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CONTEXT: Consumption of acidic beverages has been reported to alter the physical and esthetic properties of resin composites, which in turn can affect clinical success. AIMS: This study aimed to evaluate the effect of acidic beverages on surface roughness and color stability of Filtek™ Bulk-Fill posterior restorative composite in comparison with Filtek P60 posterior restorative composite. SETTINGS AND DESIGN: Ninety composite discs were used for surface change analysis and another ninety were used for color change analysis. MATERIALS AND METHODS: Ninety Filtek P60 and Filtek Bulk-Fill composite discs were fabricated and divided into three subgroups according to the solutions - artificial saliva (control group), orange juice, and Coca-Cola® (test groups). The samples were immersed in each beverage for 10 min each day for 56 days. To measure the surface roughness, a profilometer was used, and the surface was qualitatively analyzed using a scanning electron microscope. A reflectance spectrophotometer was used for assessing the color change. STATISTICAL ANALYSIS USED: Two-way analysis of variance was used to compare the surface alteration and color change values between the two composite groups and their respective three subgroups. Tukey's multiple post hoc test was performed for pair-wise comparison. RESULTS: Filtek P60 had exhibited higher color change than Filtek Bulk-Fill in all immersion solutions. Coca-Cola resulted in highest staining in both the composites. CONCLUSIONS: The surface roughness and color change of both composites increased significantly in acidic beverages and more in Coca-Cola. Bulk-fill exhibited better surface quality and color stability than P60.
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BACKGROUND: The Prostate Health Index (phi) outperforms PSA and other PSA derivatives for the diagnosis of prostate cancer (PCa). The impact of phi testing in the real-world clinical setting has not been previously assessed. METHODS: In a single, large, academic center, phi was tested in 345 patients presenting for diagnostic evaluation for PCa. Findings on prostate biopsy (including Grade Group (GG), defined as GG1: Gleason score (GS) 6, GG2: GS 3+4=7, GG3: GS 4+3=7, GG4: GS 8 and GG5: GS 9-10), magnetic resonance imaging (MRI) and radical prostatectomy (RP) were prospectively recorded. Biopsy rates and outcomes were compared with a contemporary cohort that did not undergo phi testing (n=1318). RESULTS: Overall, 39% of men with phi testing underwent prostate biopsy. No men with phi<19.6 were diagnosed with PCa, and only three men with phi<27 had cancer of GG⩾2. Phi was superior to PSA for the prediction of any PCa (area under the receiver operating characteristic curve (AUC) 0.72 vs 0.47) and GG⩾2 PCa (AUC 0.77 vs 0.53) on prostate biopsy. Among men undergoing MRI and phi, no men with phi<27 and PI-RADS⩽3 had GG⩾2 cancer. For those men proceeding to RP, increasing phi was associated with higher pathologic GG (P=0.002) and stage (P=0.001). Compared with patients who did not undergo phi testing, the use of phi was associated with a 9% reduction in the rate of prostate biopsy (39% vs 48%; P<0.001). Importantly, the reduction in biopsy among the phi population was secondary to decreased incidence of negative (8%) and GG1 (1%) biopsies, whereas the proportion of biopsies detecting GG⩾2 cancers remained unchanged. CONCLUSIONS: In this large, real-time clinical experience, phi outperformed PSA alone, was associated with high-grade PCa, and provided complementary information to MRI. Incorporation of phi into clinical practice reduced the rate of unnecessary biopsies without changing the frequency of detection of higher-grade cancers.
