10-Methacryloyloxydecyl Dihydrogen Phosphate (10-MDP)-Containing Cleaner Improves Bond Strength to Contaminated Monolithic Zirconia: An In-Vitro Study

Contamination of zirconia restorations before cementation can impair the resin–zirconia bonding durability. The objective of this study was to evaluate the effect of human saliva or blood decontamination with 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP)-containing cleaner on the resin–zirconia shear bond strength (SBS). Methods: A total of 220 zirconia specimens were prepared and air-abraded and randomly distributed into 11 groups (n = 20 per group). Except for the control group (no contamination), zirconia specimens were contaminated with either human saliva (five groups) or blood (five groups), and then subjected to one of five cleaning methods: water rinsing, 38% phosphoric acid etchant (Pulpdent Corp., Watertown, MA, USA), 70% isopropanol alcohol (Avalon Pharma, Riyadh, Saudi Arabia), Ivoclean (Ivoclar Vivadent, Schaan, Lichtenstein) and Katana Cleaner (Kuraray Noritake, Tokyo, Japan). The resin–zirconia SBS was tested at 24 h and after thermocycling (10 k cycles). Three-way ANOVA followed by Tukey’s multiple comparisons test were utilized to analyze the SBS data. Failure modes were evaluated using a scanning electron microscope. Results: Both blood and saliva significantly affected resin–zirconia SBS as contaminants. After thermocycling, there was no statistically significant difference between SBS obtained after decontamination with the Katana Cleaner (blood, 6.026 ± 2.805 MPa; saliva, 5.206 ± 2.212 MPa) or Ivoclean (blood, 7.08 ± 3.309 MPa; saliva, 6.297 ± 3.083 MPa), and the control group (no contamination, 7.479 ± 3.64 MPa). Adhesive and mixed failures were the most frequent among the tested groups. Conclusion: Both 10-MDP-containing cleaner (Katana Cleaner) and zirconium oxide-containing cleaner (Ivoclean) could eliminate the negative effect of saliva and blood contamination on resin–zirconia SBS

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results: A total of 4164 patients were included, with a median age of 68 (i.q.r. 57\u201375) years (54\ub79 per cent men). Some 1153 (27\ub77 per cent) received NSAIDs on postoperative days 1\u20133, of whom 1061 (92\ub70 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4\ub76 versus 4\ub78 days; hazard ratio 1\ub704, 95 per cent c.i. 0\ub796 to 1\ub712; P = 0\ub7360). There were no significant differences in anastomotic leak rate (5\ub74 versus 4\ub76 per cent; P = 0\ub7349) or acute kidney injury (14\ub73 versus 13\ub78 per cent; P = 0\ub7666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35\ub73 versus 56\ub77 per cent; P < 0\ub7001). Conclusion: NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement