Nevin Manimala

J Adhes Dent. 2022 Apr 13;24(1):195-202. doi: 10.3290/j.jad.b2916451.

ABSTRACT

PURPOSE: This study evaluated the effect of incorporating different concentrations of biosilicate in an experimental self-etch adhesive (SE).

MATERIALS AND METHODS: Biosilicate microparticles (0, 2, 5, and 10 wt%) were incorporated into the primer, and degree of conversion (DC) and wettability were tested (one-way ANOVA, Tukey’s test, p < 0.05). The two best concentrations were selected (2% and 5%) for µTBS evaluation. Sound human molars (n=20) were sectioned into quarters and randomly assigned to 4 experimental groups: 1. experimental SE + 0% biosilicate (Exp0%; negative control); 2. experimental SE + 2% biosilicate (Exp2%); 3. experimental SE + 5% biosilicate (Exp5%); 4. AdheSE (Ivoclar Vivadent, positive control). After adhesive application, Filtek Z350 (3M Oral Care) composite was built up incrementally to 5 mm. Each quarter tooth was sectioned into sticks (0.9 mm2) and stored in distilled water (37°C) for 24 h, 6 months, or 1 year. After storage, sticks were submitted to µTBS (0.75 mm/min). The Ca:P ratio was analyzed using scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS). Data were analyzed using two-way ANOVA with Bonferroni’s correction, with statistical siginificance set at p < 0.05. Fracture patterns were observed under a digital microscope and adhesive interfaces with transmission electron microscopy (TEM).

RESULTS: Exp2% presented the highest DC (p < 0.05), Exp5% exhibited the lowest µTBS (p < 0.05), and adhesive failures were predominant in all groups. TEM suggested remineralized areas in Exp2% and to a lesser degree in Exp5%. Exp2% and Exp5% showed a higher Ca:P ratio after aging (p < 0.05).

CONCLUSION: The incorporation of biosilicate microparticles can improve the properties of self-etch adhesives. It increased the DC of the experimental adhesive as well as mineral deposition. However, the adhesive properties are concentration dependent, as a higher concentration of microparticles can adversely affect the mechanical properties of an adhesive.

PMID:35416447 | DOI:10.3290/j.jad.b2916451

J Adhes Dent. 2022 Apr 13;24(1):175-186. doi: 10.3290/j.jad.b2916437.

ABSTRACT

PURPOSE: To identify the most effective cleaning method for saliva-contaminated zirconia surface before adhesive cementation through a systematic review and meta-analysis.

MATERIALS AND METHODS: PubMed, Scopus, and Web of Science databases were searched to select in vitro studies published through October 2021. Studies that did not perform aging methods, had a sample size less than 5 per group, or did not present a group with zirconia contaminated only with saliva were excluded. Data were extracted and risk of bias was assessed. Statistical analysis comparing the cleaning methods was conducted, and the standardized mean difference was assessed using the R software program.

RESULTS: Among 804 potentially eligible studies, 36 were selected for full-text reading, of which 13 were included in qualitative analysis, and 11 of these were subsequently included in the quantitative analysis. A meta-analysis revealed a significant difference in the bond strength between the cleaning methods. Sandblasting with Al2O3  showed a higher bond strength than cleaning solution (Ivoclean, Ivoclar Vivadent) (p < 0.01, I2 = 65%), and both methods promoted higher resin-bond strength to zirconia than water cleaning. In addition, there was no significant difference in the bond strength between alcohol (p = 0.35, I2 = 79%), phosphoric acid (p < 0.23, I2 = 90%), and water cleaning.

CONCLUSION: Sandblasting with Al2O3 seems to be the best method for zirconia surface cleaning before adhesive luting, promoting better resin-bond strength to zirconia.

PMID:35416445 | DOI:10.3290/j.jad.b2916437

J Adhes Dent. 2022 Apr 13;24(1):165-174. doi: 10.3290/j.jad.b2916433.

ABSTRACT

PURPOSE: To compare a self-etch and a two-step etch-and-rinse adhesive in terms of internal and marginal composite-tooth bond failure separately on enamel and dentin/cement at 36-48 months after restoration placement using optical coherence tomography (OCT).

MATERIALS AND METHODS: Twenty-seven patients with two or three class V composite restorations of noncarious cervical lesions 36-48 months after placement were included. The one-step self-etch adhesive Futurabond M ([Voco] group SE, n = 25) and the two-step etch-and-rinse adhesive Solobond M ([Voco] group ER, n = 20) combined with the nanohybrid composite Amaris (Voco) were evaluated. The four-step etch-and-rinse adhesive Syntac classic combined with Tetric EvoCeram (Ivoclar Vivadent) served as the control (n = 18). Spectral-domain OCT (SD-OCT, 1310-nm center wavelength) was applied. Marginal gaps and internal interfacial adhesive defects were quantified in cross-sectional OCT images. Groups were statistically compared using the Friedman/Wilcoxon test (α = 0.05).

RESULTS: In enamel, nonsignificantly different percentages of marginal gap formation and internal interfacial adhesive defects were found between the groups (pi ≥ 0.258). In dentin/cement, SE showed significantly less marginal gap formation compared to ER (p < 0.001) and control (p = 0.001), and at the internal dentin-composite interface less adhesive defects were found compared to ER (p < 0.001) and control (p = 0.003).

CONCLUSION: The self-etch adhesive used in the current study appears recommendable for restoration of noncarious cervical lesions with composite.

PMID:35416444 | DOI:10.3290/j.jad.b2916433

J Adhes Dent. 2022 Apr 13;24(1):147-154. doi: 10.3290/j.jad.b2916403.

ABSTRACT

PURPOSE: To determine the interfacial fracture energy (IFE) and stress distribution of Brazil-nut-shaped specimens made of translucent zirconia and resin cement.

MATERIALS AND METHODS: Three types of translucent zirconia were used: 3Y-TZP (high, Vita YZ HT), 4Y-TZP (super, Vita YZ ST), and 5Y-TZP (extra, Vita YZ XT). The adhesive surfaces were air abraded and 10-MDP-based resin cement was used. The cemented Brazil-nut-shaped specimens, with an elliptical defect in the center (as in real Brazil nuts), were thermally aged (5°C-55°C; 40,000 cycles). The IFE test was conducted with a piston to apply compression on the specimen, while the adhesive interface was positioned at four different angles (0, 10, 20, and 30 degrees) to measure the IFE during tensile, shear, and mixed failure modes. All adhesive interfaces were observed to determine failure patterns. The finite element analysis (FEA) was used to calculate tensile and shear stress distributions according to inclinations. Statistical analysis was conducted using the Kruskal-Wallis and Dunn’s post-hoc tests (95%), as well as the Mann-Whitney test (95%) was applied to compare each group regarding the aging factor.

RESULTS: According to Kruskal-Wallis and Dunn’s post-hoc tests, there were no statistically significant differences between non-aged (p > 0.05) and aged materials (p > 0.05). However, there was a significant difference between aged and non-aged materials for all inclinations (p < 0.05) (Mann-Whitney test). According to the FEA, the compressive loading of Brazil-nut-shaped specimens at different angles showed a predominance of tensile stress at 0 degrees and shear stress at 30 degrees.

CONCLUSION: The IFE under predominantly shear stresses is higher than when specimens are subjected only to tensile stresses, which allows the interpretation that failures in the oral environmental will probably occur preferentially under tensile stresses, because less energy is needed. All translucent zirconia bonded to resin cement has similar IFE, and thermal aging negatively affects these bonding interfaces.

PMID:35416442 | DOI:10.3290/j.jad.b2916403

J Adhes Dent. 2022 Apr 13;24(1):137-146. doi: 10.3290/j.jad.b2916387.

ABSTRACT

PURPOSE: To investigate the effect of roughness and drying time of dentin as well as the number of coats of a self-adhesive composite-cement primer on the bond strength of self-adhesive composite cement.

MATERIAL AND METHODS: Sixty human teeth were prepared and assigned to 12 groups (n = 5), according to three experimental factors: 1) dentin surface roughness, rough or fine, as achieved by 250- and 600-grit silicon carbide papers, respectively; 2) dentin wetness based on air-drying time (5 or 10 s); and 3) the self-adhesive composite-cement primer applications (no-coat, 1-coat, and 2-coat). Composite resin blocks were made with hybrid composite resin (M1 GraceFil) and cemented with G-CEM ONE (both GC). Cement-dentin sticks (12) were prepared, and the microtensile bond strength (μTBS) test was performed. Failure modes were observed with a stereomicroscope (40X), and bonding interfaces were evaluated with confocal laser scanning microscopy (CLSM). Statistical analysis was performed using three-way ANOVA and Tukey’s post-hoc comparisons test (α = 0.05).

RESULTS: Dentin roughness (250-grit > 600-grit, p = 0.000), drying time (5-s drying > 10-s drying, p = 0.000), and primer application (no-coat < 1-coat = 2-coat, p = 0.000) had significant effects on bond strength. These factors also showed significant interactions with each other (p = 0.003). The highest μTBS (31.8 ± 3.1 MPa) was observed in the 1-coat/fine roughness/10-s drying group and the lowest μTBS (13.4 ± 2.7 MPa) in the no-coat/coarse roughness/5-s drying group. CLSM showed higher penetration of cement in the primer-coated groups compared to that in the no-coat groups.

CONCLUSION: Bond strength between the self-adhesive composite cement and dentin was higher in the fine-roughness dentin group than in the coarse-roughness dentin group, and in the 5-s drying group compared to the 10-s drying group. Applying a primer to dentin improved bond strength of the self-adhesive composite cement.

PMID:35416441 | DOI:10.3290/j.jad.b2916387

J Evid Based Med. 2022 Mar;15(1):30-38. doi: 10.1111/jebm.12465.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness and safety of Qingjin Yiqi granules (QJYQ) on post-COVID-19 condition (PCC).

METHOD: Patients who met the inclusion criteria were randomly assigned to two groups, the QJYQ group received QJYQ combined with standard rehabilitation treatments (SRTs) and the control group only received SRTs. The treatment course was 14 days. The primary outcomes were modified Medical Research Council (mMRC) scale and Borg scale, while the secondary outcomes included symptoms score and 6-minute walking distance (6MWD). The safety outcome was the incidence of adverse events.

RESULTS: A total of 388 patients with PCC were enrolled and randomly assigned to the QJYQ group (n = 194) and the control group (n = 194). Compared to the controls, the mMRC scale was improved in the QJYQ group, which was better than that of the control group [β (95%CI): -0.626 (-1.101, -0.151), p = 0.010]. A significant improvement in Borg scale was also observed in the QJYQ group compared to the control group [β (95%CI): -0.395(-0.744, -0.046), p = 0.026]. There was no statistically significant difference in symptoms score and 6MWD between the two groups (p = 0.293, p = 0.724). No treatment-related adverse events were observed in either group.

CONCLUSIONS: QJYQ can bring benefits to patients with PCC, mainly in the improvement of breathlessness and fatigue.

PMID:35416437 | DOI:10.1111/jebm.12465

J Evid Based Med. 2022 Mar;15(1):19-29. doi: 10.1111/jebm.12464.

ABSTRACT

AIM: To evaluate the effectiveness and safety of Danmu Extract Syrup for the treatment of acute upper respiratory tract infection (AURI) in children.

METHODS: In this prospective cohort study, we enrolled children with AURI in the pediatric outpatient department and emergency department of West China Second Hospital. According to the treatment, they were divided into two groups: Danmu Extract Syrup Group (Danmu Group) and Xiaoer Chiqiao Granule Group (Chiqiao Group). The primary outcome was time to symptom remission, and the secondary outcomes were defervescence time, relief time, admission rate, and adherence. We used restricted mean survival time (RMST) to quantify the treatment effects and test noninferiority for primary outcome. Propensity score matching (PSM) was used to adjust confounding. Subgroup analysis and sensitivity analysis were used to verify the robustness of results.

RESULTS: We enrolled 1036 children with AURI, including 516 in Danmu Group and 520 in Chiqiao Group. After PSM, no significant difference was observed in the baseline characteristics of the two groups. The primary results showed that the RMST difference was -3 h (95% CI: -15.1 to 9.1) and the upper limit of the 95% CI was less than the noninferiority margin of 11 h. There was no statistical difference in the secondary outcomes except for defervescence between the two groups. The results of safety analysis showed that the incidence of adverse events occurred is 4.1% in Danmu Group, which was lower than the incidence of Chiqiao Group (6.9%).

CONCLUSION: This study indicated that Danmu extract syrup is noninferiority to Chiqiao Granule for AURI in children.

PMID:35416436 | DOI:10.1111/jebm.12464

J Genet Couns. 2022 Apr 13. doi: 10.1002/jgc4.1572. Online ahead of print.

ABSTRACT

Genetic counselors (GCs) and healthcare interpreters (HIs) are key members of the healthcare team when providing genetic counseling services to patients with Limited English Proficiency (LEP); however, the working relationship between GCs and HIs and the role each member plays within a genetic counseling session is unclear. Previous studies assessing this relationship have been qualitative and limited in sample size (Agather et al., 2018, Journal of Genetic Counseling, 26, 1388; Krieger et al., 2018, Journal of Genetic Counseling, 26, 1388; Lara-Otero et al., 2019, Health Communication, 34, 1608; Rosenbaum et al., 2020, Journal of Genetic Counseling, 29, 352). This study utilized a quantitative approach to allow for sampling of larger populations and to simultaneously understand current perspectives of GCs and HIs regarding each other’s and their own roles within a genetic counseling session. GC and HI participants from the United States were recruited via email to complete an online survey with questions regarding interactions prior to a session, roles during a session, and opportunities for collaboration and constraints in the working relationship. Descriptive and inferential statistics were utilized to analyze responses of GCs and HIs. 130 GC and 40 HI participants were included in this study. There were statistically significant differences (p < .001) in responses between GC and HI participants on the expected distribution of roles during a session in advocacy, psychosocial and cultural domains. Additionally, this study identified that HI desired resources and training regarding genetics and genetic counseling are currently not being met. To our knowledge, this is the largest study to simultaneously survey GC and HI perspectives on these topics. Our findings suggest the need for greater communication and collaboration between GCs and HIs to ensure high-quality care for patients with LEP. Integrating a pre-session meeting between the GC and HI for sessions with patients with LEP and increasing education for GCs and HIs on the roles each group brings into a session is warranted to optimize this collaborative relationship and patient care.

PMID:35416393 | DOI:10.1002/jgc4.1572

Luminescence. 2022 Apr 13. doi: 10.1002/bio.4257. Online ahead of print.

ABSTRACT

A novel, simple and sensitive spectrofluorimetric approach for determination of terbutaline sulphate (TER) and its prodrug bambuterol (BAM) in their pure and pharmaceutical dosage forms was developed. The suggested approach depends on enhancing the native fluorescence of either TER or BAM at 315 and 297.2 nm after excitation at 277 and 259 nm, respectively, using sodium dodecyl sulphate (SDS) as a micellar media. In the presence of 0.7% w/v SDS, about 1.38-fold and 1.18-fold enhancement is achieved in the relative fluorescence intensity (RFI) of TER and BAM, respectively. The fluorescence-concentration curves were rectilinear over the concentration range of 0.8-16 μg mL^-1 , with detection limits (LOD) of 0.252 and 0.26 (μg mL-1), quantitation limits (LOQ) of 0.76 and 0.79 (μg mL-1), determination coefficients (r2) of 0.9981, and slopes of 45.92 and 10.44 for TER and BAM, respectively. The suggested approach was validated in accordance with ICH criteria and was effectively applied in the analysis of the studied drugs in their commercial tablets. The high sensitivity of the proposed approach allows its application in evaluating the content uniformity testing of the studied drugs in their tablets through using the official United States Pharmacopeia criteria (USP). Statistical analogies of the findings with that of the reported methods showed really good harmony and indicated no major differences in precision and accuracy.

PMID:35416388 | DOI:10.1002/bio.4257

Eur J Cancer Care (Engl). 2022 Apr 13. doi: 10.1111/ecc.13578. Online ahead of print.

ABSTRACT

OBJECTIVE: The role of social networks, especially weaker ties (e.g. casual acquaintances and hobby groups), in self-management of long-term consequences of cancer is unexplored. This study aimed to explore the structure of cancer survivors’ social networks and their contribution to self-management support and health-related quality of life (HRQoL).

METHODS: The study used a sequential, exploratory mixed methods design. Phase 1 surveyed 349 lymphoma, colorectal, breast and prostate cancer survivors. Phase 2 analysed 20 semi-structured interviews with respondents recruited from Phase 1.

RESULTS: Phase 1 results suggested participants’ HRQoL increased if they participated in an exercise group, if their self-management skills increased, and social distress and negative illness perception decreased (p < 0.0005 adj. R² = 0.631). These findings were explored in Phase 2, identifying underlying mechanisms. Four themes were identified: disrupted networks after cancer treatment; navigating formal support and building individual capacity; peer networks and self-management knowledge and linking networks to enable adaptation in recovery.

CONCLUSIONS: This study suggests engagement with community groups, particularly those not directly related to illness management and social interaction with weak ties, make a valuable contribution to self-management support, increase HRQoL and enhance well-being.

PMID:35416341 | DOI:10.1111/ecc.13578