International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Tensile strength and ultrastructure of a compomer and a composite in aqueous and non-aqueous storage media.

PURPOSE: To compare the ultimate tensile strength (UTS) of a compomer (Dyract AP) and a composite (Spectrum TPH) that were stored in an aqueous or a non-aqueous medium for up to 180 days. METHODS: 156 hourglass-shaped specimens of each material with cylindrical cross-sectional areas along the test regions were prepared. For each material, 12 beams were stressed to failure using a microtensile testing method to obtain the baseline UTS data. The rest were divided into two groups. One group was stored in de-ionized water (W), and the other (control) in silicone fluid (O) at 37 degrees C. 12 beams were removed from the respective storage medium after 1, 7, 14, 30, 90, 180 days for evaluation of the NTS. Materials retrieved from the intact central cylindrical portion of the fractured 180-day specimens were prepared for transmission electron microscopy (TEM). RESULTS: Baseline UTS for Dyract AP (D) and Spectrum TPH (S) were 76 +/- 16 MPa and 92 +/- 13 MPa, respectively. One-way ANOVA on ranks and Dunn's multiple comparison tests showed that UTS of Groups D-O, S-O and S-W remained stable during 180 days and were not significantly different from the baseline results. There was a significant drop in UTS in Group D-W after 90 and 180 days when compared with the 1-day result (P < 0.05). A highly significant nonlinear correlation was also observed in Group D-W between the mean UTS after the first day and the storage time (P < 0.01). No difference could be seen between the filler-matrix interface in S-O and S-W. A very thin glass-ionomer phase (ca. 200 nm thick siliceous hydrogel layer) could be observed in D-W, but not in D-O.link_to_subscribed_fulltex