Progress in Dental Adhesive Materials.

There have been significant advances in adhesive dentistry in recent decades, with efforts being made to improve the mechanical and bonding properties of resin-based dental adhesive materials. Various attempts have been made to achieve versatility, introducing functional monomers and silanes into the materials' composition to enable the chemical reaction with tooth structure and restorative materials and a multimode use. The novel adhesive materials also tend to be simpler in terms of clinical use, requiring reduced number of steps, making them less technique sensitive. However, these materials must also be reliable and have a long-lasting bond with different substrates. In order to fulfill these arduous tasks, different chemical constituents and different techniques are continuously being developed and introduced into dental adhesive materials. This critical review aims to discuss the concepts behind novel monomers, bioactive molecules, and alternative techniques recently implemented in adhesive dentistry. Incorporating monomers that are more resistant to hydrolytic degradation and functional monomers that enhance the micromechanical retention and improve chemical interactions between adhesive resin materials and various substrates improved the performance of adhesive materials. The current trend is to blend bioactive molecules into adhesive materials to enhance the mechanical properties and prevent endogenous enzymatic degradation of the dental substrate, thus ensuring the longevity of resin-dentin bonds. Moreover, alternative etching materials and techniques have been developed to address the drawbacks of phosphoric acid dentin etching. Altogether, we are witnessing a dynamic era in adhesive dentistry, with advancements aiming to bring us closer to simple and reliable bonding. However, simplification and novelty should not be achieved at the expense of material properties.

ADRIS: The new open-source accessible driving simulator for training and evaluation of driving abilities.

BACKGROUND AND OBJECTIVE: Independent living and transportation are crucial aspects for people living with a disability. After an injury, it is important to assess driving ability, in terms of physical and psychological conditions, and to test the effects of prescribed drugs. Within this framework, driving simulators are suitable tools for training driving skills; however, available tools are expensive or lack appropriate sets of behavioral measures to fully characterize the drivers' ability. METHODS: This work presents the first step toward the development of ADRIS, a new open-source, accessible, realistic virtual reality simulator for training and testing driving skills of people with sensory-motor disability. This includes a prototype based on an open-source simulator for autonomous driving research (CARLA), with the addition of customized features such as adaptable driving controllers, a virtual reality headset, and the possibility to collect behavioral and physiological data. Also, the new system allows to set different environmental conditions, to include and control the timing of potentially dangerous situations, and to set scenarios with various difficulty levels. RESULTS: Tests on 17 healthy participants demonstrated that the simulator is well tolerated in terms of discomfort, physical fatigue, and mental effort. Also, the system is easy to use and is capable of providing a realistic driving experience, allowing the extraction of reliable behavioral parameters. CONCLUSIONS: ADRIS combines a high-fidelity virtual world, with customizable features specifically designed for the training and testing of people living with a disability, thus making it usable in many contexts such as home training, rehabilitation, education, and research.

Quantitative data on cell loss and cellular atrophy of intralaminar nuclei following cortical and subcortical lesions.

Morphological changes in the intralaminar nuclei centralis medialis, paracentralis and centralis lateralis of the thalamus of adult cats after cortical excisions have been determined by means of a quantitative method. The number and size of the remaining neurons on the operated side have been compared with those of the normal side. The differences between the normal and the operated side have been compared to those found between the two sides in the control animals. The most important result is the demonstration that after cortical ablations the intralaminar nuclei show not only chromatolytic or atrophic changes of their cells but also a true cell loss. These reactions are qualitatively similar to those observed in the specific nuclei of the thalamus, the only difference being a quantitative one. As a consequence it can be suggested that some intralaminar nuclei project to certain areas of the cerebral cortex which also receive projections from one or other specific thalamic nucleus. A large essential connection of the intralaminar nuclei, in particular the nucleus centralis medialis, with subcortical structures is confirmed.

The therapeutic role of naltrexone in negative symptom schizophrenia.

1. Naltrexone (50 mg bid, p.o.) was administered in a double-blind fashion (with placebo control) to chronic schizophrenic patients who maintained their routine neuroleptic and anxiolytic therapy. 2. Both positive and negative symptom patients who received naltrexone improved with regard to symptoms involving deterioration and social withdrawal. No significant amelioration was recorded in subjects assuming placebo relative to the same psychopathological areas. 3. Favourable results were obtained mainly from patients affected by negative symptom schizophrenia. 4. Naltrexone may have acted by direct or indirect neurochemical mechanisms related to negative symptom schizophrenia.

Validation of automated oscillometric sphygmomanometer (HDBPM) for arterial pressure measurement during haemodialysis.

An HDBPM oscillometric sphygmomanometer used for the automatic measurement of arterial blood pressure is evaluated according to the ANSI/AAMI SP10-1992 standard. The accuracy of the HDBPM is ascertained by comparing it against the standard Riva-Rocci ascultatory method. Following the ascultatory method, two independent observers use the HDBPM devise to simultaneously measure the arterial blood pressure in 92 subjects of varying ages and having different blood pressures and arm sizes. High agreement is found when comparing the observers' pressure determinations (within 10 mmHg for 100% of observations). Correlation between the average of two ascultatory determinations and the HDBPM is high both for the systolic (r = 0.98) and diastolic (r = 0.94) pressures. The mean of the differences between the pressures measured by the observers and the HDBPM device are 0.2 mmHg (systolic) and -0.4 mmHg (diastolic). The percentages of readings within 10 mmHg between those taken by the observers and those taken by the HDBPM are 88% (systolic) and 97% (diastolic). These results largely satisfy current requirements.

[Long-term results of prolonged dicoumarol anticoagulant therapy in 327 peipheral arteriopathic subjects]. / Risultati a distanza della terapia anticoagulante dicumarolica protratta su 327 arteriopatici periferici.

327 patients with peripheral arteriopathy were treated solely with protracted dicoumarol anticoagulant therapy. The indication for such therapy was applied not only in patients in whom the high risk and poor run-off contraindicated revascularisation operations, but also in those in good general conditions at the 2nd or 3rd stage with iliac and femoral thromboses. Two-thirds of the arteriopathics observed were given the anticoagulant treatment for more than two years, with a maximum of eight years. Clinical evolution of the disease is discussed in relation to the treated patients' age and stage, while emphasis is given to the very low incidence of complications and contraindications, despite the long period of treatment.

[Alcohol and smoking. The risk factors for the oral cavity]. / Alcol e fumo. Fattori di rischio per il cavo orale.

A higher risk for the development of oral cancer was associated with heavy smoking and heavy drinking, but alcohol drinking and tobacco smoking are also correlated with other oral cavity disease. Tobacco is the most important factor of leukoplakia, but other diseases like ANUG, periodontitis, median rhomboid glossitis, chronic hyperplastic candidiasis and others are also correlated to cigarette smoking. It was observed that smokers have more plaque than non-smokers, even if no difference in the bacteria composition was found between smokers and non-smokers samples, and the vascular reaction associated with plaque induced gingivitis is suppressed in smokers. Periodontitis are generally considered to be a consequence of an unfavourable host-parasite interaction, but personal factors that diminish the efficiency of the host defence, like tobacco smoking and alcohol drinking, can play an important role in the development of periodontal diseases. Cigarette smoking may be considered a major risk factor for periodontitis and it can also increase its severity; therefore, alveolar bone loss increases with tobacco smoking. Recent investigations show that smokers respond less favourably than no smokers to the different modalities of periodontal therapy, as surgical and non surgical, or guided tissue regeneration. Moving from these observations the authors critically analyze the literature concerning these important risk factors which appear to be strongly correlated with periodontal diseases.

Comparative study of the in vitro activity of various antifungal drugs against Scedosporium spp. in aerobic and hyperbaric atmosphere versus normal atmosphere.

INTRODUCTION: Scedosporium spp. have been observed with increasing frequency over the last decade in immunocompromised patients and trauma patients. This mould is often multi-drug resistant and its mortality rate remains very high. AIM: The primary goal of this study was to obtain data concerning the in vitro susceptibility of 13 Scedosporium strains comparing the in vitro incubation in aerobic versus hyperbaric conditions. MATERIALS AND METHODS: Chemosensitivity of thirteen Scedosporium strains was evaluated after a 72h-incubation in a normoxic (21% O2) normobaric (1 ATA) atmosphere versus a hyperoxic (100% O2) hyperbaric (2-3 ATA), and after a re-incubation at room temperature for an additional 72h. RESULTS: All S. apiospermum and S. prolificans strains showed no growth after incubation in hyperbaric hyperoxic atmosphere. However, when plates were then maintained at room temperature in aerobic conditions, growth was systematically observed from 36 to 96h, and Minimal inhibitory concentration (MIC) values were the same obtained after incubation in aerobic conditions. CONCLUSIONS: These results suggest impressive in vitro fungistatic activity of the hyperoxic hyperbaric atmosphere, even if its effect is strictly time-dependent. This preliminary in vitro study has potential clinical relevance because it focuses on examining in vitro combination therapy using hyperoxic hyperbaric conditions plus a single antifungal agent, rather than using combinations of different antifungal drugs, to potentially increase the antifungal activity.

Kinetics of polymerization and contraction stress development in self-adhesive resin cements.

OBJECTIVES: The aim of the study was to evaluate the contraction stress, microhardness and polymerization kinetics of three self-adhesive cements vs. conventional dual-cure resin cement. METHODS: Cements tested were: RelyX Unicem (3M ESPE, St. Paul, MN, USA), MaxCem Elite (Kerr, Orange, CA, USA), Clearfil SA Cement (Kuraray, Tokyo, Japan) and Duolink (Bisco Inc., Schaumburg, IL, USA). Cements were irradiated with a LED-curing unit (bluephase, IvoclarVivadent) for 20 or 40 s and the contraction forces (N) generated during polymerization were continuously recorded for 6 h with a universal testing machine. Polymerization kinetics were monitored using micro-Raman spectroscopy and degree of conversion was calculated. Vickers microhardness was also recorded. All measurements were performed at 10 min and 6h. Data were statistically analyzed by three-way ANOVA with repeated measures and Tukey's post hoc test (α=0.05). RESULTS: Irrespective of exposure time, stress analysis ranked in the following order: Clearfil SA Cement

Influence of chlorhexidine on the degree of conversion and E-modulus of experimental adhesive blends.

OBJECTIVES: This study examined the effect of chlorhexidine (CHX) content on degree of conversion (DC) and E-modulus of experimental adhesive blends. The hypothesis tested was that increasing concentrations of CHX result in decreased DC and E-modulus in relation to adhesive hydrophilicity. METHODS: Experimental adhesive blends with increasing hydrophilicity R2 (70% bisGMA, 28.75% TEGDMA); R3 (70% BisGMA, 28.75% HEMA); R4 (40% BisGMA, 30% TCDM, 28.75% TEGDMA); R5 (40% BisGMA, 30% BisMP, 28.75% HEMA) and different CHX concentrations (1 and 5%) were analyzed. 5% CHX could not be dissolved in R2. A differential scanning calorimeter was used to measure the DC of resin blends. Photopolymerized disks of the experimental comonomer mixtures (n=10/gp) were used to measure the E-modulus of each specimen using a biaxial flexure test. Data were analyzed with two-way ANOVA (resin type and CHX concentration) and Tukey's post hoc test. RESULTS: The addition of 1% CHX did not significantly alter the DC of R2 and R3. Significant decrease in R3 DC values was observed when 5% CHX was added. CHX significantly increased the DC of R4 and R5. 1% CHX reduced the E-modulus of all resins (p<0.05) except for R2, in which the E-modulus was significantly increased (p<0.05). 5% CHX significantly reduced the E-modulus of resins R3 to R5 (p<0.05). SIGNIFICANCE: In conclusion, increasing concentrations of CHX dissolved in resin blends had little adverse effect on DC but decreased the E-modulus 27-48% compared to controls. Solvation of CHX in ethanol prior to incorporation of CHX into R2 may permit higher CHX concentrations without lower polymer stiffness.