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1.
Dent Mater J ; 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34602588

RESUMO

This study aimed to evaluate the pulpal responses of monkey's pulp after direct pulp capping (DPC) with the novel mineral trioxide aggregate containing phosphorylated pullulan-based material (MTAPPL). Seventy-two teeth were randomly divided into four groups: MTAPPL; Nex-Cem MTA (NX); TheraCal LC (TH); and Dycal (DY). Histopathological changes in the pulps were observed at days 3, 7 and 70. On day 3, mild inflammatory responses were observed in the MTAPPL, no to moderate inflammatory responses in the TH, whereas moderate inflammatory responses in the NX and DY. No mineralized tissue formation (MTF) was observed in all groups. On day 7, no or mild inflammatory responses were observed in all groups. Initial MTF was observed except for DY. No inflammation with complete MTF including presence of odontoblast-like cells was observed in the MTAPPL, NX and TH groups at day 70. These findings indicate that MTAPPL could be an efficient DPC material.

2.
Polymers (Basel) ; 13(19)2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34641143

RESUMO

Oral biofilm reactor (OBR) and pH cycling (pHC) artificial caries model were employed to evaluate the anti-demineralization effects of four composite filling systems on enamel-root dentin junction. Sixty-four enamel-root dentin blocks (6 mm × 6 mm × 2 mm) each with a cylindrical cavity were randomly assigned to the pHC and OBR group, then four subgroups (n = 8) and filled with either the Beautifil II (BEF, SPRG-filler-containing) or Estelite (EST) composite after the adhesive (either Single Bond Universal (SBU) or FL Bond II (FL, SPRG-filler-containing)). The demineralization lesions of filling interface were examined by micro-computerized tomography (µCT) and swept-source-optical coherence tomography (SS-OCT). According to the degree of interface damage, the caries lesions were sorted into four types: Type A and B (no attachment loss); Type C and D (attachment loss). EST/SBU showed the worst demineralization lesion and attachment loss (100% Type D), while BEF/FL exhibited the shallowest lesion depth (p < 0.05, 145 ± 45 µm on enamel, 275 ± 35 µm on root dentin) and no attachment loss (75% Type A and 25% Type B). Using FL adhesive alone does not effectively reduce enamel demineralization. BEF plays a leading role in acid resistance. The combination of BEF and FL showed a cumulative synergistic effect on anti-demineralization.

3.
Intern Med ; 60(19): 3061-3070, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34602520

RESUMO

Objective Chronic hepatitis C virus (HCV) infection carries a residual risk of hepatocarcinogenesis even after viral elimination, so appropriate follow-up is necessary. The present study investigated the current hospital visits and hepatocarcinogenesis status of patients who received daclatasvir plus asunaprevir treatment (DCV+ASV) to determine whether or not appropriate follow-up was being performed. Methods We retrospectively analyzed hepatocarcinogenesis, the overall survival, and the length of hospital visits in 442 patients who applied for the medical expense subsidy system for viral hepatitis and received DCV+ASV treatment in Gunma Prefecture between October 2014 and December 2015. This also included 61 patients who had a history of hepatocellular carcinoma (HCC). Results Among 442 patients, 388 achieved a sustained viral response (SVR) by DCV+ASV therapy (87.8%), and 95.9% achieved an SVR if additional treatment was included. HCC was found in 75 cases (17.0%). A history of HCC, the FIB-4 index and the treatment effect SVR were determined to be factors affecting the incidence of HCC. Regarding the follow-up rate, 89.9% of patients continued to regularly visit the hospital after 5 years of treatment. However, patients ≤60 years old had significantly lower persistence rates than older patients. The persistence rate of hospital visits to the same institution was 67.7% over a 5-year period, which was significantly better in small and medium-sized institutions than in large, specialized institutions (71.7% vs. 63.9%, p=0.039). Conclusion Patients with direct-acting antiviral treatment generally received adequate follow-up, but younger patients had a slightly higher rate of follow-up interruption and were considered to need support.


Assuntos
Carcinoma Hepatocelular , Hepatite C Crônica , Neoplasias Hepáticas , Antivirais/uso terapêutico , Carcinoma Hepatocelular/epidemiologia , Seguimentos , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/epidemiologia , Humanos , Neoplasias Hepáticas/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos
4.
Dent Mater ; 37(8): 1260-1272, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33965251

RESUMO

OBJECTIVE: We aimed to evaluate morphological, mechanical and chemical characteristics at resin-dentin interfaces using multiple combinations of adhesives and resins after a short-term biofilm-induced degradation. METHODS: Cervical cavities were prepared in bovine incisors, treated by Clearfil SE Bond 2 (SE) or FL-Bond II (FL), restored by Clearfil Majesty ES Flow (ES) or Beautifil Flow Plus (BFP) and grouped into SE-ES, SE-BFP, FL-ES and FL-BFP. After biofilm challenge, interfacial gaps and dentin wall lesions were examined by optical coherence tomography (OCT). Gap depth (GD), gap pattern scale (GPS) and dentin wall lesion depth (WLD) were evaluated from confocal laser scanning microscope. Microhardness of dentin lesions was measured with a Vickers microhardness tester. Chemical elements in resins and dentin wall lesions were analyzed by scanning electron microscopy and energy dispersive X-ray spectrometry (SEM/EDS). Morphological structures of interfacial gaps were observed by SEM. RESULTS: OCT could detect adhesive-dentin-bonded and adhesive-dentin-debonded gaps. SE-containing groups showed significantly lower GPS than FL-containing groups. FL-BFP showed significantly lower WLD than FL-ES. Microhardness of dentin wall lesions was higher than that of outer lesions and they showed significant differences in FL-BFP. SE-BFP showed a lower GPS curve and higher intensities of Ca and P in the upper half of dentin wall lesions than other groups. From SEM, microgaps between filler and matrix, break and loss of matrix, separation of adhesive matrix with hybrid layer occurred at interfacial gaps. SIGNIFICANCE: The morphological, mechanical and chemical characteristics of resin-dentin interfacial degradation depend on the component and chemistry of restorative materials.


Assuntos
Colagem Dentária , Dentina , Adesivos , Animais , Biofilmes , Bovinos , Resinas Compostas , Cimentos Dentários , Materiais Dentários , Adesivos Dentinários , Teste de Materiais , Microscopia Eletrônica de Varredura , Cimentos de Resina , Propriedades de Superfície
5.
Materials (Basel) ; 14(8)2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33918865

RESUMO

The purpose of this study was to evaluate the mechanism of action and the inhibiting effects of two types of desensitizers against dentin demineralization using pre-demineralized hypersensitivity tooth model in vitro. In this study, we confirmed that a hypersensitivity tooth model from our preliminary experiment could be prepared by immersing dentin discs in an acetic acid-based solution with pH 5.0 for three days. Dentin discs with three days of demineralization were prepared and applied by one of the desensitizers containing calcium fluoro-alumino-silicate glass (Nanoseal, NS) or fluoro-zinc-silicate glass (Caredyne Shield, CS), followed by an additional three days of demineralization. Dentin discs for three days of demineralization (de3) and six days of demineralization (de6) without the desensitizers were also prepared. The dentin discs after the experimental protocol were scanned using swept-source optical coherence tomography (SS-OCT) to image the cross-sectional (2D) view of the samples and evaluate the SS-OCT signal. The signal intensity profiles of SS-OCT from the region of interest of 300, 500, and 700 µm in depth were obtained to calculate the integrated signal intensity and signal attenuation coefficient. The morphological differences and remaining chemical elements of the dentin discs were also analyzed using scanning electron microscopy and energy-dispersive X-ray spectroscopy. SS-OCT images of CS and NS groups showed no obvious differences between the groups. However, SS-OCT signal profiles for both the CS and NS groups showed smaller attenuation coefficients and larger integrated signal intensities than those of the de6 group. Reactional deposits of the desensitizers even after the additional three days of demineralization were observed on the dentin surface in NS group, whereas remnants containing Zn were detected within the dentinal tubules in CS group. Consequently, both CS and NS groups showed inhibition effects against the additional three days of demineralization in this study. Our findings demonstrate that SS-OCT signal analysis can be used to monitor the dentin demineralization and inhibition effects of desensitizers against dentin demineralization in vitro.

6.
Dent Mater ; 37(5): 849-862, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33674077

RESUMO

OBJECTIVE: To evaluate preventive effects of S-PRG-filled resin-composites on surrounding tooth demineralization and interfacial bacterial penetration. METHODS: Cavities were prepared on enamel or dentin blocks and treated by BeautiBond Universal (Shofu) and filled by resin-composites containing S-PRG filler (Shofu) at 0 wt% (P0, control), 10 wt% (P10), 30 wt% (P30), 50 wt% (P50) or 70 wt% (P70). The specimens were demineralized by Streptococcus mutans biofilms for 12 days. Wall lesion depth (WL-depth) and outer lesion depth (OL-depth) were measured from fluorescence microscopy. Interfacial bacterial penetration area (BPA) was evaluated from confocal laser scanning microscopy. Wall lesion hardness (WL-hardness) and outer lesion hardness (OL-hardness) were measured with a Vickers microhardness tester. Elemental analysis of resins and surrounding lesions was conducted by scanning electron microscopy and energy dispersive X-ray spectrometry. RESULTS: Resin-composites in P70 contained significantly more F, Na and Al than that in P0 and P10. P70, P50 and P30 showed significantly lower WL-depth than P0. P70 showed significantly lower OL-depth, fewer Ca and P loss in lesions than P0. P70 showed significantly higher WL-hardness and OL-hardness in dentin specimens than P0. Enamel margins had a higher gap frequency than dentin margins. However, BPA did not show significant differences among the groups. SIGNIFICANCE: Resin-composites containing S-PRG fillers at ≥30 wt% can inhibit wall lesions and that at 70 wt% can further decrease outer lesions, reduce Ca and P loss in lesions and increase surrounding dentin hardness. However, S-PRG-filled resin-composites does not inhibit interfacial biofilm penetration after a short-term demineralization period.


Assuntos
Cárie Dentária , Desmineralização do Dente , Resinas Compostas , Esmalte Dentário , Cimentos de Ionômeros de Vidro , Humanos , Streptococcus mutans
7.
Antiviral Res ; 188: 105036, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33577807

RESUMO

Baloxavir marboxil has been used for influenza treatment since March 2018 in Japan. After baloxavir treatment, the most frequently detected substitution is Ile38Thr in polymerase acidic protein (PA/I38T), and this substitution reduces baloxavir susceptibility in influenza A viruses. To rapidly investigate the frequency of PA/I38T in influenza A (H1N1)pdm09 and A (H3N2) viruses in clinical samples, we established a rapid real-time system to detect single nucleotide polymorphisms in PA, using cycling probe real-time PCR. We designed two sets of probes that were labeled with either 6-carboxyfluorescein (FAM) or 6-carboxy-X-rhodamine (ROX) to identify PA/I38 (wild type strain) or PA/I38T, respectively. The established cycling probe real-time PCR system showed a dynamic linear range of 101 to 106 copies with high sensitivity in plasmid DNA controls. This real-time PCR system discriminated between PA/I38T and wild type viruses well. During the 2018/19 season, 377 influenza A-positive clinical samples were collected in Japan before antiviral treatment. Using our cycling probe real-time PCR system, we detected no (0/129, 0.0%) influenza A (H1N1)pdm09 viruses with PA/I38T substitutions and four A (H3N2) (4/229, 1.7%) with PA/I38T substitution prior to treatment. In addition, we found PA/I38T variant in siblings who did not received baloxavir treatment during an infection caused by A (H3N2) that afflicted the entire family. Although human-to-human transmission of PA/I38T variant may have occurred in a closed environment, the prevalence of this variant in influenza A viruses was still limited. Our cycling probe-PCR system is thus useful for antiviral surveillance of influenza A viruses possessing PA/I38T.


Assuntos
Antivirais/farmacologia , Dibenzotiepinas/farmacologia , Vírus da Influenza A/efeitos dos fármacos , Vírus da Influenza A/genética , Morfolinas/farmacologia , Piridonas/farmacologia , RNA Polimerase Dependente de RNA/genética , Reação em Cadeia da Polimerase em Tempo Real/métodos , Triazinas/farmacologia , Proteínas Virais/genética , Substituição de Aminoácidos , Animais , Linhagem Celular , Humanos , Vírus da Influenza A/enzimologia , Vírus da Influenza A/isolamento & purificação , Testes de Sensibilidade Microbiana , RNA Viral/biossíntese , Replicação Viral/efeitos dos fármacos
8.
J Dent ; 106: 103583, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33450311

RESUMO

OBJECTIVE: To evaluate early degradation at resin-dentin interface using non-invasive swept-source optical coherence tomography (SS-OCT) and confocal laser scanning microscope (CLSM). METHODS: Self-etch adhesives and resin-composites containing bisphenol-glycidyl-dimethacrylate (Bis-GMA), which is one of the most widely used monomers in restorative materials, were investigated in this study. Forty cervical cavities were prepared in bovine incisors and applied by the adhesive with/without Bis-GMA (AdhesiveBG/Adhesive), filled by the resin with/without Bis-GMA (ResinBG/Resin) and then challenged by cariogenic biofilm (37 °C, 24 h). Gap Formation and dentin demineralization around resin-composites were observed by SS-OCT and CLSM. RESULTS: Three types of resin-dentin interfacial degradation could be detected from SS-OCT. Type I-dentin demineralization around resin without gap, showing feather-shaped dark zones without bright scattered lines at resin-dentin interfaces. Type II-dentin demineralization around resin with adhesive-dentin bonded gaps, showing feather-shaped dark zones with bright scattered lines at resin-dentin interfaces. Type III-dentin demineralization around resin with adhesive-dentin debonded gaps, showing edge-shaped dark zones with bright scattered lines at resin-dentin interface. From CLSM, the groups were compared in gap scale (GS), gap depth (GD), gap width (GW) and dentin wall lesion depth (WLD). Bis-GMA-containing adhesive groups showed significantly lower GS than Bis-GMA-free adhesive groups. Bis-GMA-containing resin groups showed significantly lower WLD than Bis-GMA-free resin groups. However, they did not show significant differences in GD and GW. CONCLUSION: Three types of early degradation at resin-dentin interface can be noninvasively detected by SS-OCT. Bis-GMA-containing and Bis-GMA-free restorative materials show differences in gap scale and dentin wall lesion depth. CLINICAL SIGNIFICANCE: SS-OCT can nondestructively detect early resin-dentin interfacial degradation. Gap scale can be used as a parameter to evaluate the risk factor of gaps.


Assuntos
Colagem Dentária , Cimentos de Resina , Animais , Bovinos , Resinas Compostas , Dentina/diagnóstico por imagem , Adesivos Dentinários , Lasers , Teste de Materiais , Tomografia de Coerência Óptica
9.
Sensors (Basel) ; 20(21)2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33113981

RESUMO

The aim of this study was to assess the utility of 3D imaging of optical coherence tomography (OCT) for the diagnosis of occlusal tooth wear ex vivo. Sixty-three extracted human molars with or without visible tooth wear were collected to take digital intraoral radiography and 3D OCT images. The degree of tooth wear was evaluated by 12 examiners and scored using 4-rank scale: 1-slight enamel wear; 2-distinct enamel wear; 3-tooth wear with slight dentin exposure; 4-tooth wear with distinct involvement of dentin. The degree of tooth wear was validated by the histological view of confocal laser scanning microscopy (CLSM). The sensitivity, specificity, and area under the curve (AUC) of receiver operating characteristic analysis were calculated. Diagnostic accuracy was compared with the agreement with CLSM observation using weighted kappa. The results were statistically analyzed at a significance level of α = 0.05. Three-dimensional OCT showed significantly higher sensitivity (p < 0.05) for all the diagnostic thresholds of enamel wear and dentin exposure than digital radiography (0.82, 0.85, and 0.79 vs. 0.56, 0.52, and 0.57, respectively). Three-dimensional OCT showed higher AUC and kappa coefficients than digital radiography (p < 0.05), where mean AUC and Kappa values were 0.95 and 0.76 for OCT and 0.92 and 0.47 for radiography, respectively. No significant difference of specificity was observed (p > 0.05). Three-dimensional OCT could visualize and estimate the degree of tooth wear and detect the dentin exposure at the tooth wear surface accurately and reproducibly. Consequently, a new guideline for tooth wear assessment can be proposed using OCT.


Assuntos
Tomografia de Coerência Óptica , Desgaste dos Dentes , Humanos , Imageamento Tridimensional , Curva ROC , Sensibilidade e Especificidade , Desgaste dos Dentes/diagnóstico por imagem
10.
Jpn Dent Sci Rev ; 56(1): 109-118, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33033549

RESUMO

Optical coherence tomography (OCT) is an imaging technique that can visualize the internal biological structure without X-ray exposure. Swept-source OCT (SS-OCT) is one of the latest version of OCT, wherein the light source is a tunable laser that sweeps near-infrared wavelength light to achieve real-time imaging. The imaging depth of OCT is highly influenced by the translucency of the medium. The medium that does not transmit light and the deeper structure beyond the range of light penetration depth are not relevant for OCT imaging. In OCT, sound enamel is almost transparent at the OCT wavelength range, and enamel and dentin can be distinguished from each other as the dentin-enamel junction (DEJ) appears as a dark border. Demineralized enamel and dentin are imaged as bright zones because of the formation of numerous micro-porosities where the backscatter of OCT signal is increased. In cavitated caries at interproximal or occlusal hidden zone, the upper margin of the cavity reflects the signal showing a distinct bright border in the SS-OCT image. SS-OCT is capable of determining crack penetration depth even when the cracks extended beyond the DEJ. SS-OCT has a high degree of sensitivity and specificity for the detection of dental caries and tooth cracks. SS-OCT is also capable of detecting non-carious cervical lesions and occlusal tooth wear in cross-sectional views to estimate the amount of tooth structure loss.

11.
Sci Rep ; 10(1): 15754, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32978464

RESUMO

Optical coherence tomography (OCT) can create cross-sectional images of tooth without X-ray exposure. This study aimed to investigate the diagnostic accuracy of 3D imaging of OCT for proximal caries in posterior teeth. Thirty-six human molar teeth with 51 proximal surfaces visibly 6 intact, 16 slightly demineralized, and 29 distinct carious changes were mounted to take digital radiographs and 3D OCT images. The sensitivity, specificity and area under the receiver operating characteristic curve (AUC) for the diagnosis of enamel caries and dentin caries were calculated to quantify the diagnostic ability of 3D OCT in comparison with digital radiography. Diagnostic accuracy was evaluated by the agreement with histology using weighted Kappa. OCT showed significantly higher sensitivity, AUC and Kappa values than radiography. OCT can be a safer option for the diagnosis of proximal caries in posterior teeth that can be applied to the patients without X-ray exposure.


Assuntos
Cárie Dentária/diagnóstico por imagem , Imageamento Tridimensional , Dente Molar/diagnóstico por imagem , Tomografia de Coerência Óptica , Humanos , Sensibilidade e Especificidade
12.
Antiviral Res ; 183: 104951, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32987032

RESUMO

We conducted a prospective, multicenter, non-randomized observational study to assess the duration of fever and symptoms of influenza A/H1N1pdm09 and A/H3N2 infected children < 19 years old treated with either baloxavir or oseltamivir. Additionally, these symptoms were investigated in association with pre- and post-baloxavir treatment-emergent polymerase acidic unit (PA) variants as compared to non-substituted viruses. Following receipt of informed consent, baloxavir was administered to 102 influenza A patients, and oseltamivir to 52 patients during the 2018-2019 influenza season in Japan. The average age was higher in the baloxavir treatment group compared to the oseltamivir treatment group (10.6 ± 2.7 versus 6.9 ± 2.9 years old, p < 0.01). The duration of fever and symptoms in baloxavir-treated A/H1N1pdm09 and A/H3N2-infected children did not differ from those in oseltamivir-treated groups (median 22.0, 11.8, 23.0, and 21.0 h, and median 114.5, 121.0, 123.0, and 122.0 h, respectively). One (1.2%) of 83 A/H3N2 patients possessed a PA/I38T substituted virus prior to treatment. The frequency of PA variants in post-treatment samples obtained 2-11 days after beginning of baloxavir was 12.5% (4/32) for A/H1N1pdm09 and 14.1% (9/64) for A/H3N2 when the total number of cases was used as the denominator, however, were 57.1% (4/7) and 33.3% (9/27) when PCR-positive cases at the time of second sampling was used as the denominator. The most frequent PA substitution was I38T (9), with E23K (1), I38K (1), I38M (1), and PA/I38S (1) also observed. The duration of fever and overall symptoms did not differ significantly following baloxavir treatment in individuals with PA variant viruses, non-substituted virus, or in those that were PCR negative at the second sampling (median 20, 24 and 11 h, and median 121, 115 and 121 h, respectively). Rebound of viral RNA load was observed in 13.5% (2/13) of PA variants but it was not associated with recurrence of fever and symptoms. Hence, prolonged fever or symptoms were not observed in children treated with baloxavir following emergence of PA variants, however, further studies are needed to evaluate the clinical impact of PA variants.


Assuntos
Antivirais/uso terapêutico , Dibenzotiepinas/uso terapêutico , Febre/virologia , Vírus da Influenza A/efeitos dos fármacos , Vírus da Influenza A/genética , Influenza Humana/tratamento farmacológico , Morfolinas/uso terapêutico , Oseltamivir/uso terapêutico , Piridonas/uso terapêutico , RNA Polimerase Dependente de RNA/genética , Triazinas/uso terapêutico , Proteínas Virais/genética , Adolescente , Substituição de Aminoácidos , Criança , Pré-Escolar , Feminino , Variação Genética , Humanos , Vírus da Influenza A/classificação , Vírus da Influenza A/enzimologia , Influenza Humana/virologia , Masculino , Estudos Prospectivos , Estações do Ano
13.
Dent Mater ; 36(9): 1170-1182, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32536587

RESUMO

OBJECTIVES: The first objective of this study was to determine if the luting material used for resin nanoceramic inlay affects interfacial adaptation. The second was to investigate whether pretreatment and the adhesive curing method before cementation affects interfacial adaptation. The final objective was to compare activation modes of luting material. METHODS: Class I cavities were prepared on extracted human third molars. Resin nanoceramic inlays were fabricated using Lava Ultimate CAD/CAM block (3 M). For the control groups, inlays were cemented using Panavia V5 (Kuraray Noritake). For the experimental groups, teeth were randomly divided into five experimental groups with four subgroups using different self-adhesive cements (SACs). Cement in Group I was dual-cured without pretreatment. In Group II, the cement was dual-cured after polyacrylic acid treatment of the tooth cavity. In Groups III and IV, the cement was dual-cured after universal dentin adhesive treatment with pre-cure and co-cure methods. In Group V, the inlay was cemented in self-cure mode. After thermocycling, interfacial adaptation at the inlay-tooth interface was measured using swept-source optical coherence tomography (SS-OCT) imaging. Finally, polymerization shrinkage strain of the luting material was measured and compared. RESULTS: Interfacial adaptation differed depending on the luting material. After application of a universal adhesive, some subgroups showed improved interfacial adaptation. Interfacial adaptation and polymerization shrinkage strain differed significantly depending on activation mode. SIGNIFICANCE: Interfacial adaptation for a resin nanoceramic inlay can differ according to the type of SAC and activation mode. For some SACs, application of a universal adhesive before cementation improves interfacial adaptation.


Assuntos
Colagem Dentária , Restaurações Intracoronárias , Resinas Compostas , Cimentos Dentários , Dentina , Humanos , Teste de Materiais , Cimentos de Resina
14.
Sensors (Basel) ; 20(6)2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32192069

RESUMO

Detecting the extent of occlusal caries is a clinically important but challenging task required for treatment decision making. The aim of this study was to assess the diagnostic power of 3D swept-source optical coherence tomography (OCT) for evaluation of occlusal caries in comparison with X-ray radiography. Extracted human molars not exhibiting American Dental Association (ADA) criteria advanced caries were mounted in a silicone block and digital dental radiographs were captured from the buccal side. Subsequently, occlusal surfaces were scanned with a prototype Yoshida Dental OCT. Thirteen examiners evaluated the presence and extent of caries on radiographs and dynamically sliced 3D OCT video images, using a 4 level scale-0: intact; 1: enamel demineralization without cavitation; 2: enamel caries with cavitation; 3: dentin caries with or without cavitation. Sensitivity, specificity and area under operating characteristic curves (Az) were statistically analyzed (α = 0.05). Reliability analysis showed an excellent agreement among the 13 examiners for both methods. The OCT presented a significantly higher sensitivity and Az value for the detection of caries compared to radiographs (p < 0.05). Radiography showed especially low sensitivity for dentin caries (0-2 versus 3). Dynamic slicing of 3D OCT volumes is a powerful adjunct tool to visual inspection to diagnose the dentin occlusal caries in vitro.


Assuntos
Cárie Dentária/diagnóstico , Diagnóstico Bucal/métodos , Imageamento Tridimensional/métodos , Tomografia de Coerência Óptica/métodos , Cárie Dentária/patologia , Esmalte Dentário/diagnóstico por imagem , Esmalte Dentário/patologia , Dentina/diagnóstico por imagem , Dentina/patologia , Diagnóstico Bucal/instrumentação , Humanos , Imageamento Tridimensional/instrumentação , Curva ROC , Radiografia Dentária/instrumentação , Radiografia Dentária/métodos , Distribuição Aleatória , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Tomografia de Coerência Óptica/instrumentação
15.
Hepatol Res ; 50(3): 303-312, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31750974

RESUMO

AIM: In patients with hepatitis C virus, treatment failure of daclatasvir plus asunaprevir combination therapy (DCV + ASV) seems to become intractable due to the induction of resistance-associated substitutions. This study aimed to investigate the outcomes of retreatment with direct-acting antivirals (DAAs) in patients with DCV + ASV therapy failure, as well as changes in drug resistance mutations. METHODS: We retrospectively analyzed 44 patients re-treated with DAAs after DCV + ASV failure between December 2015 and April 2018. All patients were analyzed for amino acid substitutions, and additional treatment regimens were selected based on the results and current treatment guidelines. RESULTS: The sustained virological response rate with second-line treatment was 81.8% (36/44), and relapse occurred in five of 16 patients who received sofosbuvir/ledipasvir and three of seven patients who received DCV/ASV/beclabuvir. Third- and fourth-line treatments were also tried in relapsed cases, and the overall sustained virological response rates were 90.9% (40/44) and 93.2% (41/44), respectively. A high rate of viral clearance was eventually observed. Before second-line treatment, the prevalence of mutations in the NS5A and NS3/4A regions was 100% (44/44) and 86.4% (38/44), respectively. There was no significant increase in the number of amino acid substitutions in patients for whom second-line treatment failed. CONCLUSIONS: Amino acid substitutions were frequently observed in patients with DCV + ASV failure, but most patients achieved a sustained virological response after retreatment with DAAs. Although the spread of drug-resistant viruses due to unsuccessful DAA treatment was a matter of concern, most cases of DCV + ASV failure were overcome with additional treatment.

16.
Hepatol Res ; 50(3): 382-395, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31760660

RESUMO

AIM: The aim of this study was to investigate the predictive factors of objective response rate (ORR) and progression-free survival (PFS), and the correlation of albumin-bilirubin (ALBI) grade with decreased appetite and fatigue in hepatocellular carcinoma patients treated with lenvatinib. METHODS: From March 2018 to December 2018, a total of 94 patients was included in this retrospective multicenter study. RESULTS: The median age of all patients was 73 years (interquartile range 66-79.3 years), and approximately 78% patients were men. The ALBI grade was 1, 2, and 3 in 27 (28.7%), 64 (68.1%), and three patients (3.2%), respectively. The Barcelona Clinic Liver Cancer stage was early, intermediate, and advanced in one (1.1%), 22 (23.4%), and 71 patients (75.5%), respectively. Best radiological response was determined to complete response, partial response, stable disease, and progressive disease in 0 (0.0%), 24 (30.4%), 38 (48.1%), and 17 patients (21.5%), respectively, giving the ORR of 30.4%. The 3-, 6-, and 12-month PFS was calculated to be 78.7% (95% CI 70.3-87.1%), 46.7% (95% CI 36.1-57.3%), and 17.4% (95% CI 6.6-28.2%). Multivariate analysis showed that the Barcelona Clinic Liver Cancer intermediate stage was shown to be the only significant factor affecting the ORR (odds ratio 3.78, 95% CI 1.14-12.5, P = 0.030) and PFS (hazard ratio 0.49, 95% CI 0.26-0.94, P = 0.030). The incidence of all grades of decreased appetite and fatigue was significantly less in patients with ALBI grade 1 compared with ALBI grade 2 + 3. CONCLUSIONS: The Barcelona Clinic Liver Cancer intermediate stage was the predictive factor affecting the ORR and PFS, and ALBI grade was a good predictive factor affecting the incidence of fatigue and decreased appetite.

17.
Dent Mater J ; 38(5): 798-805, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31341147

RESUMO

The objective of this study was to determine the effect of flowable composite lining and dentin location on internal dentin fracture formation in the microtensile bond strength (MTBS) test using swept-source optical coherence tomography (SS-OCT). MTBS test beams (1.0×1.0 mm) were prepared from human superficial and deep dentin, which was bonded with a self-etch adhesive (Clearfil SE Bond) and hybrid composite resin (Clearfil AP-X), with or without flowable lining (Clearfil Majesty ES-Flow). We tested 4 groups according to placement technique (with vs. without flowable liner) and dentin (superficial vs. deep) locations. Cross-sectional 2D images of the bonded interface were obtained before and after the MTBS test. Internal dentin fracture after MTBT was observed as a bright zone in SS-OCT. Flowable lining significantly reduced internal fracture formation in dentin (p<0.05). Dentin location significantly influenced MTBS (p<0.05), and this was reduced by flowable lining usage.


Assuntos
Colagem Dentária , Adesivos Dentinários , Resinas Compostas , Estudos Transversais , Análise do Estresse Dentário , Dentina , Humanos , Teste de Materiais , Cimentos de Resina , Propriedades de Superfície , Resistência à Tração
18.
Dent Mater J ; 38(5): 779-789, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31341148

RESUMO

Evaluation of gap formation at the interfaces of a two-step self-etching adhesive with/without pre-etching was performed using sweptsource optical coherence tomography (SS-OCT). Round cavities were prepared in bovine incisors at the middle (MC) and cervical (CC) thirds of the crown and the cervical third of the root (CR). Clearfil SE bond was directly applied to one group (SE) and another (PA) was pretreated with K-etchant gel. Following restoration by flowable composite resin, the teeth were thermally challenged and stored for 2 months. Interfacial gaps observed in the cross-sectional OCT images were analyzed and the bottom cavities exhibited increased gaps compared to the margin and dentin-enamel junction (DEJ). The CR site had a larger gap than at MC and CC in the SE group. DEJ separation at the MC was significantly smaller than that at CC in both groups. Therefore, gap formation depends on the cavity region, location, and bonding protocol.


Assuntos
Colagem Dentária , Adesivos Dentinários , Animais , Bovinos , Resinas Compostas , Estudos Transversais , Coroas , Preparo da Cavidade Dentária , Esmalte Dentário , Restauração Dentária Permanente , Dentina , Cimentos de Resina , Tomografia de Coerência Óptica
19.
Dent Mater J ; 38(4): 621-629, 2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31178547

RESUMO

The aim of this study was to investigate volumetric polymerization shrinkage (VS), using swept-source optical coherence tomography (SS-OCT), of bulk-fill composites with different light-curing strategies; immediately after light-irradiation and after 24 h, and to evaluate their regional ultimate tensile strength (UTS) at different curing depths. The immediate VS after photo-polymerization decreased when the curing light-curing time was reduced from 20 to 10 to 5 s. On the other hand, their VS values after 24 h significantly increased due to the post-cure polymerization, resulting in similar VS values at all the light-curing times. Five seconds light-curing decreased the regional UTS of resin composites after the 24 h period compared with the 10 and 20 s light-curing regimes; therefore, the remarkable progress of post-cure polymerization after light-curing for a short time would not lead to an improvement in the mechanical properties of resin composites. The influence of the light-curing time on the curing depth was dependent upon the bulk-fill composite material.


Assuntos
Resinas Compostas , Luzes de Cura Dentária , Teste de Materiais , Polimerização , Resistência à Tração
20.
Dent Mater ; 35(4): 585-596, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30819550

RESUMO

OBJECTIVES: This study visualized in real-time the gap forming of bulk-fill resin composites during polymerization using optical coherence tomography (OCT). METHODS: Light-cured bulk-fill resin composites; Tetric N-ceram Bulk Fill (TNB), SonicFill (SNF), Surefil SDR (SDR), dual-cured bulk-fill resin composite Bulk EZ (BEZ), and light-cured core resin composite Clearfil Photo Core (CPC) were investigated. Swept-source OCT real-time cross-sectional monitoring was obtained during resin composite placement and curing procedure. Gap formation was observed in bonded cylindrical resin composite molds (4-mm depth, 3-mm diameter) and free shrinkage volume was observed at the top and bottom of a tube with similar dimensions (n=10). OCT 3D data were analyzed to calculate sealing floor area percentage (SFA%) and volumetric shrinkage in bonded tube (VS%). Data were analyzed by ANOVA at significance level of 0.05. The bottom-top degree of conversion ratio (DC%-R) through 4-mm depth was measured using the XploRA Plus micro-Raman spectroscopy. RESULTS: BEZ showed no gap formation at the cavity floor in any specimens while SNF showed the highest gap formation; the statistical order in terms of SFA% was BEZ (100±0)>TNB (84.97±2.98)>CPC (52.13±8.23)=SDR (45.97±9.21)>SNF (16.23±6.00) (p<0.05). On the other hand, total VS% was statistically ordered as BEZ (3.40±0.14)>SDR (3.22±0.09)>TNB (1.82±0.11)>SNF (1.65±0.04)=CPC (1.56±0.04) (p<0.05). Unlike BEZ, the light-cured resin composites showed larger shrinkage at specimen bottom than top. TNB showed the lowest DC%-R followed by SNF (p<0.05). SIGNIFICANCE: Light-cured bulk-fill resin composites showed various degrees of gap formation and shrinkage at 4-mm deep cavity. The dual-cured bulk-filled resin composite showed no decrease of degree of conversion through the depth and the highest cavity adaptation despite its tendency for higher volumetric shrinkage.


Assuntos
Resinas Compostas , Cárie Dentária , Estudos Transversais , Humanos , Teste de Materiais , Polimerização
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