Urgent Abdominal Re-Explorations

BACKGROUND: Treatment of a number of complications that occur after abdominal surgeries may require that Urgent Abdominal Re-explorations (UARs), the life-saving and obligatory operations, are performed. The objectives of this study were to evaluate the reasons for performing UARs, outcomes of relaparotomies (RLs) and factors that affect mortality. METHODS: Demographic characteristics; initial diagnoses; information from and complications of the first surgery received; durations and outcomes of UAR(s) performed in patients who received early RLs because of complicated abdominal surgeries in our clinic between 01.01.2000 and 31.12.2004 were investigated retrospectively. Statistical analyses were done using the chi-square and Fisher exact tests. RESULTS: Early UAR was performed in 81 out of 4410 cases (1.8%). Average patient age was 50.46 (13–81) years with a male-to-female ratio of 60/21. Fifty one (62.96%) patients had infection, 41 (50.61%) of them had an accompanying serious disease, 24 (29.62%) of them had various tumors and 57 (70.37%) patients were operated under emergency conditions during first operation. Causes of urgent abdominal re-explorations were as follows: leakage from intestinal repair site or from anostomosis (n:34; 41.97%); hemorrhage (n:15; 18.51%); intestinal perforation (n:8; 9.87%); intraabdominal infection or abscess (n:8; 9.87%); progressive intestinal necrosis (n:7; 8.64%); stomal complications (n:5; 6.17%); and postoperative ileus (n:4; 4.93%). Two or more UARs were performed in 18 (22.22%) cases, and overall mortality was 34.97% (n:30). Interval between the first laparotomy and UAR averaged as 6.95 (1–20) days, and average hospitalization period was 27.1 (3–78) days. Mortality rate was found to be higher among the patients who received multiple UARs. The most common (55.5%) cause of mortality was sepsis/multiple organ failure (MOF). The rates for common mortality and sepsis/MOF-dependent mortality that occured following UAR were significantly higher in patients who received GIS surgery than in those who received other types of surgeries (p:0.000 and 0.010, respectively). CONCLUSION: UARs that are performed following complicated abdominal surgeries have high mortality rates. In particular, UARs have higher mortality rates following GIS surgeries or when infectious complications occur. The possibility of efficiently lowering these high rates depends on the success of the first operations that the patient had received

JOURNAL OF NANOMATERIALS

This study examines the properties of nanobased dental restorativematerials with nanoindentationmethod in a precise, repeatable, and comparableway. Microhybrid and nanohybrid composites, conventional glass ionomermaterials, and light cured nanoionomer materialswere utilised for the study. Specimen discs (r = 10mm, h = 2 mm) were prepared to test the hardness, modulus of elasticity, yield strength, and fracture toughness values for each sample in a nanoindentation device with an atomic force microscopy addon (n = 25). Comparative analyses were performed by one-way ANOVA and post hoc Tukey tests. The hardness and modulus of elasticity values of nanocomposite were higher (2.58 GPa and 32.86GPa, resp.) than those of other dental materials. Although glass ionomer exhibited a hardness that was similar to a nanoionomer (0.81 versus 0.87GPa), glass ionomer had the lowest fracture toughness value (K-c = 0.83MPa/mm(0.5)). The mechanical properties of resin composites improve with additional nanoscale fillers, unlike the glass ionomer material

Sağlıklı ve Çürük Diş Dokularının Mekanik Özelliklerinin Nanoindentasyon Yöntemiyle Karşılıklı Olarak İncelenmesi

Giriş ve Amaç: Çalışmamızın amacı nanoindentasyon yöntemiyle diş sert dokularının ve farklı aşamalardaki çürük lezyonunun mekanik özelliklerinin karşılaştırmalı olarak incelenmesidir. Yöntem ve Gereçler: Nanoindentasyon test yöntemi için yarı retansiyonlu ve sürme güçlüğü nedeniyle çekilmiş üçüncü alt molar dişler kullanılmıştır. 2 mm kalınlığında diskler şeklinde hazırlanan mine ve dentin örnekleri toplamda 6 gruba ayrılarak (n=12), DUH-W201S nanoindentasyon cihazında test edilmiş ve her bir örneğe ait gerilme, gerinim, sertlik, elastisite modülü, akma dayanımı ve kırılma tokluğu değerleri ölçülmüştür. Gruplar arasında fark olup olmadığı Kruskal Wallis ve Mann Whitney U testleri ile, sağlıklı mine ve dentin gruplarının demineralizasyona bağlı değişimi ise Wilcoxen Sum Rank Testi ile incelenmiştir (p=0.01). Bulgular: Sağlıklı mine dokusunun sertlik, gerilme, elastisite modülü, akma dayanımı ve kırılma tokluğu değerlerinin diğer gruplara kıyasla yüksek olduğu belirlenmiştir. Demineralize mine ve dentin dokularından elde edilen sertlik ve gerilme değerleri sağlıklı mine ve dentin dokularına kıyasla %90 oranında azalırken, gerinim (%265), kırılma tokluğu (%45) ve elastik toparlanma değerleri (%160) artmıştır. Demineralize mine ve dentin dokuları arasında tüm mekanik özellikler açısından istatistiksel olarak anlamlı fark varken (p=0.000), mine ve dentin çürükleri arasında tüm mekanik özellikler açısından fark bulunmamaktadır (p=0.099). Tartışma ve Sonuç: Farklı diş dokularında meydana gelen demineralizasyon işlemi dişin mekanik özelliklerini azaltırken, dişin yapısını daha esnek ve fiziksel açıdan zayıf hale getirmektedir.

Comparative Evaluation of Mechanical Properties of Dental Nanomaterials

This study examines the properties of nanobased dental restorative materials with nanoindentation method in a precise, repeatable, and comparable way. Microhybrid and nanohybrid composites, conventional glass ionomer materials, and light cured nanoionomer materials were utilised for the study. Specimen discs (r=10 mm, h= 2 mm) were prepared to test the hardness, modulus of elasticity, yield strength, and fracture toughness values for each sample in a nanoindentation device with an atomic force microscopy add-on (n=25). Comparative analyses were performed by one-way ANOVA and post hoc Tukey tests. The hardness and modulus of elasticity values of nanocomposite were higher (2.58 GPa and 32.86 GPa, resp.) than those of other dental materials. Although glass ionomer exhibited a hardness that was similar to a nanoionomer (0.81 versus 0.87 GPa), glass ionomer had the lowest fracture toughness value (Kc=0.83 MPa/mm0.5). The mechanical properties of resin composites improve with additional nanoscale fillers, unlike the glass ionomer material

Efficacy of different calcium silicate materials as pulp-capping agents: Randomized clinical trial

Background/purpose: Calcium hydroxide-based materials were the gold standard in vital pulp therapies for decades’ despite of several shortcomings. However, calcium silicates have been discussed as an alternative to overcome these drawbacks. It was aimed to investigate the in-vivo effectiveness of different calcium silicates based materials in pulp capping in this study. Materials and methods: A parallel-design, randomized controlled trial with 213 patients who has deep dentin caries, vital pulps and without spontaneous pain or history of swelling was designed. 525 M teeth were randomized, blinded and allocated to one of the five groups for pulp capping treatment (n = 105). All teeth were followed up clinically and radiographically (after 1st, 6th, 12th and 36th months) by blinded investigators. The clinical and radiographic success, and the effect of the pulp exposure to the success rate analyzed with Wald chi-square and Z tests. Results: Clinical and radiographic success of MTA+ (86.3%, 85.4%) and Biodentine (79.4%, 80.1%) were found the highest. Although results of Theracal LC group (72.1%, 73.6%) were better than Dycal group (69.4%, 70.2%), the difference was nonsignificant (p > 0.05). Only in light-cured groups, (TheraCal LC & LC Calcihyd) pulpal exposure size effected the success of the materials (p < 0.05). MTA+ and Biodentine resulted better scores, when compared with TheraCal LC in large pulpal exposures (p < 0.05). Conclusion: After 36-month follow-up, both MTA+ and Biodentine were found to be the appropriate material for direct pulp capping in permanent teeth. The filler ingredient of the Theracal-LC eases the usage of calcium silicates but decreases the success rate. © 2020 Association for Dental Sciences of the Republic of ChinaThis study was funded by grant 2013-DIS-016 from the Ege University Hospital , Turkey

The Effect of Flowable Composite Resins on Periodontal Health, Cytokine Levels, and Immunoglobulins

Objective. This study investigated the effects of flowable resin composites (FCR) on the restoration of noncarious cervical lesions (NCCL) and their impact on periodontal tissues. Materials and Methods. 30 periodontally healthy patients were assigned into three groups randomly; group VF: self-adhering FCR, group NF: fluoride-releasing FCR, and group SF: microhybrid FCR. Gingival crevicular fluid (GCF) volume levels of osteoprotegerin (OPG), immunoglobulins (IgA, IgM), and interleukins (IL-1, IL-1?, and IL-10) in GCF were analyzed with ELISA tests. Clinical success rates were evaluated using USPHS criteria during the 12-month follow-up. Results. The GCF volume was increased mostly in group SF (1.34±0.09 ?l). While the titer of interleukin was increased in all groups, higher increases were observed in IL-1 and IL-1? in group NF (170.78 pg/ml and 39.35 pg/ml). Increased IL-10 was observed in group VF (14.33±0.85 pg/ml). IgA levels varied partially among all groups (p>0.05), and even IgM levels were elevated immediately after the restoration process but returned to normal on the 28th day (p<0.05). Group NF failed in most of the USPHS criteria, while the material group VF and group SF presented acceptable results except in the marginal adaptation criterion (p<0.05). Conclusions. Clinical efficacy of self-adhering FCR was found the best for restoration of NCCL while fluoride-releasing FCR stimulated the periodontal response and had negative effects on GCF volume, cytokine, and immunoglobulin levels. © 2022 Cem Peskersoy et al