Effect of photon induced photoacoustic streaming (PIPS) on bond strength to dentine of two root canal filling materials.

OBJECTIVES: The aim of this study was to evaluate the effect of photon induced photoacoustic streaming (PIPS) technique in combination with EDTA on bond strength of gutta-percha/AH Plus and Resilon/RealSeal SE root canal fillings to root dentine. MATERIALS AND METHODS: Forty freshly extracted human maxillary anterior teeth with intact straight roots, were instrumented endodontically with rotating ProTaper instruments and randomly divided into two experimental groups. In group 1 (n = 20), root canals were rinsed for 1 minute with 2 ml of 17% EDTA. In group 2 (n = 20), Er:YAG laser, with a 14 mm long 400 µ diameter tapered PIPS tip, was used for 1 minute with 2 ml of 17% EDTA. The laser parameters used were: 20 mJ per pulse, 15 Hz, 50 microsecond. In each experimental group, half of the root canals (n = 10) were obturated with gutta-percha/AH Plus and other half (n = 10) with Resilon/RealSeal SE. A micropush-out test was performed on sectiond specimens of the filled roots using a universal testing machine and resistance to failure plus failure modes were determined. RESULTS: Both gutta-percha/AH Plus groups had higher bond strength to root dentin than the Resilon/RealSeal SE groups (P < 0.05). The smear layer removal protocol, with EDTA only or combining PIPS technique with EDTA, had no influence on bond strength of either gutta-percha/AH Plus, or Resilon/RealSeal SE (P > 0.05). CONCLUSION: Within the limitations of this study, it was found that the application of the PIPS technique did not have an affect on the push-out bond strength of Resilon/RealSeal SE root canal filling to dentin nor on the gutta-percha/AH Plus. A significant difference in bond strength was noted between the two root canal filling materials. Lasers Surg. Med. 48:951-954, 2016. © 2016 Wiley Periodicals, Inc.

Risk of acute myocardial infarction after transurethral resection of prostate in elderly.

BACKGROUND: Benign prostatic hyperplasia is a frequent disease among elderly, and is responsible for considerable disability. Benign prostatic hyperplasia can be clinically significant due to lower urinary tract symptoms that take place because the gland is enlarged and obstructs urine flow. Transurethral resection of the prostate remains the gold standard treatment for patients with moderate or severe symptoms who need active treatment or who either fail or do not want medical therapy. Moreover, perioperative and postoperative surgery complications as cardiovascular ones still occur. The incidence of acute myocardial infarction in patients undergoing transurethral resection of the prostate is controversial. The first studies showed an increase in mortality and relative risk of death from myocardial infarction in transurethral resection of the prostate group vs open prostatectomy but these results are in contrast with more recent data. DISCUSSION: Given the conflicting evidence of the studies in the literature, in this review we are going to discuss the factors that may influence the risk of myocardial infarction in elderly patients undergoing prostate surgery. We analyzed the possible common factors that lead to the development of myocardial infarction and benign prostatic hyperplasia (cardiovascular and metabolic), the stressor factors related to prostatectomy (surgical and haemodynamic) and the risk factors specific of the elderly population (comorbidity and therapies). SUMMARY: Although transurethral resection of the prostate is considered at low risk for severe complications, there are several reports indicating that cardiovascular events in elderly patients undergoing this surgical operation are more common than in the general population. Several cardio-metabolic, surgical and aging-related factors may help explain this observation but results in literature are not concord, especially due to the fact that most data derive from retrospective studies in which selection bias cannot be excluded. Subsequently, further studies are necessary to clarify the incidence of acute myocardial infarction in old people.