Effect Of Etching Time And Light Source On The Bond Strength Of Metallic Brackets To Ceramic

This study evaluated the bond strength of brackets to ceramic testing different etching times and light sources for photo-activation of the bonding agent. Cylinders of feldspathic ceramic were etched with 10% hydrofluoric acid for 20 or 60 s. After application of silane on the ceramic surface, metallic brackets were bonded to the cylinders using Transbond XT (3M Unitek). The specimens for each etching time were assigned to 4 groups (n=15), according to the light source: XL2500 halogen light, UltraLume 5 LED, AccuCure 3000 argon laser, and Apollo 95E plasma arc. Light-activation was carried out with total exposure times of 40, 40, 20 and 12 s, respectively. Shear strength testing was carried out after 24 h. The adhesive remnant index (ARI) was evaluated under magnification. Data were subjected to two-way ANOVA and Tukey's test (α=0.05). Specimens etched for 20 s presented significantly lower bond strength (p0.05) were detected among the light sources. The ARI showed a predominance of scores 0 in all groups, with an increase in scores 1, 2 and 3 for the 60 s time. In conclusion, only the etching time had significant influence on the bond strength of brackets to ceramic.223245248Barghi, N., Fischer, D.E., Vatani, L., Effects of porcelain leucite content, types of etchants, and etching time on porcelaincomposite bond (2006) J Esthet Restor Dent, 18, pp. 47-52Nagayassu, M.P., Shintome, L.K., Uemura, E.S., Araújo, J.E., Effect of surface treatment on the shear bond strength of a resin-based cement to porcelain (2006) Braz Dent J, 17, pp. 290-295Shimada, Y., Yamaguchi, S., Tagami, J., Micro-shear bond strength of dual-cured resin cement to glass ceramics (2002) Dent Mater, 18, pp. 380-388Chen, J.H., Matsumura, H., Atsuta, M., Effect of different etching periods on the bond strength of a composite resin to a machinable porcelain (1998) J Dent, 26, pp. 53-58Guler, A.U., Yilmaz, F., Yenisey, M., Guler, E., Ural, C., Effect of acid etching time and a self-etching adhesive on the shear bond strength of composite resin to porcelain (2006) J Adhes Dent, 8, pp. 21-25Kasuya, K., Miyazaki, Y., Ogawa, N., Maki, K., Manabe, A., Itoh, K., Efficacy of experimental dual-cure resin cement for orthodontic direct bond system (2006) Orthod Waves, 65, pp. 107-111Meguro, D., Hayakawa, T., Kasai, K., Efficacy of using orthodontic adhesive resin in bonding and debonding characteristics of a calcium phosphate ceramic bracket (2006) Orthod Waves, 65, pp. 148-154Dall'igna, C.M., Marchioro, E.M., Spohr, A.M., Mota, E.G., Effect of curing time on the bond strength of a bracket-bonding system cured with a light-emitting diode or plasma arc light (2011) Eur J Orthod, 33, pp. 55-59Correr, A.B., Sinhoreti, M.A., Sobrinho, L.C., Tango, R.N., Schneider, L.F., Consani, S., Effect of the increase of energy density on Knoop hardness of dental composites light-cured by conventional QTH, LED and xenon plasma arc (2005) Braz Dent J, 16, pp. 218-224Cekic-Nagas, I., Egilmez, F., Ergun, G., The effect of irradiation distance on microhardness of resin composites cured with different light curing units (2010) Eur J Dent, 4, pp. 440-446Thind, B.S., Stirrups, D.R., Lloyd, C.H., A comparison of tungstenquartz- halogen, plasma arc and light-emitting diode light sources for the polymerization of an orthodontic adhesive (2006) Eur J Orthod, 28, pp. 78-82Filipov, I.A., Vladimirov, S.B., Residual monomer in a composite resin after light-curing with different sources, light intensities and spectra of radiation (2006) Braz Dent J, 17, pp. 34-38Park, J.K., Hur, B., Ko, C.C., García-Godoy, F., Kim, H.I., Kwon, Y.H., Effect of light-curing units on the thermal expansion of resin nanocomposites (2010) Am J Dent, 23, pp. 331-334Price, R.B., Labrie, D., Rueggeberg, F.A., Felix, C.M., Irraciance differences in the violet (405 nm) and blue (460 nm) spectral ranges among dental light-curing units (2010) J Esthet Restor Dent, 22, pp. 363-377Yen, T.W., Blackman, R.B., Baez, R.J., Effect of acid etching on the flexural strength of a feldspathic porcelain and a castable glass ceramic (1993) J Prosthet Dent, 70, pp. 224-233Reynolds, I.R., Composite filling materials as adhesives in orthodontics (1975) Br Dent J, 138, p. 83Rueggeberg, F., Contemporary issues in photocuring (1999) Compend Contin Educ Dent, (SUPPL.), pp. 4-15Olsen, M.E., Bishara, S.E., Boyer, D.B., Jakobsen, J.R., Effect of varying etching times on the bond strength of ceramic brackets (1996) Am J Orthod Dentofacial Orthop, 109, pp. 403-409Sant'anna, E.F., Monnerat, M.E., Chevitarese, O., Stuani, M.B., Bonding brackets to porcelain - in vitro study (2002) Braz Dent J, 3, pp. 191-196Canay, S., Hersek, N., Ertan, A., Effect of different acid treatments on a porcelain surface (2001) J Oral Rehabil, 28, pp. 95-10

Effects Of Thermocycling And Light Source On The Bond Strength Of Metallic Brackets To Bovine Teeth

This study evaluated the effects of thermocycling and different light sources on the bond strength of metallic brackets to bovine tooth enamel using an adhesive resin. Bovine teeth were etched with 35% phosphoric acid gel for 20 s. After application of primer, metallic brackets were bonded to the buccal surface using Transbond XT, forming 8 groups (n=20), depending on the light source used for photoactivation (AccuCure 3000 argon laser - 20 s, Apollo 95E plasma arc - 12 s, UltraLume 5 LED - 40 s and XL2500 halogen light - 40 s) and experimental conditions without (Groups 1 to 4) or with thermocycling (Groups 5 to 8). Shear bond testing was carried out after 24 h of distilled water storage (Groups 1 to 4) or storage and thermocycling in distilled water (groups 5 to 8; 1,500 cycles - 5°/55°C). Data were subjected to two-way ANOVA and Tukey's test (α=0.05). The Adhesive Remnant Index (ARI) was evaluated at ×8 magnification. No significant differences (p>0.05) in bond strength were found when the conditions without and with thermocycling were compared for any of the light sources. No significant differences (p>0.05) in bond strength were found among the light sources, irrespective of performing or not thermocycling. There was a predominance of ARI scores 1 in all groups. In conclusion, light sources and thermocycling had no influence on the bond strength of brackets to bovine enamel.226486489Sfondrini, M.F., Cacciafesta, V., Scribante, A., Klersy, C., Plasma arc versus halogen light curing of orthodontic brackets: A 12-month clinical study of bond failures (2004) Am J Orthod Dentofacial Orthop, 125, pp. 342-347Dall'igna, C.M., Marchioro, E.M., Spohr, A.M., Mota, E.G., Effect of curing time on the bond strength of a bracket-bonding system cured with a light-emitting diode or plasma arc light (2011) Eur J Orthod, 33, pp. 55-59Correr, A.B., Sinhoreti, M.A., Sobrinho, L.C., Tango, R.N., Schneider, L.F., Consani, S., Effect of the increase of energy density on Knoop hardness of dental composites light-cured by conventional QTH, LED and xenon plasma arc (2005) Braz Dent J, 16, pp. 218-224Cekic-Nagas, I., Egilmez, F., Ergun, G., The effect of irradiation distance on microhardness of resin composites cured with different light curing units (2010) Eur J Dent, 4, pp. 440-446Thind, B.S., Stirrups, D.R., Lloyd, C.H., A comparison of tungsten- quartz halogen, plasma arc and light-emitting diode light sources for the polymerization of an orthodontic adhesive (2006) Eur J Orthod, 28, pp. 78-82Filipov, I.A., Vladimirov, S.B., Residual monomer in a composite resin after light-curing with different sources, light intensities and spectra of radiation (2006) Braz Dent J, 17, pp. 34-38Park, J.K., Hur, B., Ko, C.C., García-Godoy, F., Kim, H.I., Kwon, Y.H., Effect of light-curing units on the thermal expansion of resin nanocomposites (2010) Am J Dent, 23, pp. 331-334Price, R.B., Labrie, D., Rueggeberg, F.A., Felix, C.M., Irradiance differences in the violet (405 nm) and blue (460 nm) spectral ranges among dental light-curing units (2010) J Esthet Restor Dent, 22, pp. 363-377Gonçalves, P.R.A., Moraes, R.R., Costa, A.R., Correr, A.B., Nouer, P.R.A., Sinhoreti, M.A.C., Effect of etching time and light source on the bond strength of metallic brackets to ceramic (2011) Braz Dent J, 22, pp. 245-248Swanson, T., Dunn, W.J., Childers, D.E., Taloumis, L.J., Shear bond strength of orthodontic brackets bonded with light-emitting diode curing units at various polymerization times (2004) Am J Orthod Dentofacial Orthop, 125, pp. 337-341Usumez, S., Buyukyilmaz, T., Karaman, A.I., Effect of light-emitting diode on bond strength of orthodontic brackets (2004) Angle Orthod, 74, pp. 259-263Talbot, T.Q., Blankenau, R.J., Zobitz, M.E., Weaver, A.L., Lohse, C.M., Rebellato, J., Effect of argon laser irradiation on shear bond strength of orthodontic brackets: An in vitro study (2000) Am J Orthod Dentofacial Orthop, 118, pp. 274-279Klocke, A., Korbmacher, H.M., Huck, L.G., Kahl-Nieke, B., Plasma arc curing lights for orthodontic bonding (2002) Am J Orthod Dentofacial Orthop, 122, pp. 643-648Bishara, S.E., Ostby, A.W., Laffoon, J.F., Warren, J., Shear bond strength comparison of two adhesive systems following thermocycling (2007) Angle Orthod, 77, pp. 337-341Faltermeier, A., Müssig, D., A comparative evaluation of bracket bonding with 1-, 2-, and 3-component adhesive systems (2007) Am J Orthod Dentofacial Orthop, 132, pp. 144.e1-144.e5Gale, M.S., Darvell, B.W., Thermal cycling procedures for laboratory testing of dental restorations (1999) J Dent, 27, pp. 89-99Trites, B., Foley, T.F., Banting, D., Bond strength comparison of 2 self-etching primers over a 3-month storage period (2004) Am J Orthod Dentofacial Orthop, 126, pp. 709-716Yuasa, T., Iijima, M., Ito, S., Muguruma, T., Saito, T., Mizoguchi, I., Effects of long-term storage and thermocycling on bond strength of two self-etching primer adhesive systems (2010) Eur J Orthod, 32, pp. 285-290Artun, J., Berglund, S., Clinical trials with crystal growth conditioning as an alternative to acid-etch enamel pretreatment (1984) Am J Orthod, 85, pp. 333-340Oesterle, L.J., Newman, S.M., Shellhart, W.C., Rapid curing of bondingcomposite with a xenon plasma arc light (2001) Am J Orthod Dentofacial Orthop, 119, pp. 610-616Staudt, C.B., Mavropoulos, A., Bouil, L.S., Kiliaridis, S., Krejcid, I., Light-curing time reduction with a new high-power halogen lamp (2005) Am J Orthod Dentofacial Orthop, 128, pp. 749-754Yu, H.S., Lee, K.J., Jin, G.C., Baik, H.S., Comparison of the shear bond strength of brackets using the LED curing light and plasma arc curing light: Polymerization time (2007) World J Orthod, 8, pp. 129-135Rueggeberg, F., Contemporary issues in photocuring (1999) Compend Contin Educ Dent Suppl, pp. 4-15de Munck, J., van Landuyt, K., Peumans, M., Poitevin, A., Lambrechts, P., Braem, M., A critical review of the durability of adhesion of tooth tissue: Methods and results (2005) J Dent Res, 84, pp. 118-132Reynolds, I.R., Composite filling materials as adhesives in Orthodontics (1975) Br Dent J, 138, p. 8

Shear Bond Strength Of Metallic Brackets Bonded With A New Orthodontic Composite

Aim: The aim of this study was to assess the shear bond strength of orthodontic brackets in different enamel surfaces using the Transbond Plus Color Change composite (TPCC-3M Unitek), and to analyze the Adhesive Remnant Index (ARI). Methods: Seventy-two human premolars were divided into six groups (n = 12), as follows: Group 1(control) - Transbond XT conventional; in Groups 2 to 6, TPCC was used under the following enamel treatment conditions: phosphoric acid and XT-primer; Transbond Plus Self-Etching Primer (TPSEP); phosphoric acid only; phosphoric acid, XT-primer and saliva; and TPSEP and saliva, respectively. Twenty-four hours after bonding, the brackets were debonded with an Instron machine at a crosshead speed of 0.5 mm/min, and ARI was evaluated by using a stereoscopic magnifying glass. Results: The mean shear strength values (MPa) for Groups 1 to 6 were 24.6, 18.7, 17.5, 19.7, 17.5 and 14.8, respectively. Data were submitted to ANOVA and Tukey’s test (? = 0.05). Group 1 had significantly higher shear bond strength values than Groups 3, 5, and 6 (p 0.05). No statistically significant differences (p > 0.05) were found between Groups 2, 3, 4, 5 and 6. Conclusions: Bracket bonding using TPCC showed adequate adhesion for clinical use, and the type of enamel preparation had no influence.8276-8

Effect of the increase of energy density on knoop hardness of dental composites light-cured by conventional QTH, LED and xenon plasma arc

The aim of this study was to evaluate the effect of the increase of energy density on Knoop hardness of Z250 and Esthet-X composite resins. Cylindrical cavities (3 mm in diameter X 3 mm in depth) were prepared on the buccal surface of 144 bovine incisors. The composite resins were bulk-inserted and polymerized using different light-curing units and times: conventional QTH (quartz-tungsten-halogen; 700 mW/cm²; 20 s, 30 s and 40 s); LED (light-emitting diode; 440 mW/cm²; 20 s, 30 s and 40 s); PAC (xenon plasma arc; 1700 mW/cm²; 3 s, 4.5 s and 6 s). The specimens were stored at 37°C for 24 h prior to sectioning for Knoop hardness assessment. Three measurements were obtained for each depth: top surface, 1 mm and 2 mm. Data were analyzed statistically by ANOVA and Tukey's test (p0.05) were found for QTH. Knoop hardness values decreased with the increase of depth. The increase of energy density produced composites with higher Knoop hardness means using LED and PAC.Este estudo teve como objetivo avaliar o efeito do aumento da densidade de energia na dureza Knoop das resinas compostas Z250 e Esthet-X. Cavidades cilíndricas (3 mm de diâmetro X 3mm de profundidade) foram preparadas na superfície vestibular de 144 incisivos bovinos. As resinas compostas foram inseridas em incremento único e fotopolimerizadas com diferentes unidades e tempos de fotopolimerização: luz halógena convencional (700 mW/cm²; 20 s, 30 s and 40 s); LED (diodo emissor de luz; 440 mW/cm²; 20 s, 30 s and 40 s); PAC (arco de plasma de xenônio; 1700 mW/cm²; 3 s, 4,5 s and 6 s). Os espécimens foram armazenados a 37°C durante 24 h, previamente à realização das leituras de dureza Knoop. Foram realizadas três leituras por profundidade: superfície, 1 mm e 2 mm. Os dados foram submetidos à ANOVA e ao teste de Tukey (p0.05). Os valores de dureza Knoop diminuíram com o aumento da profundidade. O aumento da densidade de energia produziu compósitos com maior dureza Knoop quando o LED e o PAC foram utilizados como fontes de polimerização.21822

Clinical evaluation of the failure rates of metallic brackets

The aim of this study was to evaluate in vivo the bonding of metallic orthodontic brackets with different adhesive systems. Material and methods: Twenty patients (10.5-15.1 years old) who had sought corrective orthodontic treatment at a University Orthodontic Clinic were evaluated. Brackets were bonded from the right second premolar to the left second premolar in the upper and lower arches using: Orthodontic Concise, conventional Transbond XT, Transbond XT without primer, and Transbond XT associated with Transbond Plus Self-etching Primer (TPSEP). The 4 adhesive systems were used in all patients using a split-mouth design; each adhesive system was used in one quadrant of each dental arch, so that each group of 5 patients received the same bonding sequence. Initial archwires were inserted 1 week after bracket bonding. The number of bracket failures for each adhesive system was quantified over a 6-month period. Results: The number of debonded brackets was: 8- Orthodontic Concise, 2- conventional Transbond XT, 9- Transbond XT without primer, and 1- Transbond XT + TPSEP. By using the Kaplan-Meier methods, statistically significant differences were found between the materials (p=0.0198), and the Logrank test identified these differences. Conventional Transbond XT and Transbond XT + TPSEP adhesive systems were statistically superior to Orthodontic Concise and Transbond XT without primer (p<0.05). There was no statistically significant difference between the dental arches (upper and lower), between the dental arch sides (right and left), and among the quadrants. Conclusions: The largest number of bracket failures occurred with Orthodontic Concise and Transbond XT without primer systems and few bracket failures occurred with conventional Transbond XT and Transbond XT+TPSEP. More bracket failures were observed in the posterior region compared with the anterior region.20222823

Efeito da contaminação salivar e do tempo de recondicionamento ácido na resistência da união ao cisalhamento de um selante de fóssulas e fissuras

O propósito deste estudo foi avaliar o efeito do tempo de contaminação salivar (TCS) e de recondicionamento ácido (TRA) na resistência da união ao cisalhamento (RC) do selante Fluroshield. Foram selecionados 45 terceiros molares. Os dentes foram seccionados no sentido mésio-distal e suas superfícies foram lixadas até a obtenção de uma área plana em esmalte. Em seguida, as amostras foram distribuídas aleatoriamente em 9 grupos (n=10), em função do TCS e TRA (segundos), respectivamente: G1 - controle; G2 - 30 e 0; G3 - 60 e 0; G4 - 30 e 2; G5 - 30 e 5; G6 - 30 e 15; G7 - 60 e 2; G8 - 60 e 5; G9 - 60 e 15. Em seguida, foi realizada a aplicação do selante de acordo com as instruções do fabricante. Os corpos-de-prova obtidos foram armazenados em água destilada a 37&ordm;C por 72 horas, e então submetidos ao ensaio de cisalhamento à velocidade de 0,5mm/min. Os resultados foram submetidos à análise de variância (ANOVA), e indicaram que não houve diferença estatística significativa (p>;0,05) entre todos os grupos. Observou-se que: 1 - quanto maior o TCS, menores os valores de RC (MPa); 2- quanto maior o TRA, maior o valor de RC (MPa). Pôde-se concluir que houve uma tendência para o menor TCS (30s) e os maiores TRA (5 e 15s) em retornar aos valores de RC do grupo controle.The aim of this study was to evaluate the effect of saliva contamination (SCT) and re-etching time (RET) on the shear bond strength (SBS) of the Fluroshield sealant. Forty-five extracted third molars were sectioned and flattened until reach an enamel surface area. Then, all samples were etched for 30 sec with 35% phosphoric acid and then they were distributed into 9 groups (n=10) according to SCT and RET (seconds), respectively: G1- control (no SCT and no RET); G2- 30s and 0s; G3- 60s and 0s; G4-30s and 2s; G5- 30s and 5s; G6- 30s and 15s; G7-60s and 2s; G8- 60s and 5s; G9- 60s and 15s. The sealant was applied according to the manufacturer's instructions. The samples were stored in distilled water at 37&ordm;C for 72h and subjected to the SBS test. The results indicated that there was no statistically significant difference between the groups (p>;0.05). However, it could be noticed that: 1- the longer the SCT, the lower the SBS values; 2 - the longer the RET, the higher the SBS values. It could be concluded that there was a tendency to the shortest SCT (30s) associated to the longest RET (5 and 15s) to reach similar SBS values for the control group

Chx stabilizes the resin/demineralized dentin interface

The aim of this study was to evaluate the effect of 2% chlorhexidine diglueonate (CHX) on microtensile bond strength (μTBS) between an adhesive system and under 3 dentin conditions. For that, this study evaluated the adhesive interface at initial, after 6 months and 1 year of storage. Forty-eight human third molars were prepared and randomly divided into 3 groups, according to dentin substrates: Sound dentin (Sd), caries-infected dentin (Ci) and caries-affected dentin (Ca). The groups were subdivided into two according to the dentin pre-treatment: Application of 2% CHX or without pre-treatment (control). The dentin surfaces were etched with 35% phosphoric acid gel and bonded with Adper Single Bond 2 (3M ESPE) adhesive system according to manufacturer's instructions. Subsequently, the specimens were stored in deionized water at 37°C for 24h, 6 months and 1 year. Two additional teeth were used to analyze the bonding interfaces by SEM. Data was submitted to three-way ANOVA in a split plot design and Tukey's test (α = 0.05). The results showed that Ci decreased μTBS values when compared to Ca and Sd, regardless storages time or treatment. Stored samples for 6 months and 1 year decreased the pTBS for the control group, but no difference was found between storages time for the CHX group. As a conclusion, the 2% CHX application after etching showed improved dentin bond strength in the storage time, regardless of the substrates evaluated

Efficacy, safety and tolerability of using abatacept for the treatment of rheumatoid arthritis

The objective is to provide an update on the clinical efficacy, safety and tolerability of the use of abatacept for treating rheumatoid arthritis. A systematic review (up to June 2011) followed by meta-analyses was performed. Randomized controlled clinical trials comparing abatacept at a dose of 10 mg/kg with a placebo, both with concomitant methotrexate, were used. Only high- or moderate-quality studies were included. The efficacy was evaluated based on changes in the ACR, DAS and HAQ; safety was assessed based on serious adverse events, serious infections, malignancies and deaths; tolerability was evaluated based on the withdrawals due to adverse events, serious adverse events and lack of efficacy. All these parameters were evaluated within one year of treatment. Nine studies met the inclusion criteria, comprising 4,219 patients. For all of the efficacy parameters, the abatacept group had better results than the placebo group, except in the case of HAQ improvement >;0.3, which presented no statistically significant difference. None of the safety parameters presented a significant difference between the groups. The tolerability parameters were also similar between groups, with the exception of withdrawals due to lack of efficacy. For this criterion, the abatacept group presented favorably compared to the control group. Abatacept showed a higher efficacy compared to placebo without significant differences between the abatacept and control group in terms of safety.O objetivo foi fornecer dados atualizados sobre eficácia clínica, segurança e tolerabilidade do uso de abatacepte para o tratamento da artrite reumatoide. Realizaram-se uma revisão sistemática (com dados até junho/2011) e metanálises. Somente estudos clínicos controlados randomizados comparando o abatacepte (10 mg/kg) com placebo, ambos com uso concomitante de metotrexato, foram incluídos; todos possuíam qualidade alta ou moderada. A eficácia foi avaliada baseando-se em mudanças no ACR, DAS e HAQ; a segurança foi avaliada pelos eventos adversos e infecções graves, malignidades e mortes e a tolerabilidade pelo abandono do tratamento devido a eventos adversos (graves ou não) e falta de eficácia. Todos esses parâmetros foram avaliados ao final de um ano de tratamento. Nove estudos se adequaram aos critérios de inclusão, envolvendo 4219 pacientes. Em todos os parâmetros avaliados, o grupo tratado com abatacepte obteve melhores resultados, exceto para a melhora (>;0,3) no HAQ (sem diferença estatisticamente significativa). Nenhum critério de segurança ou tolerabilidade apresentou diferença significativa entre os grupos, com exceção dos abandonos devido à falta de eficácia (grupo abatacepte apresentou resultados favoráveis em relação ao controle). O abatacepte possui maior eficácia quando comparado com o placebo, sem diferença significativa entre os grupos em termos de segurança

Color stability and gloss of esthetic restorative materials after chemical challenges

This study evaluated gloss and color changes of esthetic restorative materials subjected to different acidic beverages. Specimens of resin composites (Z350XT (Z350), IPS Empress Direct (ED), Charisma Diamond (CD)) were prepared and the initial surface gloss and color (ΔE) were measured (n=10). Then, the specimens were immersed in 4 mL of each of the different beverages (cranberry juice; Coca-Cola; coffee or artificial saliva) during 15 min, 3x/day for 14 days and new gloss and color readings were obtained. Color change was evaluated with the ΔE formula and gloss change values were obtained by the formula: (final gloss - initial gloss). Data was submitted to two-way ANOVA followed by Tukey’s post hoc test (a=0.05). CD showed the lowest color change among resin composites. The highest ΔE values were obtained after immersion in coffee and cranberry juice. Coffee promoted the highest gloss change (worst gloss retention), followed by cranberry juice, Coca-cola and artificial saliva (p<0.05). The type of beverage significantly influenced the gloss of resin composites. Coca-cola reduced gloss of the three resin composites in a similar manner. Coffee affected the ED gloss more than that of Z350 and CD, while cranberry juice affected Z350 more than ED and CD. Saliva had a more pronounced effect on the gloss retention of CD than ED. The beverages used in this study influenced the optical surface properties of the composites studied301525

Efficacy, safety and tolerability of using abatacept for the treatment of rheumatoid arthritis

The objective is to provide an update on the clinical efficacy, safety and tolerability of the use of abatacept for treating rheumatoid arthritis. A systematic review (up to June 2011) followed by meta-analyses was performed. Randomized controlled clinical trials comparing abatacept at a dose of 10 mg/kg with a placebo, both with concomitant methotrexate, were used. Only high- or moderate-quality studies were included. The efficacy was evaluated based on changes in the ACR, DAS and HAQ; safety was assessed based on serious adverse events, serious infections, malignancies and deaths; tolerability was evaluated based on the withdrawals due to adverse events, serious adverse events and lack of efficacy. All these parameters were evaluated within one year of treatment. Nine studies met the inclusion criteria, comprising 4,219 patients. For all of the efficacy parameters, the abatacept group had better results than the placebo group, except in the case of HAQ improvement &gt;0.3, which presented no statistically significant difference. None of the safety parameters presented a significant difference between the groups. The tolerability parameters were also similar between groups, with the exception of withdrawals due to lack of efficacy. For this criterion, the abatacept group presented favorably compared to the control group. Abatacept showed a higher efficacy compared to placebo without significant differences between the abatacept and control group in terms of safety