One-year clinical results of restorations using a novel self-adhesive resin-based bulk-fill restorative.

This prospective study assessed the dual-curing self-adhesive bulk-fill restorative Surefil one. The restorations were placed and reviewed by dental practitioners who are members of a practice-based research network in the United States. Seven practitioners filled 60 cavities (20 class I, 19 class II and 21 class V) in 41 patients with Surefil one without adhesive, according to the manufacturer's instructions. The restorations were evaluated using modified USPHS criteria at baseline, 3 months, and 1 year. Patients were also contacted to report postoperative hypersensitivity one to four weeks after placement. The only patient that showed moderate hypersensitivity after 1 year had previously reported symptoms that were unlikely associated to the class I molar restoration. One class II restoration in a fractured maxillary molar was partially lost. The remaining restorations were found to be in clinically acceptable condition resulting in an annual failure rate of 2%. Color match showed the lowest number of acceptable scores (88%) revealing significant changes over time (P = 0.0002). No significant differences were found for the other criteria (P > 0.05). The novel self-adhesive bulk-fill restorative showed clinically acceptable results in stress-bearing class I and II as well as non-retentive class V cavities at 1-year recall

Extracellular matrixâ based scaffolding technologies for periodontal and periâ implant soft tissue regeneration

The present article focuses on the properties and indications of scaffoldâ based extracellular matrix (ECM) technologies as alternatives to autogenous soft tissue grafts for periodontal and periâ implant plastic surgical reconstruction. The different processing methods for the creation of cellâ free constructs resulting in preservation of the extracellular matrices influence the characteristics and behavior of scaffolding biomaterials. The aim of this review is to discuss the properties, clinical application, and limitations of ECMâ based scaffold technologies in periodontal and periâ implant soft tissue augmentation when used as alternatives to autogenous soft tissue grafts.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153617/1/jper10427.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153617/2/jper10427_am.pd

Biologicsâ based regenerative technologies for periodontal soft tissue engineering

This manuscript provides a stateâ ofâ theâ art review on the efficacy of biologics in root coverage procedures, including enamel matrix derivative, plateletâ derived growth factor, platelet concentrates, and fibroblastâ growth factorâ 2. The mechanism of action and the rationale for using biologics in periodontal plastic surgery, as well as their anticipated benefits when compared with conventional approaches are discussed. Although the clinical significance is still under investigation, preclinical data and histologic evidence demonstrate that biologicâ based techniques are able to promote periodontal regeneration coupled with the provision of tooth root coverage.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154295/1/jper10426_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154295/2/jper10426.pd

Platelet‐Derived Growth Factor Promotes Periodontal Regeneration in Localized Osseous Defects: 36‐Month Extension Results From a Randomized, Controlled, Double‐Masked Clinical Trial

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141092/1/jper0456.pd

Autogenous soft tissue grafting for periodontal and periâ implant plastic surgical reconstruction

This stateâ ofâ theâ art review presents the latest evidence and the current status of autogenous soft tissue grafting for soft tissue augmentation and recession coverage at teeth and dental implant sites. The indications and predictability of the free gingival graft and connective tissue graft (CTG) techniques are highlighted, together with their expected clinical and esthetic outcomes. CTGs can be harvested from the maxillary tuberosity or from palate with different approaches that can have an impact on graft quality and patient morbidity. The influence of CTGs on soft tissue thickness and keratinized tissue width are also discussed.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153773/1/jper10428_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153773/2/jper10428.pd

Living cellâ based regenerative medicine technologies for periodontal soft tissue augmentation

The cultivation of human living cells into scaffolding matrices has progressively gained popularity in the field of periodontal wound healing and regeneration. Living cellular constructs based on fibroblasts, keratinocytes alone or in combination have been developed and used as alternatives to autogenous soft tissue grafts in keratinized tissue augmentation and in root coverage procedures. Their promising advantages include reduced patient morbidity, unlimited graft availability, and comparable esthetics. This manuscript reviews soft tissue augmentation and root coverage procedures using bioengineered living cellular therapy and highlights their expected clinical, esthetic, and patientâ related outcomes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154237/1/jper10429.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154237/2/jper10429_am.pd

Emergency Medical Service, Nursing, and Physician Providers’ Perspectives on Delirium Identification and Management

Purpose of the study The study objective was to understand providers’ perceptions regarding identifying and treating older adults with delirium, a common complication of acute illness in persons with dementia, in the pre-hospital and emergency department environments. Design and methods The authors conducted structured focus group interviews with separate groups of emergency medical services staff, emergency nurses, and emergency physicians. Recordings of each session were transcribed, coded, and analyzed for themes with representative supporting quotations identified. Results Providers shared that the busy emergency department environment was the largest challenge to delirium recognition and treatment. When describing delirium, participants frequently detailed hyperactive features of delirium, rather than hypoactive features. Participants shared that they employed no clear diagnostic strategy for identifying the condition and that they used heterogeneous approaches to treat the condition. To improve care for older adults with delirium, emergency nurses identified the need for more training around the management of the condition. Emergency medical services providers identified the need for more support in managing agitated patients when in transport to the hospital and more guidance from emergency physicians on what information to collect from the patient’s home environment. Emergency physicians felt that delirium care would be improved if they could have baseline mental status data on their patients and if they had access to a simple, accurate diagnostic tool for the condition. Implications Emergency medical services providers, emergency nurses, and emergency physicians frequently encounter delirious patients, but do not employ clear diagnostic strategies for identifying the condition and have varying levels of comfort in managing the condition. Clear steps should be taken to improve delirium care in the emergency department including the development of mechanisms to communicate patients’ baseline mental status, the adoption of a systematized approach to recognizing delirium, and the institution of a standardized method to treat the condition when identified