Laser crown lengthening and direct composite veneers as single-visit treatment

Introduction: Minimally invasive treatment of gummy smile is essential when there is additional need for veneer restorations. This case report presents long-term treatment results of single-visit treatment of three patients with laser-corrected gummy smile and direct composite veneers. Case Description: : Three patients presented with moderate to pronounced gummy smile and unremarkable medical/medication history. Direct veneers were indicated to manage anterior diastemas, caries or failing restorations. Crown lengthening was performed with Er,Cr:YSGG laser (Waterlase MD, Biolase). Teeth were isolated, adhesive (G Bond, GC) was applied following a total-etch technique, followed by a thin layer of flowable composite (Gradia Direct Flo, GC) in the demarcation zone and uniersal composite (Gradia Direct, GC). Postoperatively, there was no bleeding, swelling or pain. Gingival inflammation subsided after 6 days.Long-term follow-up showed stable position of gingival margin without recession up to 15 years postoperatively. Composite veneers required repolishing or superficial repair to maintain superior aesthetics but without complete replacement. Discussion: No data exists on long-term outcomes of laser-corrected gummy smile with direct composite veneers in the same visit. This case series shows no postoperative complications and stable periodontal results achieved with laser crown-lengthening for up to 15 years. Flowable composite was used to allow precise and pressure-free adaptation, minimizing the risk of trauma of laser-treated gingiva. Dentine and enamel shades of the sculptable composite allowed highly aesthetic shade matching. Conclusion: Crown lengthening using Er,Cr:YSGG laser and direct composite veneers are minimally invasive surgical and restorative treatment options, respectively, to correct gummy smile and manage caries, failing restorations and/or inadequate tooth position/size/shape in the same visit

Polymorphisms of Antioxidant Enzymes SOD2 (rs4880) and GPX1 (rs1050450) Are Associated with Bladder Cancer Risk or Its Aggressiveness

Background and Objectives: Oxidative stress induced by increased reactive oxygen species (ROS) production plays an important role in carcinogenesis. The entire urinary tract is continuously exposed to numerous potentially mutagenic environmental agents which generate ROS during their biotransformation. In first line defense against free radicals, antioxidant enzymes superoxide dismutase (SOD2) and glutathione peroxidase (GPX1) both have essential roles. Altered enzyme activity and decreased ability of neutralizing free oxygen radicals as a consequence of genetic polymorphisms in genes encoding these two enzymes are well described so far. This study aimed to investigate the association of GPX1 (rs1050450) and SOD2 (rs4880) genetic variants with the urothelial bladder cancer (UBC) risk independently and in combination with smoking. Furthermore, we aimed to determine whether the UBC stage and pathological grade were influenced by GPX1 and SOD2 polymorphisms. Material and Methods: The study population included 330 patients with UBC (mean age 65 ± 10.3 years) and 227 respective controls (mean age 63.4 ± 7.9 years). Single nucleotide polymorphism (SNP) of GPX1 (rs1050450) was analyzed using the PCR-RFLP, while SOD2 (rs4880) SNP was analyzed using the q-PCR method. Results: Our results showed that UBC risk was significantly increased among carriers of at least one variant SOD2 Val allele compared to the SOD2 Ala16Ala homozygotes (OR = 1.55, p = 0.03). Moreover, this risk was even more pronounced in smokers with at least one variant SOD2 Val allele, since they have even 7.5 fold higher UBC risk (OR = 7.5, p GPX1 polymorphism, we have not found an association with UBC risk. However, GPX1 genotypes distribution differed significantly according to the tumor stage (p ˂ 0.049) and pathohistological grade (p ˂ 0.018). Conclusion: We found that SOD2 genetic polymorphism is associated with the risk of UBC development independently and in combination with cigarette smoking. Furthermore, we showed that GPX1 genetic polymorphism is associated with the aggressiveness of the disease

Postoperative sensitivity associated with low shrinkage versus conventional composites

Introduction. Postoperative sensitivity in restorative dentistry can be related to preparation trauma, dentin adhesives' ability to seal open dentinal tubules, deformation of restorations under occlusal stresses and microleakage. Objective. The study assessed possible reduction in postoperative sensitivity with low shrinkage compared to conventional composites using different bonding agents and the influence of the operator skill on the incidence of postoperative sensitivity. Methods. Nine hundred and sixty permanent premolars and molars with primary carious lesions from patients 21 to 40 years old were used. Cavities 2 to 3 mm deep and with margins in enamel were prepared by four operators. Two operators had five years (A and B) and two had over 20 years (C and D) of clinical experience. Teeth were divided into eight groups each contained 120 restorations: (1) Els®+James-2 (original formula), (2) Els®+James-2 (new formula), (3) Els®+Excite, (4) InTenSe®+James-2 (original formula), (5) InTenSe®+James-2 (new formula), (6) InTenSe®+Excite, (7) Tetric Ceram®+Excite, and (8) Point 4®+OptiBond Solo Plus. At 14 days postoperatively, two independent operators, who did not take part in the clinical procedure, assessed postoperative teeth sensitivity using special questionnaires. Data were analyzed using non-parametric chi-square, Mann-Whitney and ANOVA tests. Results. Group 8 showed significantly higher score than the other groups. Less postoperative sensitivity was reported with two low-shrinkage composites (groups 2, 3, and 5) but with no significant difference. There was no statistical difference between groups 1, 2, 3, 4, 5, 6 and 7. Operator A had the highest postoperative sensitivity score compared to the other three. Conclusion. Conventional composite material Point 4® with its bonding agent caused significantly more postoperative sensitivity than low shrinkage composites combined with different adhesives. Operator skill influenced the incidence of postoperative sensitivity.Uvod. Posle postavljanja kompozitnih ispuna može da se javi postoperaciona osetljivost izazvana preparacionom traumom, sposobnošću adhezivnog sistema da hermetički zatvori dentinske kanaliće, deformacijom pod okluzalnim opterećenjem ili prodorom bakterijskih toksina. Cilj rada. Cilj istraživanja je bio da se ispita da li je osetljivost zuba manja kod kompozita s malom kontrakcijom u poređenju s konvencionalnim kompozitima i odgovarajućim adhezivnim sistemima, kao i uticaj veštine stomatologa na incidenciju postoperacione osetljivosti zuba. Metode rada. Na 960 premolara i molara stalne denticije s primarnim karijesom, pacijenata starosti od 21 godine do 40 godina, preparisani su kaviteti dubine 2-3 mm s rubovima u gleđi. Čitavu proceduru su obavila četiri specijalista stomatologije, od kojih su dva imala pet (A i B), a druga dva više od 20 godina kliničkog iskustva (C i D). Zubi su svrstani u osam grupa od po 120 uzoraka prema korišćenom kompozitnom i adhezivnom sistemu: 1) Els®+James-2; 2) Els®+James-2 (nova formula); 3) Els®+Excite; 4) InTenSe®+James-2; 5) InTenSe®+James-2 (nova formula); 6) InTenSe®+Excite; 7) Tetric Ceram®+Excite; i 8) Point 4®+OptiBond Solo Plus. Dve nedelje posle intervencije dva nezavisna stomatologa (koja nisu učestvovala u kliničkoj proceduri) ocenjivala su posebnim upitnicima postoperacionu osetljivost zuba. Podaci su analizirani neparametrijskim c2, Man-Vitnijevim (Mann-Whitney) i ANOVA testom. Rezultati. U osmoj grupi utvrđena je statistički značajno češća postoperaciona osetljivost nego u ostalim grupama zuba. Nije bilo statistički značajne razlike između grupa 1, 2, 3, 4, 5, 6 i 7. Kompoziti sa nižom polimerizacionom kontrakcijom izazvali su manju postoperacionu ostetljivost, ali bez statističke značajnosti razlika (grupe 2, 3 i 5). Kod stomatologa A javljala se statistički značajno češće postoperaciona osetljivost nego kod ostala tri. Zaključak. Tip kompozitnog materijala s odgovarajućim adhezivnim sistemom i spretnost stomatologa utiču na učestalost pojave osetljivosti zuba posle restauracija srednje dubokih kaviteta II klase

Folic acid affects cardiometabolic, oxidative stress, and immunohistochemical parameters in monocrotaline-induced rat heart failure

Heart failure (HF) is one of the major cardiovascular causes of death worldwide. In this study, we explored the effects of folic acid (FA) on cardiometabolic, oxidative stress biomarker changes, and the activity of proliferation marker Ki67 in monocrotaline-induced HF. The research was conducted during a 4 week period using five experimental groups (eight animals per group): blank solution exposed controls (C1: 1 mL/kg physiological saline, 1 day; C2: 1 mL/kg physiological saline, 28 days), monocrotaline (MCT) induced HF (50 mg/kg MCT), FA (5 mg·kg−1·day−1 FA), and MCT+FA (50 mg/kg MCT, 5 mg·kg−1·day−1 FA). Superoxide dismutase and glutathione peroxidase activities together with total glutathione and parameters of oxidative damage of proteins were determined in cardiac tissue as well as cardiometabolic parameters in plasma or serum. The total glutathionylation was determined by Western blot and proliferation marker Ki67 was assessed by immunohistochemistry. The right ventricular (RV) wall hypertrophy and Ki67 positivity, accompanied by a significant increase of troponin T, has been shown in MCT-induced HF. The antioxidant effect of FA was reflected through superoxide dismutase activity, reduced Ki67 positivity in the RV wall, and a slightly decreased total glutathionylation level.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

The influence of subchronic co-application of vitamins B6 and folic acid on cardiac oxidative stress and biochemical markers in monocrotaline-induced heart failure in male Wistar albino rats

The aim of this study was to test the hypothesis that subchronic co-application of vitamins B6 and folic acid (FA) could affect heart failure (HF) induced by monocrotaline (MCT), with the modulation of oxidative stress parameters and cardiometabolic biomarkers. Biochemical and histomorphometric analyses were assessed in blank solution-exposed controls (C1 physiological saline 1 mL/kg, 1 day, n = 8; C2 physiological saline 1 mL/kg, 28 days, n = 8), MCT-induced HF (MCT 50 mg/kg, n = 8), B6+FA (vitamin B6 7 mg·kg–1·day–1, FA 5 mg·kg–1·day–1; n = 8), and MCT+B6+FA (MCT 50 mg/kg, vitamin B6 7 mg·kg–1·day–1, FA 5 mg·kg–1·day–1; n = 8) in male Wistar albino rats (body mass 160 g at the start). Superoxide dismutase and glutathione peroxidase activities, thiol-, carbonyl groups, and nitrotyrosine were determined in cardiac tissue. Echocardiography was performed to confirm MCT-induced HF. The right ventricular wall hypertrophy, accompanied with significant increase of troponin T and preserved renal and liver function, has been shown in MCT-induced HF. However, these effects were not related to antioxidant effects of vitamin B6 and FA, since several parameters of oxidative stress were more pronounced after treatment. In this study, co-application of vitamins B6 and FA did not attenuate hypertrophy of the right ventricle wall but aggravated oxidative stress, which is involved in HF pathogenesis.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Optical properties of composite restorations influenced by dissimilar dentin restoratives

Objectives. To evaluate optical properties (color and translucency) of 'sandwich' restorations of resin-based composites and esthetically unfavorable dentin restoratives. Methods. Cylindrical 'dentin' specimens (8 mm in diameter and 2 mm thick, N = 5/group) were prepared using EverX Posterior (GC), Biodentine (Septodont), experimental hydroxyapatite (HAP) or conventional composites (Gradia Direct Posterior, GC; Filtek Z250 and Filtek Z500, 3M ESPE). Capping 'enamel' layers were prepared using composites (Gradia Direct Posterior, Filtek Z250 or Z550) of Al or A3 shade and the following thickness: 0.6, 1 or 2 mm. Color (Delta E) and translucency parameter (TP) were determined using a spectrophotometer (VITA Easyshade Advance 4.0, VITA Zahnfabrik). Data were statistically analyzed using analysis of variance with Tukey's post-hoc tests (alpha = 0.05). Results. TP was greatly affected by layer thickness, whilst Delta E depended on shade and layer thickness of the capping composite. HAP and Biodentine showed significantly lower TP and higher Delta E (deviation from 'ideal white') than composites (p lt 0.05). Greater TP was seen in EverX_composite groups than in corresponding control groups of the same shade and thickness. TP of composites combined with Biodentine or HAP was below 2, lower than the corresponding control groups (p lt 0.05). Within-group differences of Delta E were greatest in HAP_composite groups. EverX_Gradia and EverX_FiltekZ250 combinations showed the most comparable Delta E with the control groups. Significance. A 2 mm thick layer of composite covering dentin restoratives with unfavorable esthetics is recommended for a final 'sandwich' restoration that is esthetically comparable to a conventional, mono-composite control restoration