Bond strength of etch-and-rinse and self-etch adhesive systems to enamel and dentin irradiated with a novel CO2 9.3 µm short-pulsed laser for dental restorative procedures.

The objective of this study was to evaluate the influence of CO2 9.3 µm short-pulsed laser irradiation on the shear bond strength of composite resin to enamel and dentin. Two hundred enamel and 210 dentin samples were irradiated with a 9.3 µm carbon dioxide laser (Solea, Convergent Dental, Inc., Natick, MA) with energies which either enhanced caries resistance or were effective for ablation. OptiBond Solo Plus [OptiBondTE] (Kerr Corporation, Orange, CA) and Peak Universal Bond light-cured adhesive [PeakTE] (Ultradent Products, South Jordan, UT) were used. In addition, Scotchbond Universal [ScotchbondSE] (3M ESPE, St. Paul, MN) and Peak SE self-etching primer with Peak Universal Bond light-cured adhesive [PeakSE] (Ultradent Products) were tested. Clearfil APX (Kuraray, New York, NY) was bonded to the samples. After 24 h, a single plane shear bond test was performed. Using the caries preventive setting on enamel resulted in increased shear bond strength for all bonding agents except for self-etch PeakSE. The highest overall bond strength was seen with PeakTE (41.29 ± 6.04 MPa). Etch-and-rinse systems achieved higher bond strength values to ablated enamel than the self-etch systems did. PeakTE showed the highest shear bond strength with 35.22 ± 4.40 MPa. OptiBondTE reached 93.8% of its control value. The self-etch system PeakSE presented significantly lower bond strength. The shear bond strength to dentin ranged between 19.15 ± 3.49 MPa for OptiBondTE and 43.94 ± 6.47 MPa for PeakSE. Etch-and-rinse systems had consistently higher bond strength to CO2 9.3 µm laser-ablated enamel. Using the maximum recommended energy for dentin ablation, the self-etch system PeakSE reached the highest bond strength (43.9 ± 6.5 MPa).

[Are all sedation scales equally useful for nursing assessment?]. / Son todas las escalas de sedación igual de útiles para la valoración de enfermería?

The usefulness of three clinical scales for monitoring sedation in intensive care units was compared. The Ramsay scale, Cook modification of the Glasgow scale, and combined Ramsay-Cook scale were evaluated. Thirty-five patients with continuous intravenous sedation were monitored using all three clinical scales. The scores were collected simultaneosly with a two-observer method carried out by the nurse in charge of the patient and a second observer (nurse or physician). The three scales were considered valid and reproductible, with "good" agreement for the Ramsay scale and "very good" agreement for the Cook modified coma scale and the combined Ramsay-Cook scale. In conclusion, since the Cook modified Glasgow scale was the most reproducible, it is preferred for use in research and daily practice. The Ramsay scale is more subjective, but may be useful for daily nursing activities.