Effect of Polymerization on the Color of Resin Composites.

OBJECTIVES: The initial shade of a resin-based restorative material should be the same as that after polymerization. In this study, the color changes of translucent and opaque composites from nine different brands were assessed after polymerization using a spectrophotometer and cross-polarization (CP) photography. METHODS AND MATERIALS: Thirteen nano-hybrid (Essentia LE, GC Corp; Ceram.x Duo SphereTEC A2E/A2D, Dentsply Sirona; Harmonize A2E/A2D, Kerr Dental; IPS Empress Direct A2E/A2D, Ivoclar Vivadent; Mosaic EN/A2, Ultradent Products; Clearfil Majesty Es-2 A2E/A2D, Kuraray Noritake; Charisma Topaz A2/OL, Kulzer), two supra nano-hybrid (Estelite Asteria NE/A2B; Tokuyama), two nano-filled (Filtek Ultimate A2E/A2D; 3M) light-curing resin composites, and one micro-hybrid (Essentia MD, GC Corp) light-curing resin composite were tested. Disc-shaped specimens (n=5) were prepared using silicone molds (12 × 5 mm) and polymerized from both sides using an LED curing light (Elipar Deepcure S, 3M) at a light intensity of 1470 mW/cm2. Measurements were performed before and 1 day after polymerization using a contact-type dental spectrophotometer (Easy Shade 5, VITA Zahnfabrik, Bad Säckingen, Germany) and a combination of CP photography and Photoshop CC software (Adobe Inc, San Jose, CA, USA). Spectrophotometry and CP photography ΔE* values were calculated; the perceptibility threshold was a ΔE* value of 1.2. VITA spectrophotometry color change scores were also calculated and evaluated. RESULTS: The overall ΔE* values ranged between 0.34 and 12.56. Two-way analysis of variance (ANOVA) showed that color change was associated most strongly with composite brand (p<0.001), followed by shade (p=0.002). Color change (p=0.002) and degree of darkening/lightening (p<0.001) were significantly greater for dentin compared to enamel shades. Clearfil Majesty Es-2 (Kuraray Noritake) showed significant lightening, whereas all other composites showed darkening after polymerization. All composite brands presented perceptible (ΔE*≥1.2) color changes. Estelite Asteria (Tokuyama), Ceram.x Duo SphereTEC (Dentsply Sirona), and Harmonize (Kerr Dental) were considered the most reliable brands regardless of the shade. The spectrophotometry and CP photography methods were positively correlated (p<0.001). Also, CIEDE2000 and CIELCH (also referred to as CIE L*c*h) color systems were positively correlated based on the ΔE* values (p<0.001). CONCLUSIONS: Despite improvements in the chemical composition of, and fillers for, contemporary resin-based composites (RBCs), all tested composite brands showed perceptible color change after polymerization, except for some shades. Under the conditions in this study, it is preferable to polymerize the composite during the trial phase, before identifying the most appropriate shade. CP photography in combination with Photoshop analysis appears to be a reliable and promising approach for color evaluation.

Longevity of Direct Resin Composite Restorations in Maxillary Anterior Crown Fractures: A 4-year Clinical Evaluation.

OBJECTIVES: To investigate the longevity of direct composites for Class IV restorations and the possible reasons of failure. METHODS AND MATERIALS: The longevity of 168 Class IV restorations in 50 adult patients was evaluated, in terms of modified United States Public Health Service criteria, for 4 years. Restorations were performed using a monochromatic layered microhybrid, resin-based composite (RBC) (Essentia, Universal Shade, GC Corporation, Japan; n=76) and polychromatic layered micro/nanohybrid (MD and LE shades, Essentia, GC Corporation, Japan; n=92) RBCs, by a single operator. RESULTS: The majority of the teeth (n=156) remained acceptable at the end of 4 years, and the overall survival (OS) rate was considered as 92.86%. Survival rates for the monochromatic layering technique (MLT) and polychromatic layering technique (PLT) were 90.8% and 94.6%, respectively. Mean survival was 46 months for MLT and 47 months for PLT, indicating no significant difference (p=0.343). Fracture of the restoration was the most common reason for failure (4.2% out of 7.1% of general failures) for both the layering techniques. CONCLUSIONS: Under the conditions of this mid-term clinical study, MLT and PLT as well as microhybrid and nanohybrid resin composite materials, showed similar clinical durability. In terms of simplicity, monochromatic layering can be preferred for Class IV restorations, when the right indication criteria are met.

Assessment of trazodone-induced cardiotoxicity after repeated doses in rats.

Trazodone (TRZ) is an antidepressant drug commonly used in the treatment of depression, anxiety, and insomnia. Although some studies demonstrated the adverse effects of TRZ related to cardiovascular system, the conflicting results were observed in these studies. Therefore, we aimed to investigate the cardiac adverse effects of TRZ in rats at repeated doses in our study. In accordance with this purpose, TRZ was administered orally to rats at 5, 10, and 20 mg/kg doses for 28 days. Electrocardiogram records, serum aspartate aminotransferase (AST), lactate dehydrogenase, creatine kinase-myoglobin band, cardiac troponin-T (cTn-T) levels, DNA damage in cardiomyocytes, and histologic view of heart tissues were evaluated. In addition, glutathione (GSH) and malondialdehyde (MDA) levels were measured to determine the oxidative status of cardiac tissue after TRZ administration. Heart rate was decreased, PR interval was prolonged, and QRS and T amplitudes were decreased in 20 mg/kg TRZ-administered group compared to the control group. Serum AST and cTn-T levels were significantly increased in 10 and 20 mg/kg TRZ-administered rats with respect to control rats. DNA damage was significantly increased in these groups. Additionally, degenerative histopathologic findings were observed in TRZ-administered groups. Although there was no difference in MDA levels between groups, GSH levels were significantly decreased in 10 and 20 mg/kg TRZ-administered groups compared to the control group. Our results have shown that TRZ induced cardiotoxicity in rats dose-dependently. It is assumed that oxidative stress related to GSH depletion may be accompanied by these adverse effects.

Does bupivacaine and fentanyl combination for epidural analgesia shorten the duration of labour?

In this study we aimed to explore the effects of epidural analgesia achieved by a combination of low-dose bupivacaine and fentanyl infused through an epidural catheter on mother, foetus and labour process in nulliparous at-term pregnant women during vaginal delivery. This study was designed in a prospective, randomised controlled manner. Epidural analgesia was achieved in 50 nulliparous women. Fifty nulliparous women did not undergo epidural analgesia procedure. The duration of the first stage of labour was significantly shortened, while the second stage was significantly lengthened in pregnant women who underwent epidural analgesia (p < 0.05). In conclusion, starting epidural analgesia application during the active phase of the first stage of labour may shorten the duration of the first stage compared with the group of nulliparous women not undergoing epidural analgesia. The factor that has an impact on this may be the addition of fentanyl to bupivacaine used for epidural analgesia.

Discrete Type Subaortic Stenosis in Dextrocardia with Situs Inversus Totalis

This paper presents the case report of a patient with discrete type subaortic stenosis in dextrocardia and its associated clinical manifestations.

Angioplasty of Subclavian Artery Stenosis: Report of Two Cases and Review of the Literature

In this study we present two patients who underwent successful percutaneous transluminal angioplasty of a symptomatic left subclavian artery stenosis. We have compared our data with the data obtained from the current literature.