Intra-radicular dentin treatments and retention of fiber posts with self-adhesive resin cements

The aim of this study was to evaluate the effect of treating intraradicular dentin with irrigating solutions on the retention of glass-fiber posts luted with self-adhesive resin cement. Bovine incisors were endodontically treated, and 9-mm-deep postholes were prepared. Before inserting the cement, the root canals were irrigated with various solutions: 11.5% polyacrylic acid for 30 s, 17% EDTA for 60 s, or 5% NaOCl for 60 s, respectively. Irrigation with distilled water was used in the control group. After all specimens had been rinsed with distilled water, the excess moisture was removed and the posts were luted using either BisCem (Bisco) or RelyX Unicem clicker (3M ESPE). Seven days after luting, the specimens were sectioned transversally into 1-mm-thick slices, which were submitted to push-out testing on a mechanical testing machine. Bond strength data (n = 6 per group) were analyzed by two-way ANOVA and Student-Newman-Keuls' test (α = 0.05). For Unicem, EDTA showed lower bond strength than the other solutions, which had similar results. For BisCem, EDTA showed higher bond strength than the other treatments, while application of NaOCl yielded higher bond strength than polyacrylic acid whereas the control group had intermediate results. In conclusion, irrigating root canals before insertion of self-adhesive resin cements, especially EDTA, might interfere with retention of the fiber posts

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Effect of different final irrigation solutions on dentinal tubule penetration depth and percentage of root canal sealer

WOS: 000304691200026PubMed ID: 22595128Introduction: The purpose of this study was to evaluate the effects of different solutions used for final irrigation on sealer penetration into dentinal tubules. Methods: Thirty-two recently extracted human mandibular premolar teeth were treated with sodium hypochlorite (NaOCl) irrigation. The samples were divided into 4 groups according to the final irrigation solution used: (1) the EDTA group: 17% EDTA + 2.5% NaOCl, (2) the maleic acid (MA) group: 7% MA + 2.5% NaOCl, (3) the citric acid (CA) group: 10% CA + 2.5% NaOCl, and (4) the control group: 2.5% NaOCl. All teeth were obturated using the cold lateral condensation technique with gutta-percha and AH 26 sealer (Dentsply; DeTrey, Konstanz, Germany) labeled with fluorescent dye. The teeth were sectioned at distances of 2, 5, and 8 mm from the root apex. Total percentage and maximum depth of sealer penetration were measured using confocal laser scanning microscopy. Results: The Kruskal-Wallis analysis results showed that there was a significant difference in the percentage and maximum depth of sealer penetration among all groups in all sections (P<.05). The coronal sections in each group showed a significantly higher percentage and maximum depth of sealer penetration than did the apical and middle sections (P<.05). Conclusions: Final irrigation with EDTA, MA, and CA after the use of NaOCl affected sealer penetration. However, there was no significant difference between these experimental groups (EDTA, MA, and CA) in all sections

Effect of Different Final Irrigation Solutions on Dentinal Tubule Penetration Depth and Percentage of Root Canal Sealer

Introduction: The purpose of this study was to evaluate the effects of different solutions used for final irrigation on sealer penetration into dentinal tubules. Methods: Thirty-two recently extracted human mandibular premolar teeth were treated with sodium hypochlorite (NaOCl) irrigation. The samples were divided into 4 groups according to the final irrigation solution used: (1) the EDTA group: 17% EDTA + 2.5% NaOCl, (2) the maleic acid (MA) group: 7% MA + 2.5% NaOCl, (3) the citric acid (CA) group: 10% CA + 2.5% NaOCl, and (4) the control group: 2.5% NaOCl. All teeth were obturated using the cold lateral condensation technique with gutta-percha and AH 26 sealer (Dentsply; DeTrey, Konstanz, Germany) labeled with fluorescent dye. The teeth were sectioned at distances of 2, 5, and 8 mm from the root apex. Total percentage and maximum depth of sealer penetration were measured using confocal laser scanning microscopy. Results: The Kruskal-Wallis analysis results showed that there was a significant difference in the percentage and maximum depth of sealer penetration among all groups in all sections (P<.05). The coronal sections in each group showed a significantly higher percentage and maximum depth of sealer penetration than did the apical and middle sections (P<.05). Conclusions: Final irrigation with EDTA, MA, and CA after the use of NaOCl affected sealer penetration. However, there was no significant difference between these experimental groups (EDTA, MA, and CA) in all sections. (J Endod 2012;38:860-863

Inhibition of cell survival, viability and proliferation by dentin adhesives after direct and indirect exposure in vitro

WOS: 000311362300016PubMed ID: 22222515Objectives The influence of dentin adhesive systems (Scotchbond Multi-Purpose, XP Bond, Xeno V, Clearfil Protect Bond, AdheSE) on cell survival, viability and proliferation was characterized after direct and indirect exposure using different cell culture techniques. Materials and methods The primers and cured bonding parts were directly exposed to cells using cell culture inserts, and complete materials were analyzed in a dentin barrier test. Cell responses were examined in 3T3 mouse fibroblasts after 24- and 72-h exposure periods by the estimation of total cell numbers (survival), apoptosis (viability) and cell proliferation. Results Cell numbers were effectively reduced by the primers of AdheSE, Protect Bond, and Scotchbond Multi-Purpose as well as XP bond after direct exposure in a cell culture insert test device. Likewise, Scotchbond Multi-Purpose primer induced a rate of apoptosis (93.9%) even higher than detected with Protect Bond primer (91.6%). Cell proliferation was entirely inhibited by primers and by Xp Bond as well. The Scotchbond Multi-Purpose was most cytotoxic in a dentin barrier test device after a 24-h indirect exposure. It also increased the percentage of cells in apoptosis to 15.4% compared to untreated controls. Conclusion Unpolymerized primers of dentin adhesives were more cytotoxic than polymerized bonding counterparts. Moreover, total etch dentin adhesives were more cytotoxic than self-etch adhesives. Clinical relevance When dentin adhesives are used in deep cavities without a protective dentin barrier the leachable hydrophobic and hydrophilic component of dentin adhesive systems can penetrate to the pulp and may induce cytotoxic responses in pulp tissues.Scientific Research Projects Coordination Unit of Istanbul University [3230]The current study is based on a thesis submitted to the graduate faculty, University of Istanbul, in partial fulfillment of the requirements for the degree of Doctor of Philosophy and was supported by Scientific Research Projects Coordination Unit of Istanbul University. Project number 3230