Validation of online version of asthma control questionnaire in pediatric patients.

Introduction: The Asthma Control Questionnaire (ACQ) is a seven-item questionnaire assessing symptoms that asthma clinicians consider to be most important for evaluating the adequacy of asthma control. An online version of the ACQ may be able to indicate whether a visit to the physician is warranted to modify therapy to achieve better control of their asthma, ultimately reducing the number of unnecessary visits, particularly during the pandemic. The aim of our study is to compare the paper and online ACQ to validate the online version for use in real-life settings.Methods: Our study included 28 patients who completed both paper and the online ACQ on the same day when they came home. The online version of the questionnaire was prepared to look similar to the paper form, with the same sentences and answers.Results: The correlation between paper and online ACQ questionnaires was very high (r = 0.935; p < 0.001). When comparing each individual item, correlation coefficients ranged from 0.672 to 0.935. The lowest correlation is obtained in activity limitations, while the next one is 0.767, others higher than 0.8. The online form gave small and insignificantly higher scores compared to paper form with mean difference between -0.07 and 0.21. Mean difference of 0.01 (p = 0.986) between paper ACQ and online ACQ is obtained.Conclusion: The online version of the ACQ can be used for asthma control monitoring in pediatric patients in order to minimize unnecessary social contacts as well as hospital patient load, but retain adequate surveillance of disease symptoms by their physician.

The effect of carbodiimide on push-out bond strength of fiber posts and endogenous enzymatic activity.

BACKGROUND: To investigate the effect of 0.3 M 1-ethyl-3(3-dimethylaminopropyl) carbodiimide (EDC) aqueous solution pretreatment on push-out bond strength (PBS) and matrix-metalloproteinases (MMPs) activity within radicular dentin when different post cementation strategies were employed. METHODS: One hundred and twenty monoradicular human teeth were endodontically treated and randomly divided into six groups, depending on the cementation strategy and root dentin pretreatment (n = 20): EAR: cementation with an etch-and-rinse adhesive (LuxaBond Total Etch, DMG) and resin cement (LuxaCore Z Dual, DMG); EAR/EDC: 1 min EDC pretreatment after etching + EAR; SE: cementation with a self-etch primer (Multilink Primer, Ivoclar Vivadent) and corresponding cement (Multilink Automix, Ivoclar Vivadent); SE/EDC: self-etch primer + EDC pretreatment + SE; SA: cementation with a universal self-adhesive cement (RelyX Universal, 3 M); SA/EDC: EDC pretreatment + SA. Slices were submitted to PBS test and interfacial nanoleakage evaluation 24 h after cementation or after thermocycling (40.000 cycles, 5-55 °C). To investigate the effect of EDC on MMPs activity, 4 additional first maxillary premolars per group were processed for in situ zymography analysis. Multivariate ANOVA and post hoc Tukey tests were used to analyze PBS values. The data from in situ zymography were analyzed with Kruskal-Wallis test and Dunn's pairwise multiple comparison procedures (α = 0.05). RESULTS: The variables "EDC pretreatment", "root region" and "thermocycling" significantly influenced PBS (p < 0.05), while the variable "cementation strategy" had no influence (p > 0.05). Thermocycling significantly reduced PBS in SE and SA groups (p < 0.05). EDC was effective in preserving PBS after artificial aging. EDC pretreatment significantly reduced enzymatic activity at baseline in EAR and SE groups, and in SA group after thermocycling (p < 0.05). CONCLUSIONS: The use of EDC prevents the reduction of bond-strength values after artificial aging and silences endogenous enzymatic activity within radicular dentin when different cementation strategies were employed.

Validation of the Serbian version of the Pelvic Organ Prolapse/Urinary Incontinence/Sexual Questionnaire short form (PISQ-12).

INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) and pelvic organ prolapse (POP) significantly decrease quality of life and sexual health. This study aimed to evaluate the reliability and validity of a Serbian adaptation of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12) used in assessing sexual function in women with UI and/or POP. METHODS: This study included 416 women, 310 (74.5%) with UI and/or POP and 106 (25.5%) without UI and/or POP. The adaptation of the PISQ-12 to Serbian language was performed via back-translation. The content validity of the questionnaire was conducted by experts in the field. The reliability and validity of the PISQ-12 were analyzed. Evaluation of the data was performed using Content Validity Index (CVI), Cronbach's alpha, test-retest reliability, item total correlation and confirmatory factor analysis. RESULTS: Content validity of the Serbian PISQ-12 was 1.00 (100%). Item total correlations were between 0.459 and 0.819 (P < 0.001). The PISQ-12 had an adequate and high internal consistency (Cronbach's alpha 0.806) as well as high test-retest reliability (Pearson correlation coefficient r = 0.807; P < 0.001). Factor analysis results revealed strong construct validity. The mean scores of PISQ-12 were significantly better in the control group compared with the women with UI and/or POP. Sexual function was negatively affected by UI and/or POP as assessed with SF-36 and I-QoL questionnaires. CONCLUSIONS: This study showed that the Serbian version of the PISQ-12 is a reliable, consistent, valid and condition-specific instrument to assess sexual function in women with UI and/or POP.

Changes in pulp sensitivity across the menstrual cycle in healthy women and women with temporomandibular disorders.

BACKGROUND: Menstrual cycle may contribute to experimental pain measures in healthy women and women with chronic pain. OBJECTIVES: The present study aimed to investigate variation in pulp sensitivity across the menstrual cycle in healthy women and women with temporomandibular disorders (TMD) and to explore the effect of TMD pain and psychosocial variables on the pulp response. METHODS: This longitudinal study involved 47 regularly menstruating women aged 20-45, 24 healthy and 23 with diagnosed painful TMD. The electric and cold stimuli were performed by electric pulp tester and refrigerant spray, respectively, on mandibular lateral incisors, in five menstrual phases (menstrual, follicular, periovulatory, luteal and premenstrual). Research Diagnostic Criteria for TMD were used to assess TMD, chronic pain, depression and somatisation. Regression analysis was performed to investigate the effect of the predictor variables on the pulp sensitivity. RESULTS: Significant phase-related differences were observed for pain intensity to cold stimuli. Higher pain sensitivity was reported in menstrual in comparison with luteal phase (P = .019) among healthy women, and in menstrual in comparison with follicular (P = .033), periovulatory (P = .003) and luteal (P = .007) phases in TMD women. No significant differences were recorded for electric stimuli. Regression analysis identified depression as the determinant of cold and electric response in menstrual phase, regardless of age and presence of TMD. CONCLUSION: Menstrual phase in healthy and TMD women with regular menstrual cycle is characterised with higher pulp sensitivity to cold stimuli. Depressive symptoms independently influence pulp response in this phase.

Genotyping of Eight Human Platelet Antigen Systems in Serbian Blood Donors: Foundation for Platelet Apheresis Registry.

INTRODUCTION: The aim of this study was to investigate the allele and genotype frequencies of 8 human platelet antigen (HPA) systems among blood donors from the Blood Transfusion Institute of Serbia and to compare them with published studies. These data would be useful to establish the basis for a platelet apheresis donor registry. MATERIAL AND METHODS: Seventy-two unrelated male platelet apheresis/blood donors from Serbia were typed for 8 HPA systems (HPA-1 to HPA-6, HPA-9, and HPA-15) via the FluoGene method, based on polymerase chain reaction-sequence-specific amplification (PCR-SSP; PCR using sequence-specific primers) with fluorometric signal detection. Allele and genotype frequencies were estimated by direct counting and compared to the expected genotype frequencies according to the Hardy-Weinberg principle. The transfusion mismatch probability was calculated for every HPA specificity. RESULTS: The allele frequencies were: HPA-1a, 0.868; HPA-1b, 0.132; HPA-2a, 0.917; HPA-2b, 0.083; HPA-3a, 0.611; HPA-3b, 0.389; HPA-5a, 0.903; HPA-5b, 0.097; HPA-9a, 0.993; HPA-9b, 0.007; HPA-15a, 0.472; and HPA-15b, 0.528. For HPA-4 and HPA-6 only allele a was detected. DISCUSSION: The HPA allele frequencies of European populations showed no significant differences in comparison with our results. Statistically significant differences were revealed in comparison with some populations of non-European origin. In the tested donors no HPA-2 bb genotype was detected, but we found 1 donor with the rare HPA-9b allele. The biggest transfusion mismatch probability in the Serbian population is for systems HPA-15 (37.4%) and HPA-3 (36.2%), which means that more than a third of random transfusions could cause mismatch in these systems. This study was enabled by the introduction of molecular HPA typing, and it provides initial results of the HPA allele and genotype frequencies in the population of blood donors in Serbia. They will be used to provide a compatible blood supply on demand for treating patients with alloimmune thrombocytopenic disorders. The successful implementation of PCR-SSP with fluorometric signal detection could be further complemented in the future by the introduction of high-throughput methods, which will largely depend on the available financial resources.

Treatment after inadequate immediate replantation of accidentally extracted immature mandibular premolar during primary molar extraction.

During extraction of the primary mandibular right second molar in an 11-year-old girl, the unerupted second premolar was accidentally extracted. Clinical and radiographic examination showed that the immediately replanted immature premolar was not oriented and positioned correctly. Four hours later, treatment consisted of manual extrusion of the permanent tooth bud, rotation, and gentle repositioning into its original position. Adequate replantation was confirmed by a post-operative radiograph. After 2 years and 4 months, clinical examination revealed normal, healthy appearance of the replanted tooth, no sensitivity to percussion, no tenderness to palpation, and a slight response to a cold pulp sensibility test. A radiograph showed completely developed root with closed apical foramen, slightly irregular root morphology and shorter root length, complete obliteration of the pulp, and no signs of periapical pathosis.

Acquired von Willebrand syndrome and post-operative drainage: a comparison of patients with aortic stenosis versus coronary artery disease.

OBJECTIVE: Degenerative aortic stenosis and coronary artery disease are considered to be the most prevalent cardiovascular diseases in industrialized countries. This study aims to determine the change over time in von Willebrand factor antigen, von Willebrand factor activity, and factor VIII and where there is a correlation with total post-operative drainage. METHODS: The single-center retrospective study included 203 consecutive patients (64.5% male), undergoing coronary artery bypass surgery between March 1, 2019 and June 30, 2020 at the University Clinical Center of Serbia in the Clinic for Cardiac Surgery in Belgrade, Serbia. All patients 18 years or older who presented with isolated, hemodynamically significant aortic stenosis were included. The control group consisted of patients who presented with only coronary artery disease. RESULTS: Between patients with only coronary artery disease and patients with coronary artery diseases and aortic stenosis, there was a statistically significant difference between pre-op and 1-month post-op fibrinogen, factor VIII, von Willebrand factor antigen, and von Willebrand factor (p < 0.001), post-op drainage, with overall lower drainage in coronary artery disease patients, and consistent increase in von Willebrand factor antigen, von Willebrand factor activity, and Factor VIII post-operatively in patients with coronary artery diseases and aortic stenosis. CONCLUSION: This study has shown that there is a correlation between von Willebrand factor antigen, von Willebrand factor activity and total drainage to the level of statistical significance in aortic stenosis patients and in the overall study population.

Push-out bond strength of an experimental self-adhesive resin cement.

The adhesion of fiber posts luted with simplified adhesive systems has been a matter of great interest over the past years. The aim of this study was to assess the post retentive potential of experimental self-adhesive resin cement (EXP) when used alone and in combination with a self-etch adhesive. Fiber posts were placed in endodontically treated teeth and divided into four groups (n = 6) according the luting material, as follows: group 1 (EXP alone); group 2 (EXP used with self-etch adhesive); group 3 (marketed dual-cured cement used with self-etch adhesive); and group 4 (marketed self-adhesive cement). The push-out test was used to assess the retentive strength of fiber posts (expressed in MPa), and specimens were analyzed under a stereomicroscope to determine failure mode. The adhesive interface between the cement and root canal dentin for each group was evaluated using scanning electron microscopy. The post retentive potential of group 1 (EXP) (7.48 ± 4.35 MPa) was comparable with that of marketed cements from group 4 (6.79 ± 3.68 MPa) and group 3 (8.77 ± 4.58 MPa). When EXP was used in combination with self-etch adhesive (group 2), significantly higher push-out bond-strength values were measured (15.87 ± 4.68 MPa) compared with the other groups.

Post-retentive ability of new flowable resin composites.

PURPOSE: To investigate the applicability of flowable composites as post luting agents by assessing the push-out strength of posts. METHODS: 36 intact single rooted human premolars were selected. The endodontic treatment was performed and half of the specimens were restored with light transmitting posts (DT Light Post Illusion) and the other half with opaque posts (Tech 21 X-OP). In both groups the following combinations of adhesive/cement were tested: OptiBond Solo Plus/Nexus Third Generation (NX3), XP Bond/SureFil SDR Flow (SDR), and Vertise Flow (VF). Push-out test was used to assess the retentive strength of fiber posts, which was expressed in megapascals (MPa). Specimens were analyzed under a stereomicroscope to determine failure mode (adhesive between luting agent and post, adhesive between luting agent and dentin or mixed failure). Push-out data and failure mode distribution were analyzed by two-way ANOVA and Chi-square test, respectively (P< 0.05). RESULTS: The statistical analysis revealed that only the type of luting material significantly influenced push-out bond strength of the post (P< 0.001). SDR (9.00 +/- 2.17 MPa) performed similarly to the control group NX3 (7.15 +/- 1.74 MPa), while VF (4.81 +/- 1.51 MPa) should significantly lower bond strength. Failure modes differed significantly among groups.

Risk Factors for Coronary Artery Calcifications in Overweight or Obese Persons with Prediabetes: Can They Predict T2 Diabetes and Coronary Vascular Events?

BACKGROUND: It is difficult to predict the risk of developing atherosclerotic cardiovascular disease in subjects with prediabetes and obesity. The aim of this study was to assess risk factors for coronary artery calcifications (CACs) and the development of type 2 diabetes (T2D) and coronary vascular events (CVEs) after 7 years in 100 overweight or obese persons with prediabetes, according to the baseline coronary artery calcium score (CACS). METHODS: Lipids, HbA1c, uric acid, and creatinine were assessed. Glucose, insulin, and c-peptide were determined during an oral glucose tolerance test. Multi-sliced computerized tomography with evaluation of CACS was performed. After 7 years, the subjects were assessed for T2D/CVE. RESULTS: CACs were present in 59 subjects. No single biochemical marker could predict presence of a CAC. After 7 years, T2D developed in 55 subjects (61.8% initially had both IFG and IGT). A gain in weight was the only contributing factor for T2D. Nineteen subjects developed a CVE; increased initial clustering of HOMA-IR > 1.9, LDL > 2.6, and mmol/Land TGL > 1.7 mmol/L and higher CACS were present in that group. CONCLUSIONS: No risk factors for CACs could be identified. A gain in weight is associated with T2D development, as are higher CACS and clustering of high LDL+TGL+HOMA-IR with CVEs.

Economic Justification Analysis of Minimally Invasive versus Conventional Aortic Valve Replacement.

There is no definitive consensus about the cost-effectiveness of minimally invasive aortic valve replacement (AVR) (MI-AVR) compared to conventional AVR (C-AVR). The aim of this study was to compare the rate of postoperative complications and total hospital costs of MI-AVR versus C-AVR overall and by the type of aortic prosthesis (biological or mechanical). Our single-center retrospective study included 324 patients over 18 years old who underwent elective isolated primary AVR with standard stented AV prosthesis at the Institute for Cardiovascular Diseases "Dedinje" between January 2019 and December 2019. Reintervention, emergencies, combined surgical interventions, and patients with sutureless valves were excluded. In both MI-AVR and C-AVR, mechanical valve implantation contributed to overall reduction of hospital costs with equal efficacy. The cost-effectiveness ratio indicated that C-AVR is cheaper and yielded a better clinical outcome with mechanical valve implantation (67.17 vs. 69.5). In biological valve implantation, MI-AVR was superior. MI-AVR patients had statistically significantly higher LVEF and a lower Euro SCORE than C-AVR patients (Mann-Whitney U-test, p = 0.002 and p = 0.002, respectively). There is a slight advantage to MI-AVR vs. C-AVR, since it costs EUR 9.44 more to address complications that may arise. Complications (mortality, early reoperation, cerebrovascular insult, pacemaker implantation, atrial fibrillation, AV block, systemic inflammatory response syndrome, wound infection) were less frequent in the MI-AVR, making MI-AVR more economically justified than C-AVR (18% vs. 22.1%).

Transcultural adaptation and validation of the Serbian version of Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction-Patient Satisfaction (FACIT-TS-PS) questionnaire.

OBJECTIVE: Transcultural adaptation and validation of FACIT-TS-PS questionnaire to Serbian language. METHODS: Standard forward and backward translation from English to Serbian language was performed. Pilot testing of FACIT-TS-PS was conducted on 12 patients with a confirmed diagnosis of malignant tumor. The study included 154 patients with malignant disease. The Questionnaire of Patient Satisfaction was used as a validated tool to evaluate concurrent validity of FACIT-TS-PS questionnaire. Reproducibility was tested on 30 subjects who answered the questionnaire for the second time two weeks later. RESULTS: Three FACIT-TS-PS subscales (Physician Communication, Treatment Staff Communication and Nurse Communication) demonstrated satisfactory construct validity using Cronbach's alpha, the remaining two subscales (Technical Competence and Confidence & Trust) showed high ceiling effect. Treatment Staff Communication subscale showed large floor effect. Concurrent validity was demonstrated by correlation with the two dimensions of the Questionnaire of Patient Satisfaction. Satisfactory reproducibility was demonstrated on 30 patients who filled the questionnaire for the second time two weeks after initial interview. CONCLUSION: The Serbian version of FACIT-TS-PS with the omission of Treatment Staff Communication subscale could be used as a valid instrument to assess patient and treatment satisfaction in chronically ill patients in the Serbian population. Omission of Treatment Staff Communication subscale is necessary because it contains questions not relevant for patients in Serbian healthcare system.

Trichinella spiralis shares epitopes with human autoantigens.

Like other helminths, Trichinella spiralis has evolved strategies to allow it to survive in the host organism, including the expression of epitopes similar to those present in either expressed or hidden host antigens. To identify T. spiralis-derived antigens that are evolutionarily conserved in the parasite and its host and that could be responsible for its evasion of the host immune response, we examined the reactivity of six different types of autoantibodies to T. spiralis larvae from muscle. T. spiralis antigens that share epitopes with human autoantigens were identified by assessing the cross-reactivity of autoantibody-containing serum samples with T. spiralis antigens in the absence of specific anti-parasite antibodies. Of the 55 autoantibody-containing human serum samples that we analysed by immunohistological screening, 24 (43.6%) recognised T. spiralis muscle larvae structures such as the subcuticular region, the genital primordium or the midgut. Using Western blots, we demonstrated that the same sera reacted with 24 protein components of T. spiralis muscle larvae excretory-secretory L1 antigens. We found that the human autoantibodies predominantly bound antigens belonging to the TSL1 group; more specifically, the autoantibody-containing sera reacted most frequently with the 53-kDa component. Thus, this protein is a good candidate for further studies of the mechanisms of T. spiralis-mediated immunomodulation.

The influence of selective enamel etch and self-etch mode of universal adhesives' application on clinical behavior of composite restorations placed on non-carious cervical lesions: A systematic review and meta-analysis.

BACKGROUND: To answer the PICOS question: "Is the risk of retention loss equal for SEE and SE approach when universal adhesives and composite restorations are indicated for restoring NCCLs?" METHODS: Web of Science, PubMed, Cochrane Central Register of Controlled Trials, Scopus, Scientific Electronic Library Online, LILACS, Google Scholar™ and OpenGrey were searched. Only randomized controlled clinical trials in which NCCLs were restored with composites and universal adhesives applied in SEE or SE mode were included. The articles were assessed for the risk of bias, after which meta-analyses were run (fixed-effects model was applied; heterogeneity was explored using Cochran Q test and I2 statistics; α = 0.05) and the certainty of evidence was assessed by the GRADE tool. RESULTS: Fifteen articles were included in qualitative, while 7 articles were included in quantitative analysis. Seven studies were judged as "low" risk of bias, while 8 were considered as "unclear" risk of bias. Statistically significant difference for retention were observed at 6- and 18/24 months (p = 0.05; OR=0.42, 95% CI [0.18, 0.99]; very low certainty of evidence and p = 0.007; OR=0.31, 95% CI [0.13, 0.72]; low certainty of evidence, respectively), favoring SEE approach. No other significant differences in clinical outcomes were observed between SEE and SE approach (very low certainty of evidence). SIGNIFICANCE: When restoring NCCLs, clinicians might consider applying universal adhesives in SEE mode since it could lead to more predictable retention compared to SE approach up to 2 years of follow-up.

Is clinical behavior of composite restorations placed in non-carious cervical lesions influenced by the application mode of universal adhesives? A systematic review and meta-analysis.

OBJECTIVE: To answer the following PICOS question: "Is the risk of retention loss, marginal discoloration, marginal adaptation and postoperative sensitivity (POS) equal for etch-and-rinse (EAR) compared to self-etch (SE) or selective-enamel etch (SEE) mode when restoring non carious cervical lesions (NCCLs) with universal adhesives?". METHODS: PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, LILACS, OpenGrey and Google Scholar™ were searched. Randomized controlled clinical trials in which resin composites and universal adhesives were used for restoration of NCCLs were considered. Cochrane Risk of Bias Tool was used to assess the risk of bias. Meta-analyses were performed using Revman; random-effects models were applied, and heterogeneity was tested using the I2 index. The significance level was set at p < 0.05. Certainty of evidence was assessed by GRADE tool. RESULTS: After screening, 20 articles were included in qualitative, while 14 articles were used for quantitative synthesis. Twelve studies ranked as "low", while 8 studies scored as "unclear" for risk of bias. At 12- and 18/24-months the risk for retention loss was higher for SE than for EAR groups (p = 0.005; RR = 0.22, 95% CI [0.08, 0.63],[moderate certainty of evidence and p = 0.0002; RR = 0.32, 95% CI [0.17, 0.58], moderate certainty of evidence, respectively). No significant differences were observed for marginal discoloration and adaptation (p > 0.05). The probability of POS occurrence was less in SE than in EAR groups (RR = 2.12, 95% CI [1.23, 3.64], moderate certainty of evidence). The certainty of evidence for other outcomes was scored as "low" or "moderate", depending on the follow-up period. SIGNIFICANCE: Using universal adhesives in EAR or SEE mode provides more predictable retention, while SE strategy reduces the risk of POS occurrence.

Microtensile vs microshear bond strength of all-in-one adhesives to unground enamel.

PURPOSE: to determine the bond strength to unground enamel of all-in-one adhesives in comparison with an etch-andrinse system and to compare the reliability of microtensile and microshear methods in providing such measurements. MATERIALS AND METHODS: the bonding procedure was performed on enamel of 64 extracted molars. The tested all-inone adhesives were: Bond Force (Tokuyama), AdheSE One (Ivoclar-Vivadent), and Xeno V (Dentsply). Prime&Bond NT (Dentsply) served as control. Microtensile specimens were obtained from 4 teeth per group. Twelve teeth per group were used for microshear testing. Microtensile specimens that failed prior to testing were included in statistical calculations; they were assigned the lowest value measured in the respective group. Failure modes were observed under light microscope and classified (cohesive within substrates, adhesive, mixed). Statistically significant differences in bond strength were assessed among the adhesives within each testing method and between microshear and microtensile data for each adhesive. Failure mode distributions were compared using the chi-square test. RESULTS: all-in-one adhesives had similar microshear and microtensile bond strengths. In both testing methods, the etch-and-rinse system achieved the strongest bond. For all adhesives, significantly higher bond strengths were measured with the microshear test. In microtensile testing, specimens bonded with the etch-and-rinse adhesive exhibited a significantly different distribution of failure modes. The coefficients of variation were extremely high for microtensile bond strength data, particularly of all-in-one adhesives. CONCLUSION: the adhesive potential to intact enamel of recently introduced all-in-one adhesives was inferior to that of an etch-and-rinse system. When testing bond strength to enamel of all-in-one adhesives, microshear testing may be a more accurate method than microtensile.

Can Fiber-post Placement Reinforce Structurally Compromised Roots?

PURPOSE: Immature teeth are characterized by short roots, thin root canal walls, and open apices, which makes them prone to fracture. The aim was to investigate whether fiber-post placement had an influence on the fracture resistance of endodontically treated immature teeth. MATERIALS AND METHODS: To simulate immature teeth, the apical third of 20 intact mandibular premolars was resected. After the access cavity was prepared, root canals and apices were enlarged. A 4-mm apical barrier was placed using calcium-silicate based material (Biodentine, Septodont). The teeth were then randomly assigned to two groups (n = 10). Root canals in group 1 were sealed using Acroseal (Septodont, France) and gutta-percha, followed by composite resin for the coronal restoration (Evetric, Ivoclar Vivadent). In group 2, fiber posts (FRC Postec Plus, Ivoclar Vivadent) were luted using self-adhesive composite cement (SpeedCEM Plus, Ivoclar Vivadent), followed by the same coronal restoration. The teeth were then subjected to fatigue and static load testing. RESULTS: The average loads (± SD) that led to tooth fracture were: 401.40 ± 296.83 N in group 1 and 636.20 ± 204.95 N in group 2. Unfavorable fractures were noted in 9 specimens from group 1 and in 7 specimens in group 2. No statistically significant difference in fracture resistance or fracture mode was found between the groups. CONCLUSION: Fiber-post placement had no significant influence on the fracture resistance of endodontically treated immature teeth.

Evaluation of the adhesion of fiber posts cemented using different adhesive approaches.

The aim of this study was to investigate the adhesion of fiber posts cemented with luting agents that utilize three currently available adhesive approaches: etch-and-rinse, self-etch, and self-adhesive. Forty-two intact single-rooted human premolars were used in the study. Teeth were divided into six groups. In each group, a different resin cement with its adhesive system (if needed) and a fiber post were used. The groups were classified, according to the adhesive approach, into the following three categories. (i) Etch-and-rinse groups: Calibra resin cement/XPBond adhesive + self-curing activator (SCA)/RadiX Fiber Post (Dentsply Caulk), FluoroCore 2 core build-up material/XPBond + SCA/RadiX Fiber Post (Dentsply Caulk), and MultiCore Flow luting and core build-up material/Excite DSC adhesive/FRC Postec Plus fiber post (Ivoclar Vivadent). (ii) Self-etch group: Panavia F 2.0/ED primer (Kuraray)/RadiX Fiber Post (Dentsply Caulk). (iii) Self-adhesive groups: experimental self-adhesive cement/RadiX Fiber Post (Dentsply Caulk), and RelyX Unicem/RelyX Fiber Post (3M ESPE). The adhesion between the post and the root canal walls was assessed using the 'thin-slice' push-out test. In the test arrangement used, the self-etching approach may offer less favourable adhesion to root canal dentin in comparison with etch-and-rinse and self-adhesive approaches.

Post space cleaning using a new nickel titanium endodontic drill combined with different cleaning regimens.

This study compared the effect of two drills and five cleaning regimens on post space debridement. One hundred extracted premolars were instrumented and obturated with warm vertical compaction of gutta percha. The teeth were divided into two groups according to the drill used to remove gutta percha/sealer and for post space preparation: a Largo drill (Largo; Dentsply, St Quentin en Yvelines, France) or a MTwo-PF drill (Sweden&Martina, Due Carrare, Padova, Italy). The following cleaning regimens were used: EDTA, ultrasonics, ultrasonics + EDTA, phosphoric acid, and distilled water. Scanning electron microscopic images of the post spaces were taken, and the presence of debris and of open dentin tubules were evaluated. The ultrasonics + EDTA, phosphoric acid, and EDTA groups were comparable in open tubules scores for both drills and in debris scores after the use of MTwo-PF (p > 0.05). The ultrasonics and control groups performed significantly worse (p < 0.05). The MTwo-PF drill resulted as effective as the Largo drill in obtaining a good post space cleaning, especially when followed by ultrasonics + EDTA irrigant regimen.

Self-adhesive resin cements: a literature review.

PURPOSE: To summarize research conducted on self-adhesive cements and provide information on their properties, based on the results of original scientific full-length papers from peer-reviewed journals listed in PubMed. MATERIALS AND METHODS: The search was conducted using the term "self-adhesive cement OR (trade names of currently available products)". RESULTS: Only in vitro studies that investigated two commercially available self-adhesive cements have been published so far. The results were summarized into the following categories: adhesion to tooth substrates (enamel, dentin, root dentin), adhesion to restorative materials (endodontic posts, ceramics, titanium abutments), marginal adaptation, microleakage, mechanical properties, biocompatibility, chemical adhesion and fluoride release, and ratings in clinical use. CONCLUSION: The majority of available literature data is based on studies that investigated one of the self-adhesive cements that are currently available to clinicians. According to the in vitro results, self-adhesive cement adhesion to dentin and various restorative materials is satisfactory and comparable to other multistep resin cements, while adhesion to enamel appears to be a weak link in their bonding properties. Long-term clinical performance of these materials needs to be assessed prior to making a general recommendation for their use.