Restoration after endodontic treatment is as important as root canal therapy for clinical success. Evolution of adhesive dentistry strongly aided in the conservation of tooth structure and reinforcement of the restored teeth. Self-etch adhesives has evolved aiming to reduce the technique sensitivity and simplifying the steps needed for bonding (one or two steps). Dual cured self-etch adhesives were also introduced to be more chemically compatible with the resin composite restorations. Bulk-fill resin composites has also achieved great popularity due to the ease of application and being more time saving. These materials made the direct restoration of endodontically treated teeth more conservative, time saving and reliable. This research was performed to assess the clinical success of the restorations of the endodontically treated molars with remaining three walls restored using self-etch adhesives and bulk fill resin composite in comparison to conventional nanohybrid resin composite at a time intervals of 1week (baseline) , 3 ,6 and 12 months. In a randomized clinical trial, 40 patients with endodontically treated molars with remaining three walls received a restorative intervention with either (Xtra-Fil) bulk fill resin composite or (Grandio) nano hybrid resin composite applied in incremental technique.
Background: The most frequent primary liver cancer in those with cirrhosis and chronic liver disease is hepatocellular carcinoma (HCC). Anti-infective and immune-modulating capabilities have been discovered for the multifunctional steroid hormone known as vitamin D. Vitamin D deficiency was found to be linked with advancement of Chronic liver disease (CLD) as non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease (ALD), as well as the hepatitis C virus (HCV). Objective: The aim of the current work was to investigate the association between vitamin D deficiency and HCC in patients with liver cirrhosis. Patients and Methods: Ninety individuals with liver cirrhosis (LC) participated in this trial. The included subjects were divided into two groups; Group A consisted of 45 cirrhotic patients without HCC, and Group B consisted of 45 cirrhotic patients with HCC. Results: Liver function tests: INR, ALT, AST, total bilirubin were all statistically substantially higher in group B than in group A (P=0.001, 0.001, 0.001, and 0.011, respectively). However, group B's serum albumin and platelet count were considerably lower than group A's (P=0.003 and 0.001, respectively) compared to each other. In comparison to group A's alphafetoprotein (AFP) of 8.69±1.84, group B's AFP of 254.33±32.69 was statistically substantially higher (P = 0.001).Vitamin D levels in group B were substantially lower (19.33±4.68) than in group A (26.31±4.95) (P= 0.00). With an area under the curve (AUC) of 0.802, vitamin D was significant at a cutoff level of ≤ 20.5 ng/ml with a sensitivity of 80.3% and a specificity of 75% for increasing the risk of HCC. Conclusion: It could be concluded that it is crucial to maintain an optimum blood level of vitamin D in cirrhotic individuals since our findings indicate a substantial correlation between vitamin D levels and HCC risk.
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