Fracture resistance of microhybrid composite,nano composite and fibre‐reinforced composite used for incisal edge restoration

Abstract – Traumatized anterior teeth need quick, aesthetic and functional repair. Along with aesthetics, the physical properties of restorative material should also be considered for long‐lasting restoration. Fibre reinforcement has been tried as a newer technique to improve the physical properties of composite materials. Hence, this study was carried out to evaluate the fracture resistance of microhybrid composite, nano composite and fibre‐reinforced composite used for restoration of incisal edge of fractured maxillary central incisors. Extracted permanent maxillary central incisors were randomly divided into four groups of 10 samples each: control group with intact teeth (Group A), microhybrid composite (Esthet X; Dentsply/Caulk, Milford, DE, USA) (group B), nano composite (Ceram X; Dentsply/Caulk) (group C) and microhybrid composite reinforced with polyethylene fibre – flowable composite unit [(Ribbond THM; Ribbond Inc., Seattle, WA, USA; Esthet X flow; Dentsply/Caulk)] (group D). The fracture resistance was measured under universal testing machine at a speed of 1 mm min^?1 with the loading tip of 2 mm diameter. The samples were further evaluated for mode of fracture under stereomicroscope at 3.5× magnification. The data were analysed using one‐way anova and Tukey’s test for fracture resistance. Group A and group D exhibited significantly higher fracture resistance than group B and group C. No significant difference was found between group B and group C as well as between group A and group D. Fisher’s exact test for the mode of fracture revealed no statistical significance. It was concluded that fibre reinforcement of composite could be an alternative technique for restoration of fractured anterior teeth for better aesthetics and longevity of the restoration.     

Hypercalcemia and metastatic calcification in a neonate with subcutaneous fat necrosis

We report a 30-day-old baby with subcutaneous fat necrosis and symptomatic hypercalcemia, who developed metastatic calcification in the subcutaneous tissue, kidneys, pericardium and brain. The baby also had anemia, hypertriglyceridemia and hypercholesterolemia. He was managed with intravenous saline, furosemide, oral steroids and bisphosphonates and improved with treatment.     

Case series of pediatric systemic lupus erythematosus from Kerala: comparison with other Indian series

Aim: To determine the clinical and laboratory characteristics of patients diagnosed with pediatric systemic lupus erythematosus (pSLE) in the general pediatrics department of a tertiary level hospital in southern India and compare them to data of case series from other parts of the country. Methods: Retrospective chart review by two independent reviewers. All patients diagnosed with SLE in the pediatrics department of the Amrita Institute of Medical Sciences hospital between 1 January 2004 and 31 September 2008, were included in the study. Results: Twenty children were diagnosed with pSLE in the above‐mentioned period (female : male ratio 2.3 : 1.0). Fever (75% of patients) and arthralgia (65%) were the most common clinical presenting features. Many patients who were referred as ‘Fever of unknown origin’ (37.5%) or ‘idiopathic thrombocytopenic purpura’ (15%) fulfilled the diagnosis of SLE on detailed evaluation. Renal manifestations were present in 11 patients, seven of whom underwent a biopsy. Class IV lupus nephritis was the most common finding (4/7). A very high percentage of our patients had hypocomplementemia (85%). The statistical significance of the differences between our cohort and previously reported cohorts could not be determined. Conclusions: pSLE patients in our series, compared to previous literature from India had a much higher incidence of fever, thrombocytopenia and hypocomplementemia at presentation and much lower incidence of arthritis. It is unclear whether these differences represent unique characteristics of ethnically dissimilar subsets of the Indian population. A high index of suspicion should be maintained in order to make an early diagnosis of pSLE, since the most common presenting features in our cohort were arthralgia and fever.