Examination of ceramic restoration adhesive coverage in cusp-replacement premolar using acoustic emission under fatigue testing.

BACKGROUND: This study investigates CAD/CAM ceramic cusp-replacing restoration resistance with and without buccal cusp replacement under static and dynamic cyclic loads, monitored using the acoustic emission (AE) technique. METHOD: The cavity was designed in a typical MODP (mesial-occlusal-distal-palatal) restoration failure shape when the palatal cusp has been lost. Two ceramic restorations [without coverage (WOC) and with (WC) buccal cuspal coverage with 2.0 mm reduction in cuspal height] were prepared to perform the fracture and fatigue tests with normal (200 N) and high (600 N) occlusal forces. The load versus AE signals in the fracture and fatigue tests were recorded to evaluate the restored tooth failure resistance. RESULTS: The results showed that non-significant differences in load value in the fracture test and the accumulated number of AE signals under normal occlusal force (200 N) in the fatigue test were found between with and without buccal cuspal coverage restorations. The first AE activity occurring for the WOC restoration was lower than that for the WC restoration in the fracture test. The number of AE signals increased with the cyclic load number. The accumulated number of AE signals for the WOC restoration was 187, higher than that (85) for the WC restoration under 600 N in the fatigue test. CONCLUSION: The AE technique and fatigue tests employed in this study were used as an assessment tool to evaluate the resistances in large CAD/CAM ceramic restorations. Non-significant differences in the tested fracture loads and accumulated number of AE signals under normal occlusal force (200 N) between different restorations indicated that aggressive treatment (with coverage preparation) in palatal cusp-replacing ceramic premolars require more attention for preserving and protecting the remaining tooth.

Genetic Characterization Conferred Co-Resistance to Isoniazid and Ethionamide in Mycobacterium tuberculosis Isolates from Southern Xinjiang, China.

Background: Ethionamide (ETH), a structural analogue of isoniazid (INH), is used for treating multidrug-resistant tuberculosis (MDR-TB). Due to the common target InhA, INH and ETH showed cross-resistance in M. tuberculosis. This study aimed to explore the INH and ETH resistant profiles and genetic mutations conferring independent INH- or ETH-resistance and INH-ETH cross-resistance in M. tuberculosis circulating in south of Xinjiang, China. Methods: From Sep 2017 to Dec 2018, 312 isolates were included using drug susceptibility testing (DST), spoligotyping, and whole genome sequencing (WGS) to analyze the resistance characteristics for INH and/or ETH. Results: Among the 312 isolates, 185 (58.3%) and 127 (40.7%) belonged to the Beijing family and non-Beijing family, respectively; 90 (28.9%) were INH-resistant (INHR) with mutation rates of 74.4% in katG, 13.3% in inhA and its promoter, 11.1% in ahpC and its upstream region, 2.2% in ndh, 0.0% in mshA, whilst 34 (10.9%) were ETH-resistant (ETHR) with mutation rates of 38.2% in ethA, 26.2% in inhA and its promoter, and 5.9% in ndh, 0.0% in ethR or mshA; and 25 (8.0%) were INH-ETH co-resistant (INHRETHR) with mutation rates of 40.0% in inhA and its promoter, and 8% in ndh. katG mutants tended to display high-level resistant to INH; and more inhA and its promoter mutants showed low-level of INH and ETH resistance. The optimal gene combinations by WGS for the prediction of INHR, ETHR, and INHRETHR were, respectively, katG+inhA and its promoter (sensitivity: 81.11%, specificity: 90.54%), ethA+inhA and its promoter+ndh (sensitivity: 61.76%, specificity: 76.62%), and inhA and its promoter+ndh (sensitivity: 48.00%, specificity: 97.65%). Conclusion: This study revealed the high diversity of genetic mutations conferring INH and/or ETH resistance among M. tuberculosis isolates, which would facilitate the study on INHR and/or ETHR mechanisms and provide clues for choosing ETH for MDR treatment and molecular DST methods in south of Xinjiang, China.

Examination of ceramic/enamel interfacial debonding using acoustic emission and optical coherence tomography.

OBJECTIVE: This study investigates monitored micro-crack growth and damage in the ceramic/enamel adhesive interface using the acoustic emission (AE) technique with optical coherence tomography (OCT) under fatigue shear testing. METHODS: Shear bond strength (SBS) was measured first with eight prepared ceramic/enamel adhesive specimens under static loads. The fatigue shear testing was performed with three specimens at each cyclic load according to a modified ISO14801 method, applying at 80%, 75%, 70%, and 65% of the SBS to monitor interface debonding. The number of cycles at each load was recorded until ceramic/enamel adhesive interface debonding occurred. The AE technique was used to detect micro-crack signals in static and fatigue shear bond tests. RESULTS: The results showed that the average SBS value in the static tests was 18.07 ± 1.72 MPa (mean ± standard deviation), expressed in Newton's at 56.77 ± 5.40N. The average number of fatigue cycles in which ceramic/enamel interface damage was detected in 80%, 75%, 70% and 65% of the SBS were 41, 410, 8141 and 76,541, respectively. The acoustic behavior varied according to the applied load level. Events were emitted during 65% and 70% fatigue tests. A good correlation was observed between the crack location in OCT images and the number of AE signal hits. SIGNIFICANCE: The AE technique combined with OCT images as a pre-clinical assessment tool to determine the integrity of cemented load bearing restored ceramic material. Sustainable cyclic load stresses in ceramic/enamel bonded specimens were substantially lower than the measured SBS. Predicted S-N curve showed that the maximum endured load was 10.98 MPa (about 34.48 N) passing 10(6) fatigue cyclic.

Examination of ceramic restorative material interfacial debonding using acoustic emission and optical coherence tomography.

OBJECTIVE: CAD/CAM ceramic restorative material is routinely bonded to tooth substrates using adhesive cement. This study investigates micro-crack growth and damage in the ceramic/dentin adhesive interface under fatigue shear testing monitored using the acoustic emission (AE) technique with optical coherence tomography (OCT). METHODS: Ceramic/dentin adhesive samples were prepared to measure the shear bond strength (SBS) under static load. Fatigue shear testing was performed using a modified ISO14801 method. Loads in the fatigue tests were applied at 80%, 70%, and 60% of the SBS to monitor interface debonding. The AE technique was used to detect micro-crack signals in static and fatigue shear bond tests. RESULTS: The results showed that the average SBS value in the static tests was 10.61±2.23MPa (mean±standard deviation). The average number of fatigue cycles in which ceramic/dentin interface damage was detected in 80%, 70% and 60% of the SBS were 152, 1962 and 9646, respectively. The acoustic behavior varied according to the applied load level. Events were emitted during 60% and 70% fatigue tests. A good correlation was observed between crack location in OCT images and the number of AE signal hits. SIGNIFICANCE: The AE technique and OCT images employed in this study could potentially be used as a pre-clinical assessment tool to determine the integrity of cemented load bearing restored ceramic material. Sustainable cyclic load stresses in ceramic/dentin-bonded specimens were substantially lower than the measured SBS. Predicted S-N curve showed that the maximum endured load was 4.18MPa passing 10(6) fatigue cyclic.