A New Dual-cure Universal Simplified Adhesive: 18-month Randomized Multicenter Clinical Trial.

CLINICAL RELEVANCE: Non-carious cervical lesion restorations using a dual-cure universal adhesive in self-etch and etch-and-rinse mode showed satisfactory clinical performance after 18 months. SUMMARY: Objectives: The objective of this multicenter, double-blind, split-mouth randomized clinical trial was to evaluate the clinical performance of a new dual-cure universal adhesive system (Futurabond U, Voco GmBH) when applied using different strategies over a period of 18 months.Methods and Materials: Fifty patients participated in this study. Two hundred non-carious cervical lesions were restored using the adhesive Futurabond U according to four adhesive strategies (n=50 per group): only self-etch (SEE), selective enamel etching + self-etch (SET), etch-and-rinse with dry dentin (ERDry), and etch-and-rinse with wet dentin (ERWet). After the adhesive application, cavities were restored using Admira Fusion composite resin. These restorations were evaluated according to FDI World Dental Federation criteria for the following characteristics: retention/fracture, marginal adaptation, marginal staining, postoperative sensitivity, and caries recurrence.Results: After 18 months, only four patients (12 months: one patient, n=4 restorations; and 18 months: three patients, n=12 restorations) were not evaluated. Fourteen restorations were lost after 18 months of clinical evaluation (four for SEE, three for SET, three for ERDry, and four for ERWet). The retention rates for 18 months (95% confidence interval) were 92% (81%-97%) for SEE, 94% (83%-97%) for SET, 94% (83%-97%) for ERDry, and 92% (81%-97%) for ERWet (p>0.05). Thirty-eight restorations were considered to have minor discrepancies in marginal adaptation at the 18-month recall (13 for SEE, 13 for SET, six for ERDry, and six for ERWet; p>0.05). Fourteen restorations were detected as a minor marginal discoloration at the 18-month recall (six for SEE, six for SET, one for ERDry, and one for ERWet; p>0.05). However, all were considered clinically acceptable. No restorations showed postoperative sensitivity or caries recurrence at the time.Conclusion: The clinical performance of the Futurabond U did not depend on the bonding strategy used, and it was considered reliable after 18 months of clinical evaluation, although more marginal discrepancy was observed in the self-etch group.

Effect of the Photo-initiator System Contained in Universal Adhesives on Radicular Dentin Bonding.

CLINICAL RELEVANCE: The photo-initiator system based on an advanced polymerization system may be an alternative that can be used to overcome the disadvantages of radicular dentin, especially for the apical third. SUMMARY: Objectives: The purpose of this study was to evaluate the effects of universal adhesives with different photo-initiator systems applied in etch-and-rinse (ER) and self-etch (SE) modes on dentin interaction (push-out bond strength [PBS], nanoleakage [NL], and degree of conversion [DC] within the hybrid layer) in the different root thirds after fiber post cementation.Methods and Materials: Roots of endodontically prepared human premolars were randomly divided into six groups according to one of three adhesive systems (Scotchbond Universal [SBU], Ambar Universal [AMB], and Ambar Universal APS [AMB-APS]) and two adhesive strategies (ER and SE) for each system. Posts were cemented, and PBS was tested at 0.5 mm/min. The NL was evaluated by scanning electron microscopy. DC was measured using micro-Raman spectroscopy. The data were analyzed by three-way analysis of variance and Tukey tests (α=0.05).Results: AMB-APS showed similar performance in all root thirds (p>0.05) and higher values of DC, especially in the apical third (p<0.0001). AMB and SBU showed the lowest values in the apical third (p<0.0001).Conclusions: The APS photo-initiator system contained in universal adhesives is a feasible alternative for improving radicular bonding procedure.

[Neopterin in phases of exacerbation of bronchial asthma and in experimental asthma conditions]. / Neopterin in Exazerbationsphasen des Asthma bronchiale und unter den Bedingungen des experimentellen Asthmas.

In conditions associated with stimulation of cellular immunity and enhanced macrophage activity, for example, in viral infections, neopterin is elevated. Acute exacerbations of bronchial asthma--in particular in the case of intrinsic asthma--are frequently precipitated by viral infections of the upper airways. In both extrinsic and intrinsic asthma, neopterin is normal in the stable phases. In the exacerbation phase with signs of infection of the upper airways, however, neopterin in significantly elevated both in the serum and in the urine. In contrast, during and following positive inhalative provocation testing with histamine, allergens and aspirin, no increase in neopterin is to be observed.

C-reactive protein as a predictor of fetal and maternal infective morbidity and fetal mortality.

The value of maternal C-reactive protein (CRP) levels as predictors of fetal and maternal infective morbidity and fetal mortality was assessed prospectively over a 6-month period in all cases of premature rupture of the fetal membranes or suspected premature labour. Statistical analysis of results showed that CRP at a level of 1.32 mg/dl is a sensitive marker of infective morbidity in mother and neonate. Furthermore, there was a significant association between raised CRP levels and low-birth-weight babies, suggesting that intra-uterine infection is a major cause of prematurity in the study population.

The unbooked patient. Part I. Reasons for failure to attend antenatal clinics.

Two hundred unbooked mothers were questioned after delivery and their reasons for non-attendance at antenatal clinics were determined. The control group consisted of 310 mothers who had booked early and were good clinic attenders. The most significant difference between the two groups was that the unbooked mothers were of lower socioeconomic status and lived in poorer areas situated further from the hospital. The main reasons given for not attending hospital clinics included the expense involved and the fact that the mothers often stayed outside the area during the pregnancy.

The unbooked patient. Part II. Outcome of pregnancy in unbooked coloured patients.

The fetal outcome was compared in 200 unbooked pregnancies and in 310 pregnancies in which the mothers had booked before 22 weeks' gestation. Of the babies born to the unbooked mothers 36% weighed less than 2,500 g compared with only 12.5% in the booked group. Among the unbooked patients the neonatal mortality rate was three times higher than among booked cases. Maternal intrinsic factors, including parity and socio-economic status, made a major contribution to the incidence of low-birth-weight babies. The need for improved attendance at clinics and for education about antenatal care in the coloured population under review is well documented. The introduction of peripheral clinics and free antenatal care could play a major role in improving fetal outcome.

True hermaphroditism. A case report with observations on its bizarre presentation.

A true XX hermaphrodite presenting in adulthood with male sex gender identity was found to have separate vaginal and urethral openings in the perineum. A total vaginectomy was performed at the same time as total abdominal hysterectomy and gonadectomy because the vaginal opening would interfere with a urethroplasty to repair the hypospadias and chordee phallus. During this procedure prostatic tissue was excised in the area of the anterior vaginal wall adjacent to the urethra. Recommendations regarding this rare XX true hermaphroditism are put toward and observations on some bizarre features of the entity are made. The authors plead for the formation of a national register to study this interesting condition.

Screening for liver metastases from ovarian cancer with serum carcinoembryonic antigen and radionuclide hepatic scintiphotography.

The association between pre-operative serum carcinoembryonic antigen (CEA) and liver scanning employing technetium (99mTc)-tin colloid was investigated in 30 women subsequently proven to have primary epithelial ovarian carcinoma to determine whether these two investigations improve the detection of hepatic metastases. The upper limit of normal for CEA (greater than or equal to 5 ng/ml) did not represent the optimal levels for use in predicting ovarian carcinoma nor the presence of liver metastases. But with CEA levels greater than 10 ng/ml sensitivity for liver metastases was 57%. Liver scanning alone demonstrated metastases in five out of seven patients (71%) with parenchymal liver metastases. The combination of CEA and liver scan was positive in six out of these seven patients (86%).

Acute leukaemia in pregnancy. A case report and discussion on modern management.

A case of acute myelomonocytic leukaemia in pregnancy with successful outcome is reported. Aspects of management are reviewed, especially with regard to expected complications following cytostatic therapy and the effects on both mother and fetus. The need to determine the optimal time for elective delivery is emphasized. The seasons for formation of an international tumour registry are outlined. The disease can no longer be regarded as invariably fatal for mother and child.