疾病谱对心肺复苏急救患者生存状况影响的研究

目的：探究疾病谱对行心肺复苏术的急救患者的生存状况的影响。方法：随机选取2012年3月至2014年3月在我院急诊手术室因发生心脏骤停实施CPR 复苏成功患者100例和复苏失败患者100例,分析两组患者的临床基本资料和直接病因。结果：复苏成功组大多为20～40岁患者（51例／100例,51％）,复苏失败组患者年龄分布集中在60岁以上（45例／100例,45％）,且差异具有统计学意义（ P＜0．05）;成功组和失败组在心肺复苏起始时间（100例／100例,100％;17例／100例,17％）、是否气管插管（91例／100例,91％;32例／100例,32％）和心电监护（79例／100例,79％;56例／100例,56％）均具有统计学意义（χ2＝12．829,P＝0．000;χ2＝10．025,P＝0．000;χ2＝4．982,P＝0．000）;直接病因主要为脑出血和梗死（44例／200例,22％）、冠心病（33例／200例,16．5％）、呼吸衰竭（40例／200例,20％）和急性心肌梗死（47例／200例,23．5％）,且两组患者间原发性疾病差异均有统计学意义（ P＜0．05）。结论：心肺复苏患者自主循环的恢复与患者年龄、原发性病、是否进行气管插管、心电监护和复苏起始时间有关。     

Do bulk‐fill resins decrease the restorative time in posterior teeth? A systematic review and meta‐analysis of in vitro studies

The aim of the present study was to compare the restorative time for filling cavities in posterior teeth using bulk‐fill and conventional resin composites through a systematic review and meta‐analysis. A search for clinical trials and laboratory studies was performed in PubMed/MEDLINE, Scopus, the Latin American and Caribbean Health Sciences Literature database, the Brazilian Library in Dentistry, Cochrane Library, Clinical Trials, and ReBEC (Registro Brasileiro de Ensaios Clínicos) databases without publication year or language restriction. Two reviewers identified eligible studies according to the inclusion criteria: bulk‐fill compared to conventional resin in class I or II, and the restorative time as an outcome. A meta‐analysis of the restorative time mean difference between composites was performed (inverse variance method, random effects model; Z‐test, P ≤ .05). From the 662 eligible studies, 133 were selected for full‐text analysis; three were included in the systematic review and in the meta‐analysis. Overall, the restorative time was lower when bulk‐fill was used (P = .0007, Z = 3.37), as the subgroup full‐body bulk‐fill (P < .00001, Z = 21.00). There was no difference in restorative time between flowable bulk‐fill and conventional resins (P = .08, Z = 1.76). Moderate‐to‐substantial heterogeneity was detected. Full‐body bulk‐fill composites decrease the restorative time in posterior teeth compared to conventional resins. Full‐body bulk‐fill resins require a shorter restorative time to perform restorations in posterior teeth than conventional resins, but the same is not valid for flowable bulk‐fill resin composites.     

Color change of some aesthetic dental materials: Effect of immersion solutions and finishing of their surfaces

ObjectivesThe purpose of this research was to evaluate the color change of five aesthetic dental materials, before and after immersion in distilled water and blue food color solution for 7 and 21 days, and to study the effect of finishing the surfaces on any color change.MethodsDisc shaped samples of five types of light curing composite (A2) (n = 10 samples/composite) were prepared and all samples were light-cured with a Plasma Arc light cure unit for ten seconds. One side of each sample disc was finished and polished with a Super-Snap system all samples. After 24 h, color measurements of each sample were conducted using a digital spectrophotometer. Five sample discs from each composite group were immersed in 30 ml of food color solution for 7 and 21 days, while the remaining five sample discs were immersed in 30 ml of distilled water as a control. Color measurements were repeated for all samples at 7 and 21 days after immersion. The color changes were statistically analyzed using t-tests within the same group. A result was considered statistically significant at α = 0.05.ResultsThe color differences (ΔE) ranged from 0.4 to 4.66 and statistically significant differences on the finished and unfinished surfaces were observed after immersion in the food color solution for 7 days. No significant differences were found in any group after immersion in the food color solution for 21 days. The Tetric EvoCeram and Arabesk groups showed less color differences after 7 and 21 days than other composites.ConclusionFinished composite surfaces showed less coloration than unfinished surfaces after 7 days, but all surfaces (finished and unfinished) were highly colored for all composite types after 21 days.     

渗透性树脂对树脂修复体微渗漏影响的实验观察

目的:观察使用渗透性树脂ICON对修复体边缘进行处理后的微渗漏变化。方法:20颗健康离体牙随机分为2组,颊面制备深度2mm的窝洞,Z350树脂充填,A组使用渗透性树脂ICON处理树脂修复体边缘处的牙体组织及树脂牙体结合处,B组为对照组。37℃水浴条件下分别置于0.1%罗丹明B荧光染料浸染,24h后激光扫描共聚焦显微镜测量染液渗入深度,定量评价微渗漏程度,对检测结果进行统计学分析。结果:A、B组微渗漏差异有统计学意义(P<0.05)。结论:渗透性树脂对改善树脂修复体微渗漏状况有明显效果。     

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.     

The effect of temperature changes on adaptation of resin fillings. II

In earlier laboratory investigations of thermal percolation at resinous fillings the duration of the heating periods was too long to be realistic. The aim of the present work was to investigate the effect of repeated heatings of realistic duration on the formation of marginal gaps between filling and tooth during a subsequent cooling below the minimum value in the temperature cycling process. Fillings made in extracted human teeth were studied. The brands investigated were Adaptic, Blendànt, Concise, Opotow, Sevriton Simplified, and Swedon. After closure of the initial gaps by water absorption expansion the fillings were polished and subjected to thermal cycling. The specimens were cycled between either 37° and 50° C or 37° and 60° C, the duration of each immersion in the warmer bath was 2 or 5 seconds, and the number of cycles was 1, 10, 100 or 1000. The effect of the cycling was investigated by measuring the width of marginal gaps appearing at a temperature lower than 37° C. It was found that the width of the gaps was only little affected by thermal cycling between 37° and 50° C. Cycling between 37° and 60° C increased the gap widths only with Opotow, Sevriton Simplified, and Swedon. The data indicate that thermal percolation for a number of brands may be of no clinical importance.     

复合树脂多色分层美学修复用于Ⅳ类洞的美学探讨

目的:应用多色分层复合树脂修复前牙Ⅳ类洞,观察其美学修复效果。方法:选取40颗Ⅳ类洞患牙,先经牙体预备,而后制备硅橡胶背板,比色,粘结,多色分层树脂修复,最后进行咬合调整,精细抛光,分别于术后1周、3、6、12、24月复查修复体充填效果。结果:36例充填体在24个月内的各项评价指标均达到临床满意的美学效果。结论:多色分层复合树脂修复前牙牙体,在较少磨除牙体组织的同时取得较好的临床美学效果。     

The cross‐pin retained implant supported restoration: a study of gasket placement and leakage

Background: Advantages of cross‐pin retained implant supported restorations (ISRs) include predictable retrieval and predictable retention. Unlike direct to fixture (DTF) or cement retained restorations, the prosthetic design of a cross‐pinned restoration retains gaps at the interfaces between the crown, abutment and cross‐pin screw. These spaces permit leakage into the suprastructure and gasket placement has been recommended to prevent this leakage. Methods: Five different gaskets were assessed for their ability to prevent leakage into a cross‐pinned ISR. The gaskets tested were: cement admixture on the cross‐pin screw; cement admixture on the inner surface of the coping and the cross‐pin screw; cement admixture on the inner surface of the coping only; cement admixture placed 1 mm from the margin of the coping and a filler placed in the abutment chimney. Results: Only gaskets which sealed both the cross‐pin screw interface and the abutment‐crown interface prevented leakage. A filler placed in the abutment chimney prevented leakage into this space but did not prevent fluid accumulating between the coping and abutment. Conservative placement of cement at the margin of the coping failed to prevent leakage. Conclusions: Cement gaskets may effectively prevent leakage into a cross‐pinned ISR. However, the use of a cement as a gasket has to be weighed against the issue of predictable retrieval, cement extrusion and incomplete seating.