The Effect of Bevel on Fracture Resistance of GIC Restorations in Primary Molars: In Vitro Study Rôle du Biseau dans la Résistance à la Fracture des Restaurations aux Ciments Verres-Ionomères des Molaires Temporaires : Étude In Vitro

Background: Glass ionomer cements (GICs) are commonly used for restorations in primary molars due to their adhesive, hydrophilic, and bioactive properties. However, their low mechanical resistance may limit their use in proximal cavities. Recent advancements in GICs, such as the high viscosity GIC EQUIA Forte®, have improved their mechanical properties. The effect of a Cavo superficial bevel on the mechanical strength of GIC restorations has been previously studied. Objectives: To investigate the effect of a Cavo superficial bevel on fracture resistance and the type of fracture (adhesive, cohesive, or catastrophic) in EQUIA Forte® GIC restorations in primary molars. Methods: 56 standardized proximal cavities were created on 51 temporary molars. The cavities were randomly divided into two groups: group I without a Cavo superficial bevel (n=28) and group II with a 45° Cavo superficial bevel (n=28). The cavities were restored with EQUIA Forte®. The samples were subjected to thermocycling and artificial aging, then, an axial speed loading of 1 mm/min was applied until fracture. Fracture toughness was recorded, and the type of fracture was observed under an optical microscope. A Mann-Whitney U test was used to compare the average fracture resistance between the groups. All tests were two-tailed and the level of significance was set at 5%. Results: The average fracture resistance for group I was (237.57 ± 139.97 N) and for group II was (294.89 ± 171.07 N). There was no statistically significant difference in fracture resistance between the two groups (p\u3e0.05). Mixed fractures were observed in all samples, with adhesive fractures only present in group I and cohesive fractures only present in group II. Conclusion: The Cavo superficial bevel does not significantly affect the fracture resistance of GIC restorations in primary molars. However, the bevel design may prevent adhesive and catastrophic fractures. Contexte : Les ciments verres-Ionomères (CVI) sont couramment utilisés pour les restaurations des molaires temporaires grâce à leurs propriétés adhésives, hydrophiles et bioactives. Cependant, leur faible résistance mécanique limite leur utilisation dans les cavités proximales. Avec les récents progrès de cette classe de matériaux, un CVI à haute viscosité a été introduit : EQUIA Forte®, visant à améliorer leurs propriétés mécaniques. Le rôle du biseau cavo-superficiel sur la résistance mécanique des restaurations au CVI a déjà été étudié. Objectifs : Tester le rôle du biseau dans l’amélioration de la résistance à la fracture et d’étudier la nature du trait de fracture adhésif, cohésif, ou catastrophique des restaurations aux CVI EQUIA Forte® des molaires temporaires. Méthodes : 56 cavités proximales standardisées ont été réalisées sur 51 molaires temporaires. Ces cavités ont été divisées aléatoirement en deux groupes : groupe I sans biseau cavo-superficiel (n=28) et groupe II avec biseau cavo-superficiel de 45° (n=28). Les cavités ont été restaurées par EQUIA Forte®. Les échantillons ont été soumis à un thermocyclage et à un vieillissement artificiel, puis une vitesse axiale de chargement de 1 mm/min a été appliquée jusqu\u27à la fracture. La résistance à la fracture a été enregistrée et le type de fracture a été observé au microscope optique. Le test de Mann-Whitney U a été utilisé pour comparer la résistance moyenne à la fracture entre les groupes. Tous les tests étaient bilatéraux et le niveau de signification a été fixé à 5 %. Résultats : La résistance moyenne à la fracture pour le groupe I était de (237,57 ± 139,97 N) et pour le groupe II était de (294,89 ± 171,07 N). Il n\u27y avait pas de différence statistiquement significative en termes de résistance à la fracture entre les deux groupes (p \u3e 0,05). Cependant, des fractures mixtes ont été observées dans tous les échantillons, les fractures adhésives étant uniquement présentes dans le groupe I et les fractures cohésives présentes uniquement dans le groupe II. Conclusion : Le biseau cavo-superficiel n\u27influence pas de manière significative la résistance à la fracture des restaurations CVI des molaires temporaires. Cependant, il s’est avéré que la conception du biseau empêche les fractures adhésives et catastrophiques d’avoir lieu. Mots clés : Biseau, CVI, Classe II, Molaires Temporaires, Restauration, Type de fractur

Virtual reality for healthcare: A scoping review of commercially available applications for head-mounted displays

Objective: This scoping review aimed to describe the scope of commercially available virtual reality (VR) healthcare applications for mainstream head-mounted displays (HMD)s. Methods: A search was conducted during late April and early May 2022 over five major VR app stores using “health,” “healthcare,” “medicine,” and “medical” as keywords. Apps were screened based on their title and description sections. Metadata collected included: title, description, release date, price (free or paid), multilingual support, VR app store availability, and HMD support. Results: The search yielded 1995 apps, out of which 60 met the inclusion criteria. The analysis showed that the number of healthcare VR apps has been steadily increasing since 2016, but no developer has released more than two apps so far. Most of the reviewed apps can run on HTC Vive, Oculus Quest, and Valve Index. Thirty-four (56.7%) apps had a free version, and 12 (20%) apps were multilingual, i.e., supported languages other than English. The reviewed apps fell into eight major themes: life science education (3D anatomy, physiology and pathology, biochemistry, and genetics); rehabilitation (physical, mental, and phobia therapy); public health training (safety, life-saving skills, and management); medical training (surgical and patient simulators); role-playing as a patient; 3D medical imagery viewing; children’s health; and online health communities. Conclusions: Although commercial healthcare VR is still in its early phases, end-users can already access a broad range of healthcare VR apps on mainstream HMDs. Further research is needed to assess the usefulness and usability of existing apps

Cost of bladder cancer in Lebanon before and after the economic collapse: a probabilistic modeling study

Abstract Background and objectives Lebanon has one of the highest incidence rates of bladder cancer (BC) in the world. In 2019, Lebanon’s economy collapsed which majorly impacted healthcare costs and coverage. This study assesses the overall direct costs of urothelial BC in Lebanon, from the perspective of public and private third-party payers (TPP) and households, and evaluates the impact of the economic collapse on these costs. Methods This was a quantitative, incidence-based cost-of-illness study, conducted using a macro-costing approach. Costs of medical procedures were obtained from the records of various TPPs and the Ministry of Public Health. We modeled the clinical management processes for each stage of BC, and conducted probabilistic sensitivity analyses to estimate and compare the cost of each stage, pre-and post-collapse, and for each payer category. Results Before the collapse, the total annual cost of BC in Lebanon was estimated at LBP 19,676,494,000 (USD 13,117,662). Post-collapse, the total annual cost of BC in Lebanon increased by 768% and was estimated at LBP 170,727,187,000 (USD 7,422,921). TPP payments increased by 61% whereas out-of-pocket (OOP) payments increased by 2,745% resulting in a decrease in TPP coverage to only 17% of total costs. Conclusion Our study shows that BC in Lebanon constitutes a significant economic burden costing 0.32% of total health expenditures. The economic collapse induced an increase of 768% in the total annual cost, and a catastrophic increase in OOP payments