GC GRADIA DIRECT光固化复合树脂修复切缘缺损疗效观察

目的：应用GC GRADIA DIRECT光固化复合树脂修复切缘缺损观察病例的疗效。方法：将189颗切缘缺损牙齿应用GC GRADIA DIRECT光固化复合树脂进行修复,并经过2年的随访观察。结果：应用GC GRADIA DIRECT光固化复合树脂进行修复切缘缺损成功率为97.88%。结论：GC GRADIA DIRECT光固化纳米混合型复合树脂模仿自然牙体散射和漫反射的光学原理,实现＂隐形＂修复（变色龙效果）。同时具有良好的粘结性能,高抗压强度,良好光泽度和抛光性,长期稳定性强等特点。因此GC GRADIA DIRECT光固化复合树脂是修复前牙各类牙体缺损的理想材料。     

复合补片修补腹壁切口疝十例的临床分析

目的评价应用复合补片腹膜内置入修补腹壁切口疝的效果。方法2003年11月至2005年6月应用复合补片修补腹膜难以对合的腹壁切口疝10例，均采用腹膜内置入修补法。结果所有患者均顺利恢复，手术后早期未发生切口感染、皮下血肿和血清肿等并发症。10例患者术后均得到随访，随访6～24个月，平均18个月。随访期内未发现肠梗阻、窦道形成和肠瘘等远期并发症和切口疝复发，10例患者均局部感觉良好。结论应用复合补片腹膜内置入修补切口疝是一种安全、有效的方法。     

复合足背皮瓣一期修复手背软组织缺损

目的探讨复合足背皮瓣在急诊中修复手背皮肤、神经及伸肌腱缺损的临床效果。方法切取带趾伸肌腱、皮神经的足背皮瓣游离移植修复手背软组织缺损9例。结果皮瓣全部成活,经13～54个月的随访,伤手运动基本正常,感觉和外形恢复良好,对足部功能无明显影响。结论应用带皮神经及趾伸肌腱的复合足背皮瓣一期修复手背皮肤软组织、肌腱和神经的缺损,是目前修复手背复合缺损的一种较理想的方法。     

肾上腺组合性嗜铬细胞瘤四例报告及文献复习

Objective To discuss the clinical characteristics and management principles of com-posite pheochromoeytoma of adrenal gland (pheochromocytoma-ganglioneuroma). Methods Four cases of composite tumor of adrenal gland diagnosed pathologically were reviewed. All the cases were male, aged 37 to 62 years;three of them had the history of hypertension, one of them accompanied with paroxysmal palpitation, while one case was asymptomatic. Computerized tomography and ultra-sonography showed single tumor in adrenal, the diameter was about 2.5、3.8、6.3、15cm respectively. Two cases showed positive results in 131Ⅰ-metaiodobenzylguanidine (MIBG) scintigraphy. One case showed positive result in 99Tcm-hydrazinonicotinamide-3trysinoctreotide (HTOC) scintigraphy. Twenty-four hours urinary catecholamine examination revealed the average of norepinephrine, epi-nephrine and dopamine were (196.1±92.2)nmol/24 h, (26.6±8.9)nmol/24 h, (1957.9±913.5) nmol/24 h respectively. Two cases were at a little elevated level and the others with normal. All cases were managed with α-adrenergic receptor blocker preoperatively for 2-4 weeks. Results Tumor re-section was performed in all 4 cases, and 3 cases by retroperitoneal laparoscopy, one by open surgery. All 4 cases were diagnosed as composite pheochromocytoma of adrenal (Pheochromocytoma-gangli-oneuroma) by pathology. All patients had no evidence of recurrence or metastasis during follow-up from 15 to 38 months. Two of three cases with hypertension reverted to normotensive. Conclusions Composite pheochromocytoma of adrenal is rare, difficult to be diagnosed preoperatively. Except mild in eatecholamine secretion, which clinical manifestations are similar to pheochromocytoma. Pheochro-mocytoma-ganglioneuroma is no apparent tendency for aggressive behaviors, the results of surgical management are favorable.     

Algorithm for Total Face and Multiorgan Procurement From a Brain‐Dead Donor

Procurement of a facial vascularized composite allograft (VCA) should allow concurrent procurement of all solid organs and ensure their integrity. Because full facial procurement is time–intensive, “simultaneous–start” procurement could entail VCA ischemia over 12 h. We procured a total face osteomyocutaneous VCA from a brain–dead donor. Bedside tracheostomy and facial mask impression were performed preoperative day 1. Solid organ recovery included heart, lungs, liver, kidneys, and pancreas. Facial dissection time was 12 h over 15 h to diminish ischemia while awaiting recipient preparation. Solid organ recovery began at 13.5 h, during midfacial osteotomies, and concluded immediately after facial explantation. Facial thoracic and abdominal teams worked concurrently. Estimated blood loss was 1300 mL, requiring five units of pRBC and two units FFP. Urine output, MAP, pH and PaO₂ remained normal. All organs had good postoperative function. We propose an algorithm that allows “face first, concurrent completion” recovery of a complex facial VCA by planning multiple pathways to expedient recovery of vital organs in the event of clinical instability. Beginning the recipient operation earlier may reduce waiting time due to extensive recipient scarring causing difficult dissection.     

The new 4DDome prosthesis: an original light and partially absorbable composite mesh for hernia repair

Introduction The use of non-absorbable meshes for the repair of inguinal hernias has become standard; however, these meshes have been associated with complications including long-term postoperative pain. To this end, a new partially absorbable composite mesh has been developed, and the aim of this study was to investigate its efficacy in animal and human trials. Materials and methods Sixty male Wistar rats were used to evaluate the behavior of the newly designed composite mesh. Composite meshes were implanted in the extra-peritoneal plane for 2, 4 and 8 weeks and compared to a standard polypropylene mesh. Forty patients with symptomatic inguinal hernias were treated using a new 4DDome designed prosthesis. Follow-up was by clinical and ultrasound examination at 1, 6 and 12 months. Results The animal study demonstrated that the inflammatory reaction associated with the new composite mesh was significantly lower than a standard polypropylene mesh, characterized by a lower macrophage infiltrate (P < 0.001). The mesh did not shrink over the 8-week period, unlike the polypropylene mesh (P < 0.05). The human study showed that there were three minor postoperative complications, no recurrences and the mesh was well tolerated. Follow-up with serial ultrasound showed that at 10 days and 1 month the dome was clearly visible in position; however, by 6 months it had flattened out, been partially absorbed and become incorporated into the repair. Conclusion These experimental and clinical studies have validated the concept of the new 4DDome composite mesh. It was well tolerated and was associated with good short-term results. The combination of the dome shape and the new composite mesh means that less polypropylene is required and represents a significant advance in anterior hernia repair.     

Effect of ascorbic acid,ethanol and acetone on adhesion between the treated fiber posts and composite resin cores

PURPOSE

The aim of the present study was to assess the effect of ascorbic acid, ethanol and acetone on microtensile bond strength between fiber posts pre-treated with hydrogen peroxide and composite resin cores.

MATERIALS AND METHODS

Twenty four fiber posts were pre-treated with 24% hydrogen peroxide and divided into 4 groups as follows: G1: no treatment, as control group; G2: treatment with 10% ascorbic acid solution for 5 minutes; G3: treatment with 70% ethanol solution for 5 minutes; and G4: treatment with 70% acetone solution for 5 minutes. Each fiber post was surrounded by a cylinder-shaped polyglass matrix which was subsequently filled with composite resin. Two sections from each sample were selected for microtensile test at a crosshead with speed of 0.5 mm/min. Statistical analyses were performed using one-way ANOVA and a post hoc Tukey HSD test. Fractured surfaces were observed under a stereomicroscope at ×20 magnification. The fractured surfaces of the specimens were observed and evaluated under a SEM.

RESULTS

Means of microtensile bond strength values (MPa) and standard deviations in the groups were as follows: G1: 9.70±0.81; G2: 12.62±1.80; G3: 16.60±1.93; and G4: 21.24±1.95. G4 and G1 had the highest and the lowest bond strength values, respectively. A greater bond strength value was seen in G3 compared to G2. There were significant differences between all the groups (P<.001). All the failures were of the adhesive mode.

CONCLUSION

Application of antioxidant agents may increase microtensile bond strength between fiber posts treated with hydrogen peroxide and composite cores. Acetone increased bond strength more than ascorbic acid and ethanol.     

三种义齿基托材料抗白色念珠菌黏附性能的比较

目的比较3种义齿基托材料的抗白色念珠菌黏附性能。方法将热凝基托树脂、不碎胶树脂、弹性材料树脂义齿基托材料制备成粗糙度相同的标准试样,每组10个。用白色念珠菌(ATCC 90028)菌液对各试样黏附培养24h、48h、168h后,分析白色念珠菌对试件表面的黏附。结果在培养24h时,3组试件白色念珠菌黏附量差异无统计学意义(P0.05);培养48h时,除不碎胶树脂组和弹性材料树脂组外,其余两两之间差异均有统计学意义(P0.05);培养168h时,3组试件两两之间差异均有统计学意义(P0.05),白色念珠菌黏附量计数,热凝基托树脂不碎胶树脂弹性材料树脂。结论与传统热凝树脂基托相比较,不碎胶树脂基托和弹性材料树脂基托能减少白色念珠菌的黏附。     

Effect of cariogenic biofilm challenge on the surface hardness of direct restorative materials in situ

Objectives

The presence of cariogenic biofilm could result in surface degradation of composite and ionomeric restorative materials. Thus, this study evaluated in situ the alterations in the surface microhardness of these materials under biofilm accumulation and cariogenic challenge.

Methods

In a split-mouth, double-blind, cross-over study, 10 volunteers wore palatal intra-oral devices containing bovine enamel slabs restored with composite resin (CR – Z250) or resin-modified glass ionomer (RMGI – Vitremer). Two phases of 14 days were carried out, one for each restorative material. In one side of the device, biofilm was allowed to accumulate under a plastic mesh, whereas in the opposing side, regular brushing was carried out 3 times/day with a dentifrice containing 1100 μg F/g as NaF. A 20% sucrose solution was applied extra-orally 10×/day on each restored dental slab. Knoop microhardness was used to calculate the percentage of surface hardness loss (%SHL).

Results

All materials showed a decrease in surface hardness after the in situ period. The restorative materials presented the following average for %SHL: RMGI without biofilm accumulation = 8.9 and with biofilm accumulation = 25.6, CR without biofilm accumulation = 14.7 and with biofilm accumulation = 17.0.

Conclusion

Biofilm accumulation and the presence of cariogenic challenge promoted faster degradation of ionomeric materials, but this was not observed for composite resin.

Clinical significance

The oral environment affects the surface hardness of aesthetic restorative materials. Biofilm accumulation and cariogenic challenge promote surface degradation for ionomeric materials, but not for composite resin.     

A randomized double-blind clinical trial of posterior composite restorations with or without bevel: 1-year follow-up

Objective

This randomized double-blind clinical trial compared the performance of posterior composite restorations with or without bevel, after 1-year follow-up.

Material and Methods

Thirteen volunteers requiring at least two posterior composite restorations were selected. Twenty-nine cavities were performed, comprising 14 without bevel (butt joint) and 15 with bevel preparation of the enamel cavosurface angle. All cavities were restored with simplified adhesive system (Adper Single Bond) and composite resin (Filtek P60). A halogen light curing unit was used through the study. Restorations were polished immediately. Analysis was carried out at baseline, after 6 months and after 1 year by a calibrated evaluator (Kappa), according to the FDI criteria. Data were statistically analyzed by Mann-Whitney test (p<0.05).

Results

Beveled and non-beveled cavities performed similarly after 1 year follow-up, regarding to fractures and retention, marginal adaptation, postoperative hypersensitivity, recurrence of caries, surface luster and anatomic form. However, for surface and marginal staining, beveled cavities showed significantly better performance (p<0.05) than butt joint restorations.

Conclusions

It was concluded that the restorations were acceptable after 1 year, but restorations placed in cavities with marginal beveling showed less marginal staining than those placed in non-beveled cavities.