Comparative Effect of Different Surface Treatments on the Shear Bond Strength of Two Types of Artificial Teeth Bonded To Two Types of Denture Base Resins.

PURPOSE: This in vitro study aims to assess the impact of various surface treatments on the shear bond strength (SBS) of two types of artificial teeth and denture base resins (DBRs). MATERIALS AND METHODS: Two types of DBRs (CAD/CAM-milled and heat-polymerized) and two types of denture teeth (acrylic and composite) were investigated. Teeth were cut into slices (5 × 5 × 2 mm) and divided according to surface treatment into four subgroups (n = 10): no treatment (control), air abrasion (Alumina-blasting; AB), bur roughening, and dichloromethane (DCM) subgroups. According to manufacturer recommendations, the treated tooth slices were bonded to the acrylic disk of DBRs. The SBS test was performed using a universal testing machine. ANOVA was used for results analysis followed by Tukey's post hoc tests (α = 0.05). RESULTS: DCM and AB increased the SBS of acrylic teeth to heat-polymerized DBR compared with other groups (p < 0.001). All surface treatments showed no significant difference in CAD/CAM DBR with acrylic teeth (p = 0.059; AB, p = 0.319; bur roughening, p = 0.895; DCM), while there was a significant decrease in SBS with composite teeth (p ˂ 0.001). Between teeth, acrylic teeth showed a statistically significant increase in SBS compared to composite teeth (p < 0.001). CONCLUSION: AB and DCM application improved the SBS for acrylic teeth with the heat-polymerized DBR when compared with the untreated group, but none of the surface treatment agents showed significant improvement with CAD/CAM DBR. All surface treatment agents reduced the SBS for composite teeth with CAD/CAM DBR while AB only increased the SBS with heat-polymerized DBR.

Using ESN-Smartphone Application to Maximize AIS Reperfusion Therapy in Alexandria Stroke Network: A Stroke Chain of Survival Organizational Model.

Background: In developing countries like Egypt, the clinical workflow of stroke management is poorly established due to the lack of awareness of the stroke patients concerning their need of therapeutic intervention and the poor identification of facilities equipped to treat stroke. Hence, establishing a stroke system of care in developing countries that can efficiently and rapidly triage patients to the appropriate reperfusion therapy center is imperative to improving stroke management and outcomes. Aims: To evaluate a pilot experience in stroke hospital identification and expediting decision-making in AIS treatment through the Alexandria stroke network and Egyptian Stroke Network (ESN)-app. Methods: Between 2017 and 2019, seven hospitals registered themselves on the AS-Network as pilot hospitals. The ESN-application was used to detect stroke type, tele-connect stroke teams and hospitals, track triage of patients to equipped facility in real time, and streamline stroke workflow. The quality of and time required for stroke management were compared between 84 patients with acute ischemic stroke (AIS) whose treatment involved the ESN-app and 276 patients whose treatment did not. Results: During this pilot study, 360 AIS cases received reperfusion therapy, 84 of which were indicated by the ESN-app. The use of the application was associated with the significant drop in time metrics for the reperfusion AIS-patients (door-in-door-out time; 56 ± 34 min vs. 96 ± 45 min, door-to-groin puncture time; 50 ± 7 min vs. 120 ± 25 min, door-to-needle time; 55 ± 12 min vs. 78 ± 16 min with p < 0.0001). Its use was also associated with higher rates of excellent outcomes at the 90-day follow-up (without ESN-app vs. with ESN-app, 67.9 vs. 47.1%, p = 0.001) but no difference in 90-day mortality or symptomatic intracerebral hemorrhage (without ESN-app vs. with ESN-app, 9.5 vs. 11.2% and 4.8 vs. 5.1%, p > 0.05). Conclusion: Our pilot experience demonstrated that the use of the ESN-app expedited the stroke treatment workflow and facilitated tele-connection between registered stroke facilities. Additionally, its use might be associated with achieving higher rates of excellent outcomes at 90 days, where a larger scale study is needed for more confirmation.

Comparative study of some mechanical properties of cobalt chromium and polyether ether ketone thermoplastic removable partial denture clasps: an In-vitro Study / Estudo comparativo de algumas propriedades mecânicas dos grampos parciais removíveis termoplásticos removíveis termoplásticos de cobalto cromo e éter cetona: um estudo in vitro

Objective: was to evaluate the retentive force, fatigue resistance and deformity of clasps made from two materials cobalt chromium and poly ether ether ketone (PEEK). Material and Methods: sixteen models were fabricated,each one having lower 1st molar. Models were divided into two groups according to materials,group I (GI) for cobalt chromium (Co-Cr) and group II (GII) for PEEK. Each testing models and its clasps were mounted inside universal testing machine, the retention was measured by applying withdrawal force to it by this machine at 5 mm/min. The Fatigue resistance is measured by the reduction in retention through repeated insertion and removal cycles using robota chewing simulator. Removal and insertion cycling of clasps was carried out for 360, 730, 1080, 1,440, 2,116 and 2,880 cycles (corresponding to 3, 6, 9, 12, 18 and 24 months of simulated clinical use of a RPD) to simulate the fatigue resistance test. Deformity was measured before and after each cycling using a digital micrometer. Statistical analysis was done by 2-way-ANOVA test to detect significance effects of each variable. Results: Retention and fatigue resistance, after 360, 730, 1080, 1,440, 2,116 and 2,880 cycles totally the difference between Co-Cr and PEEK groups was statistically non-significant (P = 0.0980> 0.05) where (Co-Cr > PEEK). Deformation results, regardless to evaluation time, Co-Cr group recorded statistically significant higher deformation mean value than PEEK group (P = 0.008 < 0.05).Regardless to material group, deformation mean value changed nonsignificantly by time (P = 0.2882> 0.05). Conclusion: PEEK clasps (1.0 mm in cross section diameter) engage 0.50 mm undercut provide sufficient retention nearly similar that of Co-Cr clasps.(AU)

Objetivo: o objetivo foi avaliar a força de retenção, a resistência à fadiga e a deformidade dos grampos fabricados com dois materiais diferentes: cromo-cobalto (Co-Cr) e poliéter-éter-étercetona (PEEK). Materiais e métodos: dezesseis modelos foram confeccionados, cada um com 1º molar inferior. Os modelos foram divididos em dois grupos de acordo com o material: grupo I Co-Cr e grupo II para PEEK. Cada modelo de teste universal e seus grampos foram montados em uma máquina de teste universal. A retenção foi medida aplicando força de retirada por esta máquina a 5 mm/min. A resistência à fadiga foi medida pela redução na retenção através de ciclos repetidos de inserção e remoção usando um simulador do ciclo de mastigação. O ciclo de remoção e inserção dos grampos foi realizado por 360, 730, 1080, 1.440, 2.116 e 2.880 ciclos (correspondendo a 3, 6, 9, 12, 18 e 24 meses de uso clínico simulado de um RPD) para simular o teste de resistência à fadiga. A deformidade foi medida antes e após cada ciclo, usando um micrômetro digital. A análise estatística foi realizada pelo teste ANOVA de 2 fatores para detectar os efeitos de significância de cada variável. Resultados: A retenção e a resistência à fadiga após 360, 730, 1080, 1.440, 2.116 e 2.880 ciclos entre os grupos Co-Cr e PEEK não mostrou diferença estatisticamente significativa (p = 0,0980> 0,05), onde (Co-Cr> PEEK). Para os resultados da deformação, independentemente do tempo de avaliação, o grupo Co-Cr registrou um valor médio de deformação maior, com diferença estatística significativa, quando comparado com o grupo PEEK (p= 0,008 < 0,05). Independentemente do grupo de material, o valor médio da deformação foi alterado de forma não significativa pelo tempo (p= 0,2882> 0,05). Conclusão: os grampos PEEK (1,0 mm de diâmetro da seção transversal) engatam 0,50 mm retenção quase semelhante à dos grampos Co-Cr (AU)

Effect of SiO2 and Al2 O3 nanoparticles on wear resistance of PMMA acrylic denture teeth / Efeito das nanopartículas de SiO2 e Al2 O3 na resistência ao desgaste de dentes em acrílico PMMA para prótese

Objetivo: Este estudo teve como objetivo avaliar a resistência ao desgaste de dentes em acrílico para próteses contendo nanopartículas de dióxido de silício (nano-SiO2 ) e dióxido de alumínio (nanoAl2 O3 ). Material e Métodos: O material em polimetilmetacrilato (PMMA) foi utilizado para fabricar 84 amostras (n=10) contendo nano-SiO2 e nano-Al2 O3 nas concentrações 0,1% em peso, 0,3% em peso e 0,5% em peso de pó acrílico. Uma máquina de teste de desgaste de dois corpos e um microscópio digital foram usados para medir as mudanças na perda de peso e rugosidade da superfície, respectivamente. Testes de ANOVA a um fator e testes de comparações múltiplas de Tukey foram utilizados para análise dos dados (α = 0,05). Resultados: O material modificado com nano-SiO2 demonstrou um aumento significativo na perda de peso em comparação com o material acrílico artificial convencional (p ˂ 0,05) enquanto o material modificado com nano-Al2 O3 demonstrou aumento não significativo na perda de peso, exceto no subgrupo 0,5% (p < 0,05). Não há diferenças significativas em relação à alteração da rugosidade após a simulação de desgaste entre todos os grupos testados (p > 0,05). Conclusão: As nanopartículas de nano-Al2 O3 exibem menos efeito negativo que o nanoSiO2 , podendo ser usado com cautela, se necessário. (AU)

Objective: This study aimed to evaluate the wear resistance of acrylic denture teeth containing silicon dioxide (nano-SiO2 ) and aluminum dioxide (nano-Al2 O3 ) nanoparticles. Material and Methods: Poly methyl methacrylate (PMMA) denture tooth material was used to denture tooth material was used to fabricate 84 specimens (n=10) containing nano-SiO2 and nano-Al2 O3 in concentrations 0.1wt%, 0.3wt%, and 0.5wt% of acrylic powder. A two-body wear testing machine and digital microscope were used to measure the changes in weight loss and surface roughness respectively. One-way ANOVA and pair-wise Tukey's post-hoc tests were used for data analysis (α = 0.05). Results: Nano-SiO2 modified teeth material demonstrated a significant increase in weight loss in comparison conventional artificial acrylic teeth material (p ˂ 0.05) while nanoAl2 O3 modified teeth material demonstrated non-significant increase in weight loss except for 0.5% subgroup (p ˂ 0.05). There is no significant differences regarding roughness change after wear simulation among all tested groups (p > 0.05). Conclusion: Nano-Al2 O3 nanoparticles exhibit less negative effect than nano-SiO2 so; it could be used with caution if necessary. (AU)

Ondansetron compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial.

OBJECTIVE: To compare ondansetron with metoclopramide in the treatment of hyperemesis gravidarum. METHODS: We enrolled 160 women with hyperemesis gravidarum in a double-blind randomized trial. Participants were randomized to intravenous 4 mg ondansetron or 10 mg metoclopramide every 8 hours for 24 hours. Participants kept an emesis diary for 24 hours; at 24 hours, they expressed their well-being using a 10-point visual numeric rating scale and answered an adverse effects questionnaire. Nausea intensity was evaluated using a 10-point visual numeric rating scale at enrollment and at 8, 16, and 24 hours. Primary analysis was on an intention-to-treat basis. RESULTS: Eighty women each were randomized to ondansetron or metoclopramide. Median well-being visual numeric rating scale scores were 9 (range, 5-10) compared with 9 (range, 4-10) (P=.33) and vomiting episodes in the first 24 hours were 1 (range, 0-9) compared with 2 (range, 0-23) (P=.38) for ondansetron compared with metoclopramide, respectively. Repeat-measures analysis of variance of nausea visual numeric rating scale showed no difference between study drugs (P=.22). Reported rates of drowsiness (12.5% compared with 30%; P=.01; number needed to treat to benefit, 6), xerostomia (10.0% compared with 23.8%; P<.01; number needed to treat to benefit, 8), and persistent ketonuria at 24 hours (12.5% compared with 30%; P=.01; number needed to treat to benefit, 6) were less frequent with ondansetron. Length of hospital stay was similar. CONCLUSION: Ondansetron and metoclopramide demonstrated similar antiemetic and antinauseant effects in hyperemesis gravidarum. However, the overall profile, particularly regarding adverse effects, was better with ondansetron. In our setting, metoclopramide was significantly less expensive than ondansetron and remained a reasonable antiemetic choice. CLINICAL TRIAL REGISTRATION: ISRCN Register, www.isrctn.org, ISRCTN00592566. LEVEL OF EVIDENCE: I.