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The Knee Jun 2024The average rate of patient dissatisfaction following total knee arthroplasty (TKA) is 10%. Multi-modal analgesia is the present standard of pain management after TKA....
BACKGROUND
The average rate of patient dissatisfaction following total knee arthroplasty (TKA) is 10%. Multi-modal analgesia is the present standard of pain management after TKA. Studies show that with multi-modal analgesia, approximately 60% of patients experience severe knee pain following surgery, while around 30% experience moderate pain. To date, there is no literature available on targeted pain management using bone cement.
OBJECTIVES
To investigate the feasibility of incorporating anti-inflammatory medications and identify the analgesic with the best release pharmacokinetics from bone cement for application in pain management.
METHODS
In an in-vitro study, 100 mg of five drugs (aceclofenac, diclofenac, naproxen, paracetamol and methyl prednisolone) were incorporated into bone cement (Palacos). Cement cubes holding each drug were made and allowed to harden for 30 min. Each drug-containing cube was placed in a beaker with saline for 72 h. Fractions of 10 ml were collected at 0, 6, 24, 48 and 72 h and analysed using high-pressure liquid chromatography to measure the percentage release of the drug from bone cement.
RESULTS
Naproxen showed superior elution from bone cement, with 10.9% at 24 h and 9.08% at 72 h. Paracetamol showed 4.9% at 24 h and 3.78% at 72 h, aceclofenac 0.2% at 24 h and 0.4% at 72 h, diclofenac 3.03% at 24 h and 1.99% at 72 h, and methylprednisolone 0.26% at 24 h and 0.32% at 72 h.
CONCLUSIONS
Polymethylmethacrylate bone cement can elute analgesics in vitro. Among the five drugs studied, naproxen had the best release kinematics from polymethylmethacrylate bone cement. Analgesic eluting bone cement is a novel approach for targeted postoperative pain management in TKA.
PubMed: 38943788
DOI: 10.1016/j.knee.2024.05.012 -
European Journal of Dentistry Jun 2024The proper closure of the access cavity between appointments during endodontic treatment is paramount and relies on temporary fillings. This systematic review evaluates...
The proper closure of the access cavity between appointments during endodontic treatment is paramount and relies on temporary fillings. This systematic review evaluates the effectiveness of zinc oxide-based materials and glass-ionomer cement (GIC) as temporary coronal sealers after root canal treatment in extracted human teeth. Three databases were searched to identify randomized clinical trials that examined the sealing properties of various temporary sealing materials using dyes or stains as indicators. A total of seven studies that fulfilled the eligibility criteria were critically analyzed. These indicated significant variations in the relative sealing ability of the coronal breach of endodontically treated teeth, either by zinc oxide or GIC-based materials. While GIC-based material (e.g., Fuji IX and Fuji II) exhibited superior sealing of single-rooted teeth, zinc oxide-based material (e.g., Cavit, Coltosol, Caviton) also showed promising attributes. Resin-modified GIC formulations displayed enhanced physical properties, yet challenges related to adhesive failure and shrinkage during polymerization were observed. Zinc oxide-based materials have demonstrated superior coronal sealing effectiveness over certain GIC in controlled settings. Their premixed nature ensures consistent application and hygroscopic properties improve cavity sealing. However, the focus on dye penetration tests for microleakage may not fully represent the risk of bacterial infiltration. Thus, studies are crucial for validating these findings in clinical contexts.
PubMed: 38942056
DOI: 10.1055/s-0044-1782695 -
The International Journal of Oral &... Jun 2024To evaluate multiple risk factors of peri-implant bone loss.
OBJECTIVE
To evaluate multiple risk factors of peri-implant bone loss.
MATERIALS AND METHODS
A case-control study was conducted on patients who had received dental implants treatment from January 2018 to December 2021. Implants with bone loss were included in the case group, and implants with no bone loss were included in the control group. Risk factors including history of periodontitis, abutment connection type, implant surface, diameter, location, three-dimensional position, opposing dentition, adjacent teeth, prosthetic type, retention type and custom abutment were evaluated. A multivariate logistic regression model was used to evaluate these risk factors, providing corresponding odds ratios (ORs) with 95% confidence intervals (CIs).
RESULTS
A total of 776 implants in 479 patients were included in the analysis. The number of implants in the case group and the control group were 84 and 692, respectively. Cement-retained prostheses (OR=2.439, 95%CI=1.241-4.795) and nonplatform switch design (OR=2.055, 95%CI=1.167-3.619) were identified as weak risk factors. Horizontal deviation (OR=4.177, 95%CI=2.265-7.703) was a moderate risk factor. Vertical deviation (OR=10.107, 95%CI=5.280-19.347) and implants located in the mandibular molar region (OR=10.427, 95%CI=1.176-92.461) were considered high risk factors.
CONCLUSION
Implants in the molar region, cement retained, non-platform switch design, and poor three-dimensional implant positioning are identified as significant risk factors for peri-implant bone loss.
PubMed: 38941164
DOI: 10.11607/jomi.10939 -
Journal of Conservative Dentistry and... May 2024This study aims to evaluate the microleakage between the gingival seat and base material and to assess the interface integrity between the base material and overlying...
Deep margin elevation in class II cavities: A comparative evaluation of microleakage and interface integrity using confocal laser microscopy and scanning electron microscopy.
AIM
This study aims to evaluate the microleakage between the gingival seat and base material and to assess the interface integrity between the base material and overlying composite in class II cavities restored using deep margin elevation.
MATERIALS AND METHODS
Thirty maxillary molars ( = 30) were taken, and class II cavities were prepared with a gingival seat extending below the cementoenamel junction. These teeth were divided into three groups for subgingival margin elevation using different materials: Group A ( = 10) - flowable composite, Group B ( = 10) - glass ionomer cement (GIC), and Group C ( = 10) - GIC with nanohydroxyapatite (GIC n-HAp). The remaining cavities were restored with bulk-fill composite. After undergoing 1000 thermocycling cycles, half of the samples were examined for microleakage using confocal laser microscopy, and the other half were assessed for interface integrity using scanning electron microscopy. Microleakage was statistically analyzed by one-way ANOVA, and interface integrity was analyzed by Kruskal-Wallis tests.
RESULTS
The study found that GIC n-HAp exhibited significantly lower microleakage between the base material and gingival seat than flowable composite and GIC. However, regarding interface integrity between the base material and bulk-fill composite, flowable composite, and GIC outperformed GIC n-HAp.
CONCLUSIONS
Incorporating n-HAp into GIC effectively reduced microleakage at the dentin-base material interface. However, the interface integrity between GIC n-HAp and the composite poses a challenge.
PubMed: 38939536
DOI: 10.4103/JCDE.JCDE_155_24 -
Journal of Conservative Dentistry and... May 2024To evaluate the efficacy of incorporated novel additives in Glass Ionomer Cement to ameliorate biocompatibility and mechanical properties.
AIM
To evaluate the efficacy of incorporated novel additives in Glass Ionomer Cement to ameliorate biocompatibility and mechanical properties.
INTRODUCTION
Though Glass Ionomer Cement (GIC) has multiple advantages, it is not strong enough for medical applications, and its biocompatibility is questionable. To improve biocompatibility and its mechanical properties, a study was performed to investigate the potential benefits of adding graphene, carbon nanotubes, hydroxyapatite, and bioactive glass to GIC. The objective was to enhance both the mechanical properties and biocompatibility of GIC.
MATERIAL AND METHOD
Modified Glass Ionomer Cement was prepared by creating five groups. Hydroxyapatite, multi-walled carbon nanotubes, graphene, and bioactive glass were incorporated in a 10:1 weight ratio, respectively. Group 5 was designated as the control group and used Fuji Type II GIC. After preparing 90 samples, they were kept in deionized water for a day and then evaluated their compressive strength, microhardness, and diametral tensile strength, and also checked their in vitro cytotoxicity by direct contact with L929 mammalian fibroblast cells.
STATISTICAL ANALYSIS
The data were examined using mean and standard deviation descriptive statistics. The comparative evaluation was done via Tukey HSD test and one-way ANOVA using S.P.S.S. software.
RESULT
It showed that Group 3 had better results in compressive strength (144.478+- 3.989), diametral tensile strength (20.29+- 0.8601), and microhardness (131+-3.536) when compared with other groups while in the biocompatibility (viability %) Group 1 [82.55], Group 3 [76.49], Group 4 [87.63], while Group 2[58.02].
CONCLUSION
Group 3 has better physical properties in microhardness, diametral tensile strength, and compressive strength, than the other groups. In Biocompatibility, Group 1, Group 3, Group 4, and Group 5 were noncytotoxic at the same time multi-walled carbon nanotubes group (Group 2) had cytotoxic potential.
PubMed: 38939535
DOI: 10.4103/JCDE.JCDE_81_24 -
BMC Oral Health Jun 2024The desirable properties of silver diamine fluoride (SDF) make it an effective agent for managing dental caries and tooth hypersensitivity. There are several clinical...
BACKGROUND
The desirable properties of silver diamine fluoride (SDF) make it an effective agent for managing dental caries and tooth hypersensitivity. There are several clinical instances that SDF application might precede the placement of direct tooth-colored restorations. On the other hand, SDF stains demineralized/carious dental tissues black, which might affect the esthetic outcomes of such restorations. Color is a key parameter of esthetics in dentistry. Therefore, this study aims to systematically review dental literature on color/color change of tooth-colored restorations placed following the application of SDF on dentine.
METHODS
Comprehensive search of PubMed, Embase, Scopus and ISI Web of Science databases (until August 2023) as well as reference lists of retrieved studies was performed. In vitro studies reported color or color change of tooth-colored restorative materials applied on SDF-treated dentine were included. Methodological quality assessment was performed using RoBDEMAT tool. Pooled weighted mean difference (WMD) and 95% confidence interval (95% CI) was calculated.
RESULTS
Eleven studies/reports with a total of 394 tooth-colored restorations placed following a) no SDF (control) or b) SDF with/without potassium iodide (KI)/glutathione dentine pre-treatments were included. Color change was quantified using ∆E formulas in most reports. The pooled findings for the comparison of resin-based composite (RBC) restorations with and without prior 38% SDF + KI application revealed no statistically significant differences in ∆E values at short- and long-term evaluations (~ 14 days: WMD: -0.56, 95% CI: -2.09 to 0.96; I: 89.6%, and ~ 60 days: WMD: 0.11; 95% CI: -1.51 to 1.72; I: 76.9%). No studies provided sufficient information for all the items in the risk of bias tool (moderate to low quality).
CONCLUSIONS
The limited evidence suggested comparable color changes of RBC restorations with and without 38% SDF + KI pre-treatment up to 60 days. The included studies lacked uniformity in methodology and reported outcomes. Further studies are imperative to draw more definite conclusions.
PROTOCOL REGISTRATION
The protocol of this systematic review was registered in PROSPERO database under number CRD42023485083.
Topics: Silver Compounds; Humans; Quaternary Ammonium Compounds; Fluorides, Topical; Dentin; Color; Dental Restoration, Permanent
PubMed: 38937760
DOI: 10.1186/s12903-024-04487-0 -
BMC Oral Health Jun 2024In dentistry, glass-ionomer cements (GICs) are extensively used for a range of applications. The unique properties of GIC include fluoride ion release and recharge,...
BACKGROUND
In dentistry, glass-ionomer cements (GICs) are extensively used for a range of applications. The unique properties of GIC include fluoride ion release and recharge, chemical bonding to the tooth's hard tissues, biocompatibility, a thermal expansion coefficient like that of enamel and dentin, and acceptable aesthetics. Their high solubility and poor mechanical qualities are among their limitations. E-glass fibers are generally utilized to reinforce the polymer matrix and are identified by their higher silica content.
OBJECTIVES
The purpose of the study was to assess the impact of adding (10 wt% and 20 wt%) silane-treated E-glass fibers to traditional GIC on its mechanical properties (compressive strength, flexural strength, and surface hardness) and solubility.
METHODS
The characterization of the E-glass fiber fillers was achieved by XRF, SEM, and PSD. The specimens were prepared by adding the E-glass fiber fillers to the traditional GIC at 10% and 20% by weight, forming two innovative groups, and compared with the unmodified GIC (control group). The physical properties (film thickness and initial setting time) were examined to confirm operability after mixing. The evaluation of the reinforced GIC was performed by assessing the compressive strength, flexural strength, hardness, and solubility (n = 10 specimens per test). A one-way ANOVA and Tukey tests were performed for statistical analysis (p ≤ 0.05).
RESULTS
The traditional GIC showed the least compressive strength, flexural strength, hardness, and highest solubility. While the GIC reinforced with 20 wt% E-glass fibers showed the highest compressive strength, flexural strength, hardness, and least solubility. Meanwhile, GIC reinforced with 10 wt% showed intermediate results (P ≤ 0.05).
CONCLUSION
Using 20 wt% E-glass fiber as a filler with the traditional GIC provides a strengthening effect and reduced solubility.
Topics: Glass Ionomer Cements; Solubility; Flexural Strength; Compressive Strength; Hardness; Materials Testing; Glass; Surface Properties; Silanes; Microscopy, Electron, Scanning; Dental Stress Analysis; Pliability; Humans
PubMed: 38937723
DOI: 10.1186/s12903-024-04447-8 -
Indian Journal of Dental Research :... Jan 2024Wet oral environment may have deleterious effects on performance of the composites due to influences of water sorption and solubility. The study evaluated the hydrolytic...
INTRODUCTION
Wet oral environment may have deleterious effects on performance of the composites due to influences of water sorption and solubility. The study evaluated the hydrolytic degradation caused because of water sorption and solubility of silorane and methacrylate-based dental composites.
METHODS
Ten disc samples (2 mm × 10 mm) were prepared. Samples were analyzed for water solubility and sorption according to ISO 4049:2000 regulations and tested for mass gain or loss following immersion in water or in artificial saliva at 1 day, 15 days, and 30 days period. Student's 't' test, repeated measures analysis of variance (ANOVA), and Tukey's post-hoc tests determined statistical significance of the experimental results with global significance set at P = 0.05.
RESULTS
Considerable sorption and solubility was observed with time in both materials on immersion. Silorane composites showed lower water sorption and solubility than methacrylate-based composite (MBC). Artificial saliva demonstrated higher sorption and solubility compared to distilled water.
CONCLUSION
Silorane composites display enhanced hydrolytic stability even after a month of immersion in contrast to conventional methacrylate-based composites (MBCs), making it a better alternative to MBC resins clinically.
Topics: Solubility; Methacrylates; Composite Resins; Water; Silorane Resins; Saliva, Artificial; Materials Testing; Hydrolysis; Dental Materials
PubMed: 38934754
DOI: 10.4103/ijdr.ijdr_195_23 -
Materials (Basel, Switzerland) Jun 2024Barium zirconate (BaZrO, BZO), which exhibits superior mechanical, thermal, and chemical stability, has been widely used in many applications. In dentistry, BZO is used...
Barium zirconate (BaZrO, BZO), which exhibits superior mechanical, thermal, and chemical stability, has been widely used in many applications. In dentistry, BZO is used as a radiopacifier in mineral trioxide aggregates (MTAs) for endodontic filling applications. In the present study, BZO was prepared using the sol-gel process, followed by calcination at 700-1000 °C. The calcined BZO powders were investigated using X-ray diffraction and scanning electron microscopy. Thereafter, MTA-like cements with the addition of calcined BZO powder were evaluated to determine the optimal composition based on radiopacity, diametral tensile strength (DTS), and setting times. The experimental results showed that calcined BZO exhibited a majority BZO phase with minor zirconia crystals. The crystallinity, the percentage, and the average crystalline size of BZO increased with the increasing calcination temperature. The optimal MTA-like cement was obtained by adding 20% of the 700 °C-calcined BZO powder. The initial and final setting times were 25 and 32 min, respectively. They were significantly shorter than those (70 and 56 min, respectively) prepared with commercial BZO powder. It exhibited a radiopacity of 3.60 ± 0.22 mmAl and a DTS of 3.02 ± 0.18 MPa. After 28 days of simulated oral environment storage, the radiopacity and DTS decreased to 3.36 ± 0.53 mmAl and 2.84 ± 0.27 MPa, respectively. This suggests that 700 °C-calcined BZO powder has potential as a novel radiopacifier for MTAs.
PubMed: 38930384
DOI: 10.3390/ma17123015 -
Journal of Clinical Medicine Jun 2024(1) Background: Cementation of glass fiber posts to root canals has been associated with various failures, especially debonding. This narrative review aims to present... (Review)
Review
(1) Background: Cementation of glass fiber posts to root canals has been associated with various failures, especially debonding. This narrative review aims to present the contemporary concepts concerning the adhesive cementation of glass fiber post and to discuss the optimal management of these factors. (2) Methods: Electronic search was performed in MEDLINE/Pub Med and Google Scholar using selected keywords examining the parameters post length, surface treatment of glass fiber posts, post space preparation and dentin pretreatment, resin cement selection, adhesive systems and hybrid layer formation, and clinical techniques. (3) Results: The search led to the selection of 44 articles. Epoxy resin-based endodontic sealers are recommended and the use of temporary cement in the root canal should be avoided. The minimum length of a glass fiber post adhesively cemented to a root canal is 5 mm. Irrigating the root canals with chlorhexidine, MTAD, or EDTA (alone or in combination with NaOCl) after post space preparation seems to enhance the bond strength. Silane application on the surface of the post seems to be beneficial. Concerning resin cements and adhesive systems, the results were rather inconclusive. Finally, resin cement should be applied inside the root canal with an elongation tip and photoactivation should be delayed. (4) Conclusions: Contemporary concepts of adhesive cementation of glass fiber posts can indeed improve the bond between glass fiber posts, resin cement, and root canal dentin, however, evidence coming from long-term randomized prospective clinical trials is needed in order to obtain safer conclusions.
PubMed: 38930007
DOI: 10.3390/jcm13123479