Current approaches and questions yet to be resolved for the prophylaxis of post-endoscopic retrograde cholangiopancreatography pancreatitis.

Prophylaxis is important for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP), which is the most common and serious complication of ERCP. Although the current guidelines include independent patient- and procedure-related risk factors for PEP and available PEP prophylactic measures, the synergistic effect of these risk factors on PEP should also be considered, given that patients often harbor multiple risk factors. Furthermore, a combination of prophylactic measures is often selected in clinical practice. However, established methods estimating the synergistic effect of independent risk factors on PEP incidence are lacking, and evidence on the impact of combining prophylactic measures on PEP should be discussed. Selection of appropriate candidate patients for ERCP is also important to reduce the incidence of PEP associated with unnecessary ERCP. ERCP indications in patients with asymptomatic common bile duct stones (CBDSs) and in those with suspected CBDSs with no imaging-based evidence of stones are controversial. Further studies are warranted to predict the synergistic effect of independent risk factors on PEP, determine the best prophylactic PEP measures, and identify appropriate candidates for ERCP in patients with asymptomatic CBDSs and those with suspected CBDSs.

Bond performance of "Touch and Cure" adhesives on resin core systems.

The purpose of this study was to compare the micro-tensile bond strength (µTBS) of three resin core composites to dentin and to examine the bonded interface of the composites. One experimental TDK-03(TD) and, two commercial, DC core Automix One (DC) and Unifil core EM(UN) were used. Flat dentin surfaces of human molars were exposed using #600 SiC paper and bonded with the respective adhesive of each system. After bonding, the composites were built up on the surfaces and cured under two conditions: "light condition" or "dark condition". µTBSs (MPa) in the light condition were: TD; 60.02±17.08, DC; 38.21±13.70, and UN; 29.50±9.71; in the dark condition: TD; 54.62±17.11, DC; 8.40±4.81, and UN; 9.47±6.56. Dark curing negatively affected the bond strength of the two commercial resin-core materials. The experimental material was not affected by the curing conditions.

Efficacy of a new filler-containing root coating material for dentin remineralization.

PURPOSE: To evaluate a new root coating material containing surface pre-reacted glass-ionomer (S-PRG) filler for remineralization of demineralized dentin. METHODS: The dentin was exposed on root surfaces of human third molars and demineralized by immersion in demineralization solution for 4 days. The demineralized dentin surface was divided into three areas. The center area was left untreated. The area on one side of the center area was coated with protective wax. The area on the other side was coated with one of four test materials: fluoride-containing S-PRG filler (PRG Barrier Coat: PR), fluoride-containing bonding agent (Bond Force: BF), fluoride-containing glass-ionomer cement as a positive control (Fuji IX EXTRA: EX), or non-fluoride-containing bonding agent as a negative control (Clearfil MegaBond: MB). The samples were stored in remineralization solution for 7 days, and then cut into two slices. The mineral changes, defined as variation in mineral loss between wax-coated area and the central untreated area, were measured in one slice by transversal microradiography. The fluoride concentration was measured in the other slice by µ-particle-induced gamma/X-ray emission. Seven thin specimens (0.25-mm thickness) of each test material were used to determine fluoride ion release from the materials over 21 days. RESULTS: The mineral changes were greatest for EX, followed by PR, with no difference between BF and MB (P> 0.05). Regarding the fluoride concentrations in dentin, there was no difference between EX and PR (P> 0.05). MB had the lowest value (P< 0.01). Fluoride release from EX was largest, followed by PR, with BF showing low fluoride release (P< 0.05). MB had no fluoride release. CLINICAL SIGNIFICANCE: A new coating material with S-PRG filler can be applied in a thin layer on root dentin, which could be especially useful for hard-to-access lesions. This material remineralized demineralized root dentin and had fluoride diffusion characteristics similar to those of glass-ionomer cement in vitro.

Microtensile bond strength of a newly developed resin cement to dentin.

The purpose of this study was to evaluate the microtensile bond strength (µTBS) of a newly developed resin cement, ECD-89 (ECD, Tokuyama Dental, Tokyo, Japan) to dentin and to observe the interfacial micromorphology by comparing with two commercial resin cements, Multilink Automix (MA, Ivoclar Vivadent AG, Schaan, Liechtenstein) and Panavia F2.0 (PF, Kuraray Noritake Dental, Tokyo, Japan). Flat dentin surfaces of human third molars were exposed using #600 SiC. After application of primer and cement to the dentin surface, each cement was applied and cured with light (light condition) or without light (dark condition). The teeth were sectioned to obtain beams (1 mm×1 mm) after 24 h of water storage. The mean bond strengths and SDs (MPa) were: ECD: 68.6±14.9, MA: 39.2±18.9, PF: 39.4±18.5 and ECD: 54.5±22.4, MA: 36.7±15.6, PF: 13.4±4.46 when cured in light and dark condition, respectively. In both conditions, ECD-89 showed statistically higher µTBS than the others.