Two-body wear simulation influence on some direct and indirect dental resin biocomposites : A qualitative analysis

Purpose: The aim of this study was to qualitatively assess the outcomes of two in vitro aging methods, thermal-cycling and twobody wear simulation accomplished with a dual-axis chewing device, on the surface characteristics of eight direct and indirect dental resin biocomposites. Methods: Eighty mesial-occlusal-distal dental cavities were restored with four direct nanohybrid composite materials and with four nano- and micro-hybrid lab-fabricated resin composite inlays. After the restored teeth were subjected to thermal-cycling and wear simulation based on mechanical loading, the surface texture features of the restorations were separately analysed for each of the methods, on epoxy resin models using a digital camera, computer-aided-design system, optical stereo-microscopy and scanning electron microscopy. Results: All the dental restorative resin based composites used in this investigation displayed different cyclic wear patterns after undergoing mechanical loading. After thermal-cycling, the group of resin composite inlays showed a better adaptation, a smoother and more polished occlusal surface compared with direct restorative materials. Only two of direct nanohybrid resin composites performed better after two aging methods. One nanohybrid and the other two microhybrid resin inlays did not perform as expected when they were subjected to simulated wear compared to the rest of test materials. Conclusions: The use of the two-body wear simulation method revealed important information about the behavior of the dental resin-based composites when multiple oral factors are involved in a lab-simulated condition. Furthermore, the macro- and micro-morphological analysis showed different abrasion patterns among the materials being tested according to the filler percentage and distribution of the particles within the resin matrix

A retrospective cohort study:pre-operative oral enteral nutritional optimisation for Crohnʼs disease in a UK tertiary IBD Centre

BACKGROUND: Low‐quality evidence suggests that pre‐operative exclusive enteral nutrition (E/EN) can improve postoperative outcomes in patients with Crohn's disease (CD). It is not standard practice in most centres. AIMS: To test the hypothesis that pre‐operative EN in patients undergoing ileal/ileocolonic surgery for CD is associated with improved postoperative outcome. METHODS: We performed a single centre retrospective observational study comparing surgical outcomes in patients receiving pre‐operative EN (≥600 kcal/day for ≥2 weeks) with those who received no nutritional optimisation. Consecutive adult patients undergoing ileal/ileocolonic resection from 2008 to 2020 were included. The primary outcome was postoperative complications <30 days. Secondary outcomes included EN tolerance, specific surgical complications, unplanned stoma formation, length of stay, length of bowel resected, readmission and biochemical/anthropometric changes. RESULTS: 300 surgeries were included comprising 96 without nutritional optimisation and 204 optimised cases: oral EN n = 173, additional PN n = 31 (4 of whom had received nasogastric/nasojejunal EN). 142/204 (69.6%) tolerated EN. 125/204 (61.3%) initiated EN in clinic. Patients in the optimised cohort were younger at operation and diagnosis, with an increased frequency of penetrating disease and exposure to antibiotics or biologics, and were more likely to undergo laparoscopic surgery. The optimised cohort had favourable outcomes on multivariate analysis: all complications [OR 0.29; 0.15–0.57, p < 0.001], surgical complications [OR 0.41; 95% CI 0.20–0.87, p = 0.02], non‐surgical complications [OR 0.24 95% CI 0.11–0.52, p < 0.001], infective complications [OR 0.32; 95% CI 0.16–0.66, p = 0.001]. CONCLUSIONS: Oral EN was reasonably well tolerated and associated with a reduction in 30‐day postoperative complications. Randomised controlled trials are required to confirm these findings