Tag: nevin manimala

Eur Heart J. 2023 Oct 25:ehad715. doi: 10.1093/eurheartj/ehad715. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: In the Partial Oral Treatment of Endocarditis (POET) trial, stabilized patients with left-sided infective endocarditis (IE) were randomized to oral step-down antibiotic therapy (PO) or conventional continued intravenous antibiotic treatment (IV), showing non-inferiority after 6 months. In this study, the first guideline-driven clinical implementation of the oral step-down POET regimen was examined.

METHODS: Patients with IE, caused by Staphylococcus aureus, Enterococcus faecalis, Streptococcus spp. or coagulase-negative staphylococci diagnosed between May 2019 and December 2020 were possible candidates for initiation of oral step-down antibiotic therapy, at the discretion of the treating physician. The composite primary outcome in patients finalizing antibiotic treatment consisted of embolic events, unplanned cardiac surgery, relapse of bacteraemia and all-cause mortality within 6 months.

RESULTS: A total of 562 patients [median age 74 years (IQR, interquartile range, 65-80), 70% males] with IE were possible candidates; PO was given to 240 (43%) patients and IV to 322 (57%) patients. More patients in the IV group had IE caused by S. aureus, or had an intra-cardiac abscess, or a pacemaker and more were surgically treated. The primary outcome occurred in 30 (13%) patients in the PO group and in 59 (18%) patients in the IV group (P = .051); in the PO group, 20 (8%) patients died vs. 46 (14%) patients in the IV group (P = .024). PO-treated patients had a shorter median length of stay [PO 24 days (IQR 17-36) vs. IV 43 days (IQR 32-51), P < .001].

CONCLUSIONS: After clinical implementation of the POET regimen almost half of the possible candidates with IE received oral step-down antibiotic therapy. Patients in the IV group had more serious risk factors for negative outcomes. At 6-month follow-up, there was a numerically but not statistically significant difference towards a lower incidence of the primary outcome, a lower incidence of all-cause mortality and a reduced length of stay in the PO group. Due to the observational design of the study, the lower mortality may to some extent reflect selection bias and unmeasured confounding. Clinical implementation of PO regimens seemed feasible and safe.

PMID:37879115 | DOI:10.1093/eurheartj/ehad715

Cutan Ocul Toxicol. 2023 Oct 25:1-22. doi: 10.1080/15569527.2023.2275025. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to investigate the effects of commercial tattoo inks used in corneal tattooing on conjunctival microbiota.

METHOD: This prospective case control study consisted of 125 participants divided in the following three groups: 35 patients with corneal tattoos, 40 patients with corneal leukoma, and 50 healthy subjects. Corneal tattooing was performed in all the cases in this study using a tattoo pen machine and commercial tattoo ink. A total of 500 cultures were taken from 250 eyes of 125 individuals on chocolate and sheep blood agar. Bacteriological samples were taken from the inferior eyelid conjunctiva using a sterile cotton swab. Without any contact elsewhere, the swabs were smeared on bedside chocolate agars and 5% sheep blood agar.

RESULTS: In tattooed eyes, bacterial growth was detected in 42.9% of the chocolate and sheep blood agar samples. In other healthy eyes of patients with corneal tattoos, 54.5% bacterial growth on chocolate agar and 57.1% on sheep blood agar were detected. No statistical difference was detected in the conjunctival microbiota of chocolate and sheep blood agar (p = 0.254, p = 0.134, respectively) in the tattooed eyes compared to the other eye of the individual. No statistically significant difference was found in terms of bacterial growth in tattooed, leukoma, or healthy eyes on chocolate and sheep blood agar (p = 0.408, p = 0.349). The growth rate of Staphylococcus epidermidis decreased by 33.3% (from 12 to 8) on chocolate agar in 35 tattooed eyes, and it decreased by 28.5% (from 14 to 10) on sheep blood agar, while gram-negative bacteria Brevundimonas diminuta, Acinetobacter lwofii, and Psychrobacter faecalis were detected in three patients.

CONCLUSION: Corneal tattooing using commercial dye does not affect conjunctival microbiota. In the past 3 years, 120 patients have been tattooed with commercial tattoo ink in Istanbul Medeniyet University Göztepe Training and Research Hospital. No complications related to infection were found in the 3-year follow-up. The gram-negative bacteria detected in the healthy control group and tattooed eyes were bacteria found on normal skin or in the respiratory tract. Although some gram-negative bacteria do not cause infection, careful eye examination, follow-up, and culture are required in suspicious cases.

PMID:37879108 | DOI:10.1080/15569527.2023.2275025

Cutan Ocul Toxicol. 2023 Oct 25:1-8. doi: 10.1080/15569527.2023.2275018. Online ahead of print.

ABSTRACT

PURPOSE: The amniotic membrane (AM), the inner layer of the placenta, is a semitransparent, avascular and thin tissue that is useful due to its structure. Amniotic membrane transplantation (AMT) avoids the need for keratoplasty to prevent corneal perforating. The purpose of the study was to evaluate the visual (gain of or no change in visual acuity) and corneal outcomes (closure of the ulcer or corneal healing) of AMT in patients with ocular surface diseases.

MATERIALS AND METHODS: This was a retrospective case control study (success or failure of the surgery). It was undertaken at a single academic center. The study cohort consisted of subjects with ocular surface diseases. Patients were treated with AMT for refractory ocular surface diseases. They were divided into five subgroups according to the preoperative diagnosis. The technique of AMT used was the onlay method with two layers of AM. Primary outcome measures included best corrected visual acuity (BCVA), the number of AMTs, and reepithelization of the corneal epithelium at the end of the treatment. Two weeks to 6 months were given to consider epithelial closure. Treatment success was defined as corneal healing within 6 months.

RESULTS: A total of the sixty-six eyes of 66 patients (39 male/27 female) with a mean age of 44 ± 23 years (range 1-88 years) were included in the study. A single AMT procedure achieved epithelial closure in 74.2% (n = 49) of the eyes (53% in <15 days, 19.6% in 15-30 days, and 1.5% in 1-6 months). The fastest reepithelization occurred in neurotrophic keratopathy, 76.9% of which cases occurred within fifteen days after the AMT procedure. Treatment failure was observed in 5 patients (7.5%), 4 with keratitis, and 1 with neurotrophic keratopathy. The highest closure rates were found in persistent epithelial defects, graft-versus-host disease (GvHD), and bullous keratopathy, although there was no statistically significant difference in BCVA. Pairwise comparisons were made of neurotropic keratoplasty versus bullous keratopathy (p = 0.025), neurotrophic keratopathy versus keratitis (p = 0.004), GVHD versus keratitis (p= 0.003), and lastly, GvHD versus bullous keratopathy (p = 0.023).

CONCLUSIONS: AMT is a safe, valuable, and fast treatment technique to treat corneal epithelial defects stemming from different etiologies that are refractory to conventional treatment.

PMID:37879107 | DOI:10.1080/15569527.2023.2275018

Int J Periodontics Restorative Dent. 2023 Oct 24;(7):s264-s282. doi: 10.11607/prd.6152.

ABSTRACT

Periodontal intrabony defects (IBDs) are commonly encountered in dental practice and are usually treated by open flap debridement (OFD) with or without bone grafts and/or guided tissue regeneration (GTR), platelet-rich fibrin (PRF), or other additives. A difficulty with these approaches is maintaining the space for bone growth at the determined location. In this report, autologous sticky bone (ASB) was used and compared to a simple mixture of PRF and bone graft (PRF-BG) using the identical graft material-bioactive glass morsels-to assess its regenerative potential in IBDs, as sticky bone is known to maintain the space, according to previous research. A total of 21 IBDs were treated by OFD, PRF-BG mixture, or ASB. Regenerative assessment was clinically and radiographically performed by CBCT at 1 year. All the treatment modalities (OFD, PRF-BG, and ASB) showed statistically significant improvements clinically and radiographically at 1 year in terms of probing pocket depth reduction (PPDR), clinical attachment level gain (CALG), CBCT defect fill (CBCT-DF), and CBCT defect resolution (CBCT-DR); P < .05. The ASB group depicted the most favorable results (P < .05) in terms of the parameters at 1 year followed by the PRF-BG group and then the OFD group. Treatment of periodontal IBDs with ASB resulted in significant improvements in clinical and CBCT parameters compared to baseline at 1 year, and intrasurgical graft handling was much better in the ASB group.

PMID:37879062 | DOI:10.11607/prd.6152

Int J Periodontics Restorative Dent. 2023 Oct 24;(7):s227-s234. doi: 10.11607/prd.6163.

ABSTRACT

PURPOSE: To investigate the effects of experience level on the clinical and esthetic results of coronally advanced flap (CAF) surgery.

MATERIAL AND METHODS: A postgraduate student’s first 40 CAF operations in the periodontology residency program were followed. The Miller Class I gingival recessions were divided into four chronologic groups (n: 10 in each). Clinical and esthetic evaluations were performed at baseline and after 6 months. The results of chronologic intervals were statistically compared.

RESULTS: While the overall mean root coverage (RC) percentage was 73.6% and the complete RC was 60%, the mean RC percentages of the groups, respectively, were 45%, 55%, 86%, and 95%, showing that the mean and complete RC percentage increased as the experience level increased (P < .05). Similarly, as the experience level increased, closure of the gingival recession depth and width and esthetic scores increased, while the surgical time decreased significantly (P < .05). Complications were observed in three patients during the first interval and in two patients during the second interval, while no complications were observed in the other groups.

CONCLUSIONS: This study showed that experience level can significantly affect the clinical and esthetic outcomes, operative time, and complication rates of CAF surgery. All education programs should determine how many of each surgical procedure residents must perform before they are considered experienced or expert surgeons who can work independently and predictably achieve safe, acceptable outcomes.

PMID:37879060 | DOI:10.11607/prd.6163

Int J Periodontics Restorative Dent. 2023 Oct 24;(7):s217-s226. doi: 10.11607/prd.6212.

ABSTRACT

OBJECTIVES: To quantify the buccal bone thickness, area, and perimeter following guided bone regeneration (GBR) using stabilizing periosteal sutures. The loss in hard tissue volume may impair proper implant placement. GBR has been used to regenerate the lost alveolar ridge prior to or at the same time as dental implant placement. The most important factor for GBR success is graft stability. The periosteal mattress suture (PMS) stabilizing technique is an alternative to pins and screws to stabilize bone grafting material and has the advantage of not requiring the removal of the fixing devices.

MATERIALS AND METHODS: A CBCT was acquired before and 6 months after surgery from six patients who underwent GBR with the PMS stabilizing technique. Images were analyzed for buccal bone thickness, area, and perimeter.

RESULTS: The mean change in buccal bone thickness was 3.42 mm (± 1.31 SD) and proved statistically significant (P = .005). The mean change in bone crest area also proved statistically significant (P = .001). No significant difference was found in bone perimeter (P = .12).

CONCLUSIONS: The PMS technique delivered optimal results without clinical complications. This study shows the potential of this technique as an alternative to pins or screws for graft stabilization in the esthetic zone.

PMID:37879059 | DOI:10.11607/prd.6212

Int J Periodontics Restorative Dent. 2023 Oct 24;(7):s156-s167. doi: 10.11607/prd.6294.

ABSTRACT

PURPOSE: To investigate the effect of erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser conditioning on dentin bond strength and nanoleakage of different universal and self-etch adhesives.

MATERIALS AND METHODS: A total of 84 intact human third molar teeth were cut at the dentin level, and half of them were laser conditioned. The specimens were divided into three groups; two different universal resins and one self-etch adhesive resin were applied and composite resin restorations were created. For the microtensile bond strength (µTBS) test, 20 microspecimens were prepared from the laser and control group of each adhesive (n = 20) and tested with a universal device. For nanoleakage observation, 10 specimens were prepared from each group (n = 10) and stored in silver nitrate solution, and then the amount of nanoleakage was analyzed by field emission scanning electron microscopy (FESEM). Data were analyzed with two-way ANOVA, Tukey’s honestly significant difference, and chi-square tests.

RESULTS: The mean dentin bond strength of all adhesives in the laser groups was found to be statistically significantly lower than those of the control groups (P < .05). No difference was found between the mean bond strength of the adhesives in the laser and control groups (P > .05). Higher nanoleakage was observed in all adhesives in the laser groups compared to the control groups (P < .05).

CONCLUSIONS: Irradiation of the dentin surface with Er,Cr:YSGG could adversely affect the µTBS and nanoleakage, likely by affecting the structure of the hybrid layer.

PMID:37879055 | DOI:10.11607/prd.6294

Int J Periodontics Restorative Dent. 2023 Oct 24;(7):s129-s145. doi: 10.11607/prd.4866.

ABSTRACT

PURPOSE: To evaluate the marginal leakage of three different types of bonding agents used with two posterior composites and a giomer, available commercially.

MATERIAL AND METHODS: Class II box-only cavities were prepared on 90 mandibular first molars with margins extending 1 mm beyond the cementoenamel junction. The samples were divided into nine groups based on three different bonding agents, two different composites, and a giomer. Cavities were restored per the manufacturer’s description. Teeth were subjected to a thermocycling procedure (500×, 5°C to 55°C) and dye penetration by immersing in a 2% methylene blue solution (Merck Specialties) for 24 hours. The marginal adaptation was evaluated as a continuous margin at the gingival level under a stereomicroscope. The results were analyzed using the Kruskal-Wallis and Mann-Whitney U tests.

RESULTS: The results of the groups with the total-etch technique showed no statistical difference between the nanohybrid Filtek Z250 XT (3M ESPE) and fine hybrid SwissTEC composite (ColtèneWhaledent AG). The groups with the self-etch technique showed no statistical difference when used with either of the two composites. The acid-etch technique showed better marginal adaptation than the self-etch technique. When the giomer (Beautifil II, Shofu) was used with the total-etch technique, it showed better adaptation than when used with the self-etch technique but overall showed more marginal leakage than the composites.

CONCLUSION: The total-etch technique provided better marginal adaptation for the composites and giomer compared to the self-etch technique.

CLINICAL SIGNIFICANCE: The demand for esthetic restorations continues to increase, and composite restorations are now considered the material of choice for Class II cavities. There are various concerns with composite restorations, one of them being good marginal adaptation to increase the life of the restoration. This study evaluated marginal leakage with the nanohybrid composite Filtek Z250 XT, fine hybrid composite SwissTEC, and a giomer when used with the total-etch technique and self-etch technique and reported satisfactory adaptation with the total-etch technique.

PMID:37879054 | DOI:10.11607/prd.4866

Int J Periodontics Restorative Dent. 2023 Oct 24;(7):s65-s77. doi: 10.11607/prd.6318.

ABSTRACT

PURPOSE: To investigate the effects of airborne-particle abrasion and nanosilica (nano-Si) infiltration treatment on the surface characteristics of dental zirconia.

MATERIALS AND METHODS: A total of 15 unsintered zirconia ceramic green bodies (10 × 10 × 3 mm) were divided into three groups (n = 5): Group C, no treatment after sintering; Group S, airborne-particle abrasion with 50-μm aluminum oxide particles after sintering; and Group N, infiltration of nano-Si followed by sintering and hydrofluoric acid (HF) etching. The zirconia disks’ surface roughness was analyzed by atomic force microscopy (AFM). The surface morphology of the specimens was analyzed using scanning electron microscopy (SEM), and the chemical composition was analyzed by energy-dispersive x-ray (EDX). Data were statistically analyzed by the Kruskal-Wallis test (P < .05).

RESULTS: Zirconia surface treatments by infiltration of nano-Si, sintering, and HF etching showed multiple changes in the surface features. The surface roughness of Groups C, S, and N were 0.88 ± 0.07 μm, 1.26 ± 0.10 μm, and 1.69 ± 0.15 μm, respectively. The surface roughness of Group N was significantly higher than that of Groups C and S (P < .05). EDX analysis showed peaks that corresponded to silica (Si) after infiltration with colloidal Si that disappeared following acid etching.

CONCLUSIONS: Infiltrating nano-Si increases the surface roughness of zirconia. The formation of retentive nanopores on the surface potentially improves the zirconia-resin cement bonding strengths.

PMID:37879051 | DOI:10.11607/prd.6318

Int J Periodontics Restorative Dent. 2023 Oct 24;(7):s18-s25. doi: 10.11607/prd.6528.

ABSTRACT

PURPOSE: To evaluate the effects of desensitizing MI Varnish (GC America) applied before or after bleaching on the mineral component of enamel and surface topography.

MATERIALS AND METHODS: The coronal portions of 10 freshly extracted bovine teeth were segmented for a total of 40 specimens. Enamel specimens obtained from each tooth were randomly divided into four groups (n = 10): Group A = no bleaching; Group B = bleaching with 40% hydrogen peroxide (HP); Group C = MI Varnish applied before bleaching; and Group D = MI Varnish applied after bleaching. The calcium (Ca) and phosphorus (P) levels of the specimens in each group were determined by energy dispersive spectroscopy (EDS). Morphologic changes were observed using scanning electron microscopy (SEM). One-way ANOVA and Tukey HSD tests were used for statistical analyses (α = .05).

RESULTS: The mean Ca content of Group B was significantly lower than those of Groups A, C, and D (P < .05). The mean Ca content of Group C was significantly lower than that of Group A (P < .05). There was no significant difference in Ca content between the other groups (P > .05). The mean P content of Group A was significantly higher than those of Groups B to D (P < .05). There was no significant difference in P content between Groups B to D (P > .05).

CONCLUSIONS: Application of MI Varnish before or after in-office bleaching was effective in reducing mineral loss. However, applying MI Varnish after bleaching was more effective.

PMID:37879050 | DOI:10.11607/prd.6528