Longer Operative Time Results in a Higher Rate of Subsequent Periprosthetic Joint Infection in Patients Undergoing Primary Joint Arthroplasty

Background

Whether prolonged operative time is an independent risk factor for subsequent surgical site infection (SSI) and periprosthetic joint infection (PJI) following total joint arthroplasty (TJA) remains a clinically significant and underexplored issue. The aim of this study is to investigate the association between operative time and the risk of subsequent SSI and PJI in patients undergoing primary TJA.

Modelo Point-of-Care Ultrasound en Atención Primaria: ¿herramienta de alta resolución?

Point-of-Care Ultrasound is a method of performing a rapid clinical ultrasound, with the aim of responding to a clinical question immediately. This is not an ultrasound performed systematically as the radiologists do, nor does it pretend to replace it. It is useful in some kind of screening (abdominal aortic aneurysm) and is of special interest in ultrasound-guided procedures (joint infiltration by injection).It allows to adapt the derivations, minimising the uncertainty, ruling out certain pathologies due to its high diagnostic precision. It can also lead to overdiagnosis, if the examinations carried out are not limited to the organs on which our clinical suspicion is based.Ultrasound is one tool more in the diagnostic process, but its use must be limited to certain clinical situations. Its use in early detection of prevalent diseases in Primary Care should be properly evaluated. On the other hand with more evidence of a high diagnostic accuracy in a large list of pathological conditions.     

In vivo influence of residual moisture on microtensile bond strengths of one-bottle adhesives

Purpose: This study evaluated the microtensile bond strengths of three dentin adhesives applied on clinically moist dentin or on dentin that was dried with air for 5 seconds. The null hypothesis to test was that the level of residual moisture does not influence bond strengths when restorations are placed in vivo.
Materials and Methods: Twenty-four premolars scheduled to be extracted for orthodontic reasons from patients between the ages of 15 and 23 years were restored with one of the following adhesive systems followed by a mini hybrid composite resin: Excite (Ivoclar/Vivadent), an ethanol-based dentin adhesive; Prime & Bond NT (Dentsply/Caulk), an acetone-based dentin adhesive; and Single Bond (3M ESPE), an ethanol and water-based dentin adhesive. After extraction, the specimens were sectioned with a slow-speed diamond saw in two perpendicular directions to obtain sticks with a cross-section of 0.7 ± 0.2 mm². The specimens were attached to a Geraldeli device and fractured using a universal testing machine at a crosshead speed of 1 mm per minute.
Results: For each dentin adhesive, there were no statistical differences between means for dry dentin versus moist dentin. Single Bond and Prime & Bond NT ranked in the same statistical subset regardless of the moisture condition of the substrate. Both Excite, dry, and Excite, moist, resulted in statistically lower bond strengths than Single Bond, moist, but similar to those of Single Bond, dry, Prime & Bond NT, moist, and Prime & Bond NT, dry.
CLINICAL SIGNIFICANCE
In this study, the level of residual moisture did not influence microtensile bond strengths. Clinically, the degree of moisture left on the dentin surface upon rinsing off the etching gel may not be as relevant as previously reported in laboratory studies.     

Effects of low power red laser on induced-dental caries in rats

OBJECTIVE: The purpose of this study was to investigate the effects of low power red laser associated with acidulated phosphate fluoride on the development of induced-dental caries in rats. DESIGN: Dental caries were induced in molars of 40 rats divided into five groups: control group (CG), the teeth were not submitted to any treatment; laser group (LG), teeth were irradiated with a low power red laser (LPRL), power of 30 mW and dose of 5 J/cm(2); fluoride group (FG), teeth were treated with topical acidulated phosphate fluoride (APF) 1.23% applied for 4 min; laser+fluoride group (LFG), teeth were irradiated with LPRL followed by APF; fluoride+laser group (FLG), teeth were treated with APF followed by LPRL. The animals were killed after 48 days, and the first and second molars were extracted to analyze the caries lesion area, microhardness, and calcium and phosphorus ratio. RESULTS: There were no statistical differences among FG, LFG, and FLG regarding to caries area and microhardness, although the caries area were smaller in LFG. Ca/P ratio did not show significant differences among all groups. CONCLUSIONS: Although LPRL before APF application appeared to diminish the caries progression, LPRL did not present any additional benefit compared with acidulated phosphate fluoride on the prevention of induced-dental caries in rats.     

The Caries Assessment Spectrum and Treatment (CAST) index: rational and development

Serious difficulties in reporting results were encountered when using ICDAS II and PUFA separately in an epidemiological survey in a child population in Brazil. That necessitated the development of a comprehensive but pragmatic caries assessment index. This publication describes the rationale, development and content of a novel caries assessment index. Strengths and weaknesses of ICDAS II, PUFA and other indices were analysed. The novel caries index developed for use in epidemiological surveys is termed 'Caries Assessment Spectrum and Treatment' (CAST). 'Spectrum' indicates what is considered the main strength of the new index - its usefulness in describing the complete range of stages of carious lesion progression: from no carious lesion, through caries protection (sealant) and caries cure (restoration) to lesions in enamel and dentine, and the advanced stages of carious lesion progression in pulpal and tooth-surrounding tissue. CAST combines elements of the ICDAS II and PUFA indices, and the M- and F-components of the DMF index. A DMF score can easily be calculated from the CAST score, thereby enabling retention of the use of existing DMF scores. The CAST index for use in epidemiological surveys is very promising. It should be validated and its reliability and usefulness be tested in different age groups in different countries and cultures.     

Synthesis and biocompatibility of an experimental glass ionomer cement prepared by a non-hydrolytic sol-gel method

The aims of this study were to demonstrate the synthesis of an experimental glass ionomer cement (GIC) by the non-hydrolytic sol-gel method and to evaluate its biocompatibility in comparison to a conventional glass ionomer cement (Vidrion R). Four polyethylene tubes containing the tested cements were implanted in the dorsal region of 15 rats, as follows: GI - experimental GIC and GII - conventional GIC. The external tube walls was considered the control group (CG). The rats were sacrificed 7, 21 and 42 days after implant placement for histopathological analysis. A four-point (I-IV) scoring system was used to graduate the inflammatory reaction. Regarding the experimental GIC sintherization, thermogravimetric and x-ray diffraction analysis demonstrated vitreous material formation at 110oC by the sol-gel method. For biocompatibility test, results showed a moderate chronic inflammatory reaction for GI (III), severe for GII (IV) and mild for CG (II) at 7 days. After 21 days, GI presented a mild reaction (II); GII, moderate (III) and CG, mild (II). At 42 days, GI showed a mild/absent inflammatory reaction (II to I), similar to GII (II to I). CG presented absence of chronic inflammatory reaction (I). It was concluded that the experimental GIC presented mild/absent tissue reaction after 42 days, being biocompatible when tested in the connective tissue of rats.