-90.7, respectively). SIGNIFICANE: The results of this meta-analysis suggest that primed sealants cannot be fully recommended for clinical practice due to their moderate survival rates. Auto-polymerizing, light-polymerizing and fluoride-releasing sealants continue to be considered the reference standards for pit and fissure sealants. However, future generations and developments of primed sealant materials may change this position.

Synthesis of 3-alkoxymethylcoumarin from 3-cyanochromene via a novel intermediate 2-phenylimino-3-alkoxymethylchromene.

In this paper a concise, efficient, and environmentally benign method for the synthesis of 3-alkoxymethylcoumarin is described. From the reaction of 3-cyanochromene with an alkoxide and arylamine in THF, (Z)-2-phenylimino-3-alkoxymethylchromene was obtained as a novel intermediate via an isomerization of the double bond, a 1,2-addition of alkoxide, a Michael-type addition of aniline, an another isomerization of double bond and an elimination of ammonia. Subsequently, the intermediate was converted into the desired coumarin by treatment with 15% HCl in THF in good yield.

What is an Appropriate Etching Time For Sealant Application on Permanent Molars? Results from a Meta-Analysis.

PURPOSE: This meta-analysis investigated the influence of different acid etching times on the retention rate of pit-and-fissure sealants based on clinical trials with a minimum duration of two years. MATERIALS AND METHODS: A literature search was carried out in electronic databases along with hand searching to identify clinical trials that evaluated pit-and-fissure sealants in permanent molars. From 1280 identified abstracts, 195 studies were selected for full-text analysis, and 28 studies with 36 test groups were included in this meta-analysis. Test groups with etching times of 15 (n = 3), 20 (n = 2), 30 (n = 10), 40 (n = 1) and 60 s (n = 20) were found. Incidence rates of pit-and-fissure sealant losses were modelled using negative binomial regression. RESULTS: The regression analysis did not reveal a significant influence of etching time on the survival of pit-and-fissure sealants based on the identified and included clinical trials. CONCLUSIONS: Due to the limited number of clinical data for 15 and 20 s, conclusions regarding very short acid etching times were not possible. On the basis of regression analysis, a minimum of 30-s acid etching might be sufficient prior to fissure sealing.