Randomized clinical trial of class II restoration in permanent teeth comparing ART with composite resin after 12 months

Abstract

Objective

This study evaluated the effectiveness of class II restorations, in permanent teeth, through the ART technique in comparison to composite resin.

Materials and methods

Participants (154), aged 8 to 19 years, with good general health, with class II cavities in permanent teeth, and without pulp involvement and tooth pain were included in this parallel and randomized clinical trial. The Ethics Committee approval number was CAAE: 24012913.0.1001.5417. Seventy-seven restorations were made with each restorative material (Equia Fil-GC Corporation and Z350-3M). Evaluations occurred at 6 and 12 months by the criteria of ART and the USPHS modified. Data were analyzed by Mann-Whitney, chi-square, Fisher's exact, chi-square tests with linear trend and logistic regression by enter method (p < 0.050). The Kaplan-Meier test evaluated the survival rates of the restorations. The log-rank test compared the survival curves.

Results

Regardless of the evaluation criteria used, the success rates of ART restorations were 98.7% (6 months) and 95.8% (12 months) and for composite resins were 100% (6 months) and 98.7% (12 months), with no statistical difference of restoration groups (p > 0.050). Survival rates for restorations, regardless of the evaluation criteria used, are the same as the success rates, with the exception of ART restorations at 12 months of follow-up (94.8%).

Conclusion

No differences in the success rates of class II restorations of ART compared to resin composite, in permanent teeth, were observed after 12 months.

Clinic significant

HVGIC can safely be used to restore proximal cavities in permanent teeth up to 12 months.

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Letter to the Editor replying to Armen Nersesyan about the article published in Clinical Oral Investigations tilted “Smoking increases the frequency of micronuclei in the oral mucosa of adults relative to non-smokers—a systematic review and meta-analysis”

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Issue Information

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Quantitative survey into value clarification of discussed treatment options among patients treated for basal‐cell carcinoma

Abstract

There are many effective treatment options for basal‐cell carcinoma (BCC). To ensure a shared treatment decision, it is essential to understand patient preferences, values, and experience with treatments. We evaluated patients' recollections of the treatment choices for their BCC and what kind of information they valued most by doing a quantitative survey via the largest Dutch patient federation ('Patiëntenfederatie Nederland', PFN). The PFN includes a 25,000 member patient‐panel; their medical history is not reported. A survey was developed by the Dermatology department of the Maastricht University Medical Center in collaboration with BCC

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Serum and blister‐fluid elevation and decreased epidermal content of HMGB1 protein in drug‐induced Stevens Johnson syndrome/toxic epidermal necrolysis

Abstract

High‐mobility group box 1 (HMGB1) is a damage‐associated molecular‐pattern protein indicative of cell/tissue injury and innate immune response. Stevens‐Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) are serious, immune‐mediated skin‐blistering conditions characterised by widespread keratinocyte death and epidermal detachment.

The purpose of the study was to determine: a) serum and/or blister‐fluid total HMGB1 levels in independent SJS/TEN cohorts: and b) HMGB1 expression in formalin‐fixed, paraffin‐embedded SJS/TEN skin vs. healthy and maculopapular exanthema (MPE).

Total serum HMGB1 was quantified by enzyme‐linked immunosorbent assay (ELISA) in 3 cohorts: i) Malawian, nevirapine‐induced hypersensitivity (51 cases, 102 tolerant); ii) Taiwanese SJS/TEN (n=73) (acute, maximal and recovery stage); iii) Spanish SJS/TEN (n=23) (acute reaction (blister‐fluid (n=13)). FFPE skin (5 healthy, 7 maculopapular exanthema (MPE), 7 SJS/TEN) was immunohistochemically (IHC) stained and semi‐quantitatively assessed for HMGB1 expression.

Serum total HMGB1 was not significantly elevated in nevirapine‐induced SJS/TEN (3·98ng/ml±2·17), MPE (3·92ng/ml±2·75) or DRESS (4·73ng/ml±3·00)) patients vs. tolerant controls (2·97ng/ml±3·00). HMGB1 was significantly elevated in Taiwanese SJS/TEN patients, highest during the acute phase 32·6ng/ml±26·6 vs. maximal (19·7ng/ml±23·2; p=0·007) and recovery (24·6ng/ml±25·3; p=0·027) phases. In blister fluid from Spanish SJS/TEN patients, HMGB1 (486·8ng/ml±687·9) was significantly higher than in serum (8·8ng/ml±7·6; p<0·0005). Pre‐blistered SJS/TEN skin demonstrated decreased epidermal nuclear HMGB1 expression in upper epidermis vs. healthy or MPE skin but retained basal/suprabasal expression.

Epidermal HMGB1 expression was decreased in SJS/TEN skin which may account for elevated serum and blister‐fluid levels. Retained basal/suprabasal epidermal HMGB1 expression, from resident keratinocytes/ infiltrating inflammatory cells, may exacerbate localised injury in SJS/TEN, though further evaluation is required.

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Osseointegrated Auditory Devices

Osseointegrated auditory devices (OADs) are hearing devices that use an external receiver/processor that stimulates bone conduction of sound via a titanium prosthesis that is drilled into the bone of the cranium. Since their introduction in 1977, OADs have undergone substantial evolution, including changes in manufacturing of the implant, improvements in the external sound processor, and simplification of implantation techniques. Expansion of criteria for patient candidacy for implantation has occurred corresponding with changes in the implants and processors.

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Electroacoustic Stimulation

Electric acoustic stimulation (EAS), also known as hybrid stimulation, is indicated for individuals with intact low-frequency hearing and profound high-frequency hearing loss. Although low frequencies contribute to speech perception, these individuals are usually only able to detect vowels, but few or no consonants, and thus have difficulty with word understanding and hearing in noise. EAS uses the cochlear implant electrode array to stimulate the high frequencies within the basal turn of the cochlea coupled with a hearing aid to convey the low frequencies at the apical turn in the same ear.

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