Multi-peak Light-emitting Diode Curing Units and Polymerization of 3D-printed Crown and Bridge Resin.

PURPOSE: This study aimed to evaluate the substitutive and additive efficacy of multi-peak light-emitting diode (LED) curing units for post-curing of a three-dimensional- (3D-) printed crown and bridge resin. METHODS: A total of 792 disc- and 180 bar-shaped specimens were printed with a crown and bridge resin (NextDent C&B MFH) and post-cured using two LED curing units (VALO Cordless and Bluephase N G4) in fast and standard modes. Conventional post-curing (LC-3D Print Box, Group PC) was compared with LED-only curing (Groups V1, V2, B1, and B2) and LED-combined curing (Groups PV1, PV2, PB1, and PB2) in terms of microhardness, flexural strength, degree of conversion (DC), and CIE L*a*b* color and translucency parameters. Cytotoxicity of the resin eluates was evaluated using the WST-1 assay. Temperature increases on the resin surface were measured with infrared thermography. Data were statistically analyzed using ANOVA and Kruskal-Wallis tests (α=0.05). RESULTS: The microhardness and flexural strength in Groups V1, V2, B1, and DC in all LED-only groups were lower than in other groups (p<0.05). Larger color disparities existed between Group PC and all LED-only groups than between Group PC and the others (p<0.05). There was no significant difference in cytotoxicity among the groups. The temperature increase was lowest in Groups V1 and PV1 during light curing (p<0.05). CONCLUSIONS: Post-curing by multi-peak LED curing units was not as effective as the conventional post-curing device. Additional post-curing by LED curing units did not improve the material properties.

Correction of severe thoracolumbar spondylolisthesis (grade 4) secondary to neurofibromatosis with posterior spinal instrumented fusion alone. A case report.

A 15-year-old teenager with Type 1 Neurofibromatosis presented with grade 4 spondylolisthesis over T12/L1 junction resulting paraparesis (Frankel D). Radiograph showed a Cobb angle of 88 degrees. Computed tomography scan showed dysplastic vertebral bodies, pedicles and facet joints of T11, T12 and L1 vertebra with complete T12/L1 facets dislocation. Magnetic resonance imaging confirmed presence of spinal cord compression. He underwent posterior instrumentation and posterolateral fusion (T8 to L4) using hybrid instrumentation. Extensive corticotomy of the posterior elements was followed by the use of large amount of bone graft. Post operatively, his neurology improved markedly back to normal. Radiographs showed a good correction of the deformity. He was immobilized in a thoracolumbar orthosis for six months. A solid posterior fusion was achieved at six months follow up. At 36-month follow up, he remained asymptomatic. This case report illustrates a successful treatment of a grade 4 thoracolumbar spondylolisthesis secondary to neurofibromatosis with posterior spinal fusion alone.

Synthesis of Cu-CNT nanocomposite powder by ball milling.

In this paper, to improve the poor wettability between the Carbon nanotubes (CNTs) and metal matrix, the mechanical alloying (MA) technique by the ball milling method was employed. Also, the CNTs were pre-coated to improve the agglomeration of the CNTs with copper powder. The main aim of this work is the fabrication of Cu-CNT nanocomposite powder using the MA by ball milling. The as-received dendritic copper powders change their shape sequentially to flaky, disk-typed particles and finally, to globular type particles. Also, the tendency of globular formation was prominent in the milled Cu-Cu coated MWNTs (multi-walled carbon nanotubes) powder and the grain size of the sintered Cu coated MWNTs specimen decreased more than that of the pure copper specimen. Finally, the homogeneous Cu-CNT nanocomposite intermetallic particles having fine grains was produced by the MA method of ball milling.

Comparison of accessory performance using a novel ERCP mechanical simulator.

BACKGROUND AND STUDY AIMS: There is a paucity of in vitro methods for evaluating ERCP accessories. We hypothesize that the time taken to perform a simulated single stent or multiple stents placement is different for stenting systems with or without the capability of intraductal ductal release (IDR) of the guide wire. PATIENTS AND METHODS: We conducted an un-blinded in vitro comparison of ERCP accessories using a mechanical simulator during hands-on ERCP practice workshops. A total of 21 U.S. participants and 20 Chinese participants with various level of ERCP experience took part in the different practice workshops. Accessories with and without the capability of intraductal release of guide wire were compared. Total time required for completing a simulated stenting procedure with single or multiple stents and the respective simulated fluoroscopy time were recorded. RESULTS: There was no significant difference in the time taken for placement of a single stent using either stenting systems. Stenting system capable of intraductal release of the guide wire required significantly shorter time to complete placement of three stents. CONCLUSIONS: Using time required to complete a specific task, i. e. biliary stenting, the mechanical simulator permits the performance of different accessories by the same group of operators to be evaluated objectively.

Reduction of polymerization contraction stress for dental composites by two-step light-activation.

OBJECTIVES: The goal of this study was to assess the reduction of polymerization contraction stress of composites during a two-step light-activation process and to relate this reduction to the process of polymerization shrinkage and specimen thickness. METHODS: Three test procedures were performed to compare two-step light-activation with delay with one-step continuous irradiation of composites: polymerization contraction stress using a closed-loop servohydraulic testing instrument, polymerization shrinkage by a mercury dilatometer, and degree of conversion by FTIR. For the one-step continuous curing method, the samples were light-activated for 60s at 330 mW/cm(2). For the two-step curing method, a 5s light exposure at 60 mW/cm(2) was followed by 2 min without light exposure, and then a second light exposure for 60s at 330 mW/cm(2). The same light parameters were used for measurements of stress, shrinkage, and degree of conversion. Three composites, Heliomolar, Herculite and Z100 were evaluated. The contraction stress experiments were repeated with varying thickness for Herculite using the one-step and two different two-step techniques. RESULTS: Polymerization contraction stress 10 min after light-activation was significantly reduced (P<0.05) by the two-step method: 29.7% for Heliomolar, 26.5% for Herculite, and 19.0% for Z100. Total volumetric shrinkage and degree of conversion were not significantly different for composites cured by the two different techniques. Increasing the thickness of the composite sample reduced the measured contraction stress, especially for one of the two-step curing methods. SIGNIFICANCE: A combination of low initial energy density followed by a lag period before a final high-intensity light irradiation provides a reduction of polymerization contraction stresses in dental composites. The stress reductions cannot be attributed to reductions in degree of conversion or unrestrained volumetric shrinkage.

Color stability of glass-ionomers and polyacid-modified resin-based composites in various environmental solutions.

PURPOSE: To evaluate the degree of color stability of glass-ionomers (GIs) and polyacid modified resin-based composites (PMRBCs) in various environmental solutions. MATERIALS AND METHODS: Seven polyacid-based esthetic restorative materials were used: three chemical-cured GIs, one resin-modified GI and three polyacid-modified RBCs. A light-cured resin-based composite (RBC) (Z 100) was used as a control. Disk type specimens were prepared and were aged in four different solutions (deionized water, 0.1 mole acetic acid solution, 75% ethanol, and 10% hydrogen peroxide solution) for 1, 7, 14, 21, 28, and 56 days. The specimens were kept at 37 degrees C throughout the study. Color coefficients (CIE L*a*b*) were measured by a reflection spectrophotometer with SCE mode, and the surface of specimens was examined by a stereo zoom microscope. RESULTS: In deionized water, all specimens showed an acceptable color stability. All of the GIs and PMRBCs showed significant color change in 0.1 mole acetic acid solution. The light-cured resin-modified GI showed a significant color change in 75% ethanol solutions. 10% hydrogen peroxide solution resulted in degradation and a high degree of color change for chemical-cured GIs. The light-cured resin-modified GI and PMRBCs showed high color change in 10% hydrogen peroxide solution. The light-cured RBC (Control), showed excellent color stability in all experimental solutions.

Design parameters of high rate algal ponds using filamentous algae matrix for treating rural stream water.

High rate algal ponds (HRAP) with a filamentous algae matrix (FAM) as the predominant species, were operated to evaluate the characteristics of FAM and the basic design parameters for treating polluted rural stream water. The porous and gelatinous FAM was formed like a sponge, which functions to prevent excessive loss of the algae in the effluent and can easily be retrieved from the ponds. The organic fraction of harvested FAM was about 88%, which is suitable for use as fertilizer. The HRAP system using FAM was found to be an effective nutrient removal process not requiring any artificial carbon sources for nitrification. At HRT 4 days, the T-N and T-P removal efficiencies were 85.9% and 65.8%, respectively. When the pH and water temperature were maintained above 9 and 15 degrees C, HRT required for achieving a 70% T-N removal efficiency could be reduced by about 3 days. The oxygen production rate by FAM was calculated as 1.45 mgO2/L/m2. The design surface area of HRAP needed per rural inhabitant was about 2.72 m2.

Improvement of existing nightsoil treatment plant for nitrogen removal.

This study was performed to increase the treatment efficiency and to reduce operation and maintenance costs of the existing nightsoil treatment plant. The existing nightsoil plant was not established by the nitrogen removal process, and was operated ineffectively with deterioration of treatment efficiency rate, and according to the demand of many operators, the expenses of operation and maintenance have become excessive. Modified plant has been changed through two steps. The first step, liquid decayed tank using closed oxidation ditch is operated to increase retention time only for nitrification. The second step, modified liquid decayed tank including anoxic tank is operated, it has an excellent nitrogen removal rate. In first step, when HRT was increased from 10 days to 13 days in liquid decayed tank including aeration tank using closed oxidation ditch, TN concentration of effluent appeared below 51 mg/L less than discharge limit, 60 mg/L. In second step, when anoxic tank and oxic tank were installed, HRT has been increased to 13 days and 26 days, respectively. Then average TN concentration of effluent was detected less than 13 mg/L for over one year. The simple process modified the existing two processes resulted in the reduction of costs for operation and maintenance in the personnel, chemical, and filter change sphere.

Longevity of direct restorations in stress-bearing posterior cavities: a retrospective study.

The aims of this retrospective clinical study were to compare the longevities of direct posterior amalgam restorations (AMs) and resin composite restorations (RCs) that were subjected to occlusal stresses and to investigate variables predictive of their outcome. A total of 269 AMs and RCs filled in Class I and II cavities of posterior teeth were evaluated with Kaplan-Meier survival estimator and multivariate Cox proportional hazard model. Seventy-one retreated restorations were reviewed from dental records. The other 198 restorations still in use were evaluated according to modified US Public Health Service (USPHS) criteria by two investigators. The longevity of RCs was significantly lower than that of AMs (AM = 8.7 years and RC = 5.0 years, p<0.05), especially in molars. The prognostic variables, such as age, restorative material, tooth type, operator group, diagnosis, cavity classification, and gender, affected the longevity of the restorations (multivariate Cox regression analysis, p<0.05). However, among the restorations working in oral cavities, their clinical performance evaluated with modified USPHS criteria showed no statistical difference between both restoratives. In contrast to the short longevity of RCs relative to AMs, the clinical performance of RCs working in oral cavities was observed to be not different from that of AMs. This suggests that once a RC starts to fail, it happens in a rapid progression. As posterior esthetic restorations, RCs must be observed carefully with periodic follow-ups for early detection and timely repair of failures.

A retrospective clinical study of cervical restorations: longevity and failure-prognostic variables.

The aim of this retrospective clinical study was to compare the longevity of cervical restorations between resin composite (RC) and glass ionomer (GI) and to investigate variables predictive of their outcome. The clinical performance of the two restorative materials in function was compared using the ratings of the modified United States Public Health Service (USPHS) criteria. A total of 479 cervical restorations were included in the study. Ninety-one already-replaced restorations were reviewed from dental records. The other 388 restorations still in function were evaluated according to the modified USPHS criteria by two investigators. Longevity and prognostic variables were analyzed with the Kaplan-Meier survival analysis and multivariate Cox proportional hazard model. The clinical performances of the two materials were evaluated according to the ratings of the USPHS criteria and compared using the Pearson chi-square test and Fisher exact test. The longevity was not significantly different between RC and GI (median survival time, 10.4 ± 0.7 and 11.5 ± 1.1 years, respectively). The main reasons for failure were loss of retention (82.2%) and secondary caries (17.8%). The longevity of cervical restoration was significantly influenced by tooth group and operator group (Wald test, p<0.05), while material, gender, presence or absence of systemic diseases, arch, and reason for treatment did not affect the longevity. Contrary to the longevity, the clinical performance of RC was superior to GI in the criteria of retention, marginal discoloration, and marginal adaptation, but similar in secondary caries, wear, and postoperative sensitivity.

Fuzzy regression modeling for tool performance prediction and degradation detection.

In this paper, the viability of using Fuzzy-Rule-Based Regression Modeling (FRM) algorithm for tool performance and degradation detection is investigated. The FRM is developed based on a multi-layered fuzzy-rule-based hybrid system with Multiple Regression Models (MRM) embedded into a fuzzy logic inference engine that employs Self Organizing Maps (SOM) for clustering. The FRM converts a complex nonlinear problem to a simplified linear format in order to further increase the accuracy in prediction and rate of convergence. The efficacy of the proposed FRM is tested through a case study - namely to predict the remaining useful life of a ball nose milling cutter during a dry machining process of hardened tool steel with a hardness of 52-54 HRc. A comparative study is further made between four predictive models using the same set of experimental data. It is shown that the FRM is superior as compared with conventional MRM, Back Propagation Neural Networks (BPNN) and Radial Basis Function Networks (RBFN) in terms of prediction accuracy and learning speed.

Effects of hydrogen peroxide (H2O2) on alkaline phosphatase activity and matrix mineralization of odontoblast and osteoblast cell lines.

Hydrogen peroxide (H(2)O(2)), an oxidizing agent, has been widely used as a disinfectant. Recently, because of its reactive properties, H(2)O(2) has also been used as a tooth bleaching agent in dental care. This is a cause for concern because of adverse biological effects on the soft and hard tissues of the oral environment. To investigate the influence of H(2)O(2) on odontoblasts, the cells producing dentin in the pulp, we assessed cellular viability, generation of reactive oxygen species (ROS), alkaline phosphatase (ALP) activity, and nodule formation of an odontoblastic cell line (MDPC-23) after treatment with H(2)O(2), and compared those with the effects on preosteoblastic MC3T3-E1 cells. Cytotoxic effects of H(2)O(2) began to appear at 0.3 mmol/L in both MDPC-23 and MC3T3-E1 cells. At that concentration, the accumulation of intracellular ROS was confirmed by a fluorescent probe, DCFH-DA. Although more ROS were detected in MDPC-23, the increasing pattern and rate are similar between the two cells. When the cells were treated with H(2)O(2) at concentrations below 0.3 mmol/L, MDPC-23 displayed a significant increase in ALP activity and mineralized bone matrix, while MC3T3-E1 cells showed adverse effects of H(2)O(2). It is known that ROS are generally harmful by-products of aerobic life and represent the primary cause of aging and numerous diseases. These data, however, suggest that ROS can induce in vitro cell differentiation, and that they play a more complex role in cell physiology than simply causing oxidative damage.

Difference in the colour and colour change of dental resin composites by the background.

The objective of this study was to evaluate the difference in the colour and colour change of dental resin composites over commonly used two backgrounds. Colour of five uncured and cured resin composites before and after polishing with 600-, 1000- or 1500-grit SiC paper was measured according to the CIELAB colour scale relative to the illuminant D65 over a white background (WB; reflectance = 91.57%) and a light trap (LT; reflectance = 0.01%) on a reflection spectrophotometer with the SCE geometry. Colour difference (DeltaE*ab) by the background, and by the specimen conditions over each of two backgrounds was calculated. DeltaE*ab values between the same specimen by the background were 2.38-11.60. DeltaE*ab values by the specimen condition were varied by the background, and DeltaE*ab between cured/polished specimens over WB were significantly higher than those over LT (P < 0.05) except a few cases. Background influenced three-colour coordinates of CIE L*, a*, and b* values differently depending on the material and the specimen condition. Background significantly influenced the colour coordinates and colour difference by the specimen conditions. As the light trap can eliminate the influence of variations at the background, measured colour over the light trap can be the colour of material itself. Correlation between the measured colour and varied shades of background should be further studied.

Effects of salicylic-lactic acid conditioner on the shear bond strength of brackets and enamel surfaces.

The purpose of this study was to evaluate the effects of salicylic-lactic (SL) acid conditioner on the shear bond strength of brackets. Fluoride releasing (Light-bond) and non-fluoride releasing (Enlight) composite adhesives were used after conditioning with 0.22% salicylic + 9% lactic acid or 34% phosphoric acid. Composite adhesives were light cured with either a halogen light curing (HLC) unit for 30-50 s or a plasma arc curing (PAC) unit for 4 s. The shear bond strength was measured with an Instron. Failure modes of debonded brackets were identified based on adhesive remnants on the bracket and tooth. Salicylic-lactic acid conditioning was found to provide adequate shear bond strength. Groups conditioned with SL acid were debonded mainly at the enamel-resin interface and comparatively clean enamel surface after debonding was observed than those conditioned with phosphoric acid. Using confocal laser scanning microscopic examinations, it was found that demineralization patterns between SL acid and phosphoric acid conditioned groups were not different when the same adhesive was used. The SL acid conditioner did not reduce the demineralization. Light-bond adhesive showed less demineralization than Enlight adhesive. The PAC unit can be recommended as an alterative to the HLC unit because it significantly reduces the irradiation time.

Intracorporeal ligation of the cystic duct during laparoscopic cholecystectomy.

During laparoscopic cholecystectomy, the cystic duct (CD) is ligated in one of two ways: by clipping or by creating a knot outside the abdominal cavity and then introducing it into the cavity. A new technique allows safe ligation of the CD intracorporeally before its division by tying the knot at the site with absorbable tie material. To build the knot, a loosely constructed surgeon's square knot encircling the CD is converted to a slip knot, which is then cinched and tightened. The tightening process of the slip know is executed by winding the long tail clockwise around the left-hand needle holder (traction) While the right-hand needle holder winds the short tail counterclockwise (countertraction). The endpoint of the tightening is determined by feeling the amount of torque to both hands and by visual confirmation of the knot integrity. To prevent reverse slippage, three single, flat knots are tied in square fashion. The cystic artery has also been ligated intracorporeally during laparoscopic cholecystectomy using the same technique with the same positive results and without complications.

Unexpected difficult intubation in a patient with normal airway on assessment.

Routine preoperative assessment of the patient's airway includes an assessment of mouth opening and a grading of the view according to the Mallampati scale. This is carried out with the patient sitting and actively opening the mouth without phonation. This case report illustrates that the temporomandibular joint is a complex joint and that certain pathologies may prevent passive depression of the mandible after induction of anaesthesia.

Bis(dithiolene)molybdenum analogues relevant to the DMSO reductase enzyme family: synthesis, structures, and oxygen atom transfer reactions and kinetics.

A series of dithiolene complexes of the general type [Mo(IV)(QR')(S(2)C(2)Me(2))(2)](1)(-) has been prepared and structurally characterized as possible structural and reactivity analogues of reduced sites of the enzymes DMSOR and TMAOR (QR' = PhO(-), 2-AdO(-), Pr(i)()O(-)), dissimilatory nitrate reductase (QR' = 2-AdS(-)), and formate dehydrogenase (QR' = 2-AdSe(-)). The complexes are square pyramidal with the molybdenum atom positioned 0.74-0.80 A above the S(4) mean plane toward axial ligand QR'. In part on the basis of a recent clarification of the active site of oxidized Rhodobacter sphaeroides DMSOR (Li, H.-K.; Temple, C.; Rajagopalan, K. V.; Schindelin, H. J. Am. Chem. Soc. 2000, 122, 7673), we have adopted the minimal reaction paradigm Mo(IV) + XO right arrow over left arrow Mo(VI)O + X involving desoxo Mo(IV), monooxo Mo(VI), and substrate/product XO/X for direct oxygen atom transfer of DMSOR and TMAOR enzymes. The [Mo(OR')(S(2)C(2)Me(2))(2)](1)(-) species carry dithiolene and anionic oxygen ligands intended to simulate cofactor ligand and serinate binding in DMSOR and TMAOR catalytic sites. In systems with N-oxide and S-oxide substrates, the observed overall reaction sequence is [Mo(IV)(OR')(S(2)C(2)Me(2))(2)](1)(-) + XO --> [Mo(VI)O(OR')(S(2)C(2)Me(2))(2)](1)(-) --> [Mo(V)O(S(2)C(2)Me(2))(2)](1)(-). Direct oxo transfer in the first step has been proven by isotope labeling. The reactivity of [Mo(OPh)(S(2)C(2)Me(2))(2)](1)(-) (1) has been the most extensively studied. In second-order reactions, 1 reduces DMSO and (CH(2))(4)SO (k(2) approximately 10(-)(6), 10(-)(4) M(-)(1) s(-)(1); DeltaS(double dagger) = -36, -39 eu) and Me(3)NO (k(2) = 200 M(-)(1) s(-)(1); DeltaS(double dagger) = -21 eu) in acetonitrile at 298 K. Activation entropies indicate an associative transition state, which from relative rates and substrate properties is inferred to be concerted with X-O bond weakening and Mo-O bond making. The Mo(VI)O product in the first step, such as [Mo(VI)O(OR')(S(2)C(2)Me(2))(2)](1)(-), is an intermediate in the overall reaction sequence, inasmuch as it is too unstable to isolate and decays by an internal redox process to a Mo(V)O product, liberating an equimolar quantity of phenol. This research affords the first analogue reaction systems of biological N-oxide and S-oxide substrates that are based on desoxo Mo(IV) complexes with biologically relevant coordination. Oxo-transfer reactions in analogue systems are substantially slower than enzyme systems based on a k(cat)/K(M) criterion. An interpretation of this behavior requires more information on the rate-limiting step(s) in enzyme catalytic cycles. (2-Ad = 2-adamantyl, DMSOR = dimethyl sulfoxide reductase, TMAOR = trimethylamine N-oxide reductase)

Synthesis and structures of bis(dithiolene)molybdenum complexes related to the active sites of the DMSO reductase enzyme family.

Structural analogues of the reduced (Mo(IV)) sites of members of the DMSO reductase family of molybdoenzymes are sought. These sites usually contain two pterin-dithiolene cofactor ligands and one protein-based ligand. Reaction of [Mo(MeCN)3(CO)3] and [Ni(S2C2R2)2] affords the trigonal prismatic complexes [Mo(CO)2(S2C2R2)2] (R = Me (1), Ph (2)), which by carbonyl substitution serve as useful precursors to a variety of bis(dithiolene)molybdenum-(IV,V) complexes. Reaction of 1 with Et4NOH yields [MoO(S2C2Me2)2]2- (3), which is readily oxidized to [MoO(S2C2Me2)2]1- (4). The hindered arene oxide ligands ArO- afford the square pyramidal complexes [Mo(OAr)(S2C2R2)2]1- (5, 6). The ligands PhQ- affordthe trigonal prismatic monocarbonyls [Mo(CO)(QPh)(S2C2Me2)2]1- (Q = S (8), Se (12)) while the bulky ligand ArS- forms square pyramidal [Mo(SAr)(S2C2R2)2]- (9, 10). In contrast, reactions with ArSe- result in [Mo(CO)(SeAr)(S2C2R2)2]1-(14, 15), which have not been successfully decarbonylated. Other compounds prepared by substitution reactions of 1 and 2 include the bridged dimers [Mo2(mu-Q)2(S2C2Me2)4]2- (Q = S (7), Se (11)) and [Mo2(mu-SePh)2(S2C2Ph2)4]2- (13). The complexes 1, 3-5, 7-10, 12-14, [Mo(S2C2Me2)3] (16), and [Mo(S2C2Me2)3]1- (17) were characterized by X-ray structure determinations. Certain complexes approach the binding arrangements in at least one DMSO reductase (5/6) and its Ser/Cys mutant, and in dissimilatory nitrate reductases (9/10). This investigation provides the initial demonstration of the new types of bis(dithiolene)molybdenum(IV) complexes available through [Mo(CO)2(S2C2R2)2] precursors, some of which will be utilized in reactivity studies. (Ar = 2,6-diisopropylphenyl or 2,4,6-triisopropylphenyl.)