The purpose of this study was to evaluate the color stability of aesthetic restorative resin-matrix materials after their immersion in different dietary and therapeutic solutions. Thirty disc-shaped specimens (10 × 2 mm) were prepared from three different types of resin-matrix composites used in dentistry (BE, FS, AF). The color coordinates (L*a*b*, ΔL*, Δa*, Δa*, Δb* and ΔE*) were measured using a VITA Easyshade 3D-Master (VITA Zahnfabrik, Bad Säckingen, Germany) before and after the immersion of the specimens in coffee, red wine, Coca-Cola®, Eludril Care®, and distilled water solutions for 40 h. The color change (ΔE*) was calculated and analyzed by the Kolmogorov -Smirnov test and the Kruskal -Wallis multiple-comparison test. All the restorative materials showed significant color (ΔE*) changes after their exposure to red wine, followed by coffee and Coca-Cola®; however, one nanohybrid resin-matrix composite showed a high color stability in such colored test solutions. The chemical composition and content of the organic matrix played a key role in the color stability of the resin-matrix composites. Clinicians should advise their patients about the chemical interaction between dietary substances and different resin-matrix composites.
Atherosclerosis is a major complication of chronic renal failure. Microinflammation is involved in atherogenesis and is associated with uremia and dialysis. The role of dialysate water contamination in inducing inflammation has been debated. Our aim was to study inflammatory markers in patients on chronic dialysis, before and 3 to 6 months after switching the water purification system from deionization to reverse osmosis. Patients had demographic, clinical and nutritional information collected and blood drawn for determination of albumin, ferritin, C-reactive protein (CRP), interleukin-6, and tumor necrosis factor-α in both situations. Acceptable levels of water purity were less than 200 colony-forming units of bacteria and less than 1 ng/ml of endotoxin. Sixteen patients died. They had higher median CRP (26.6 vs 11.2 mg/dl, P = 0.007) and lower median albumin levels (3.1 vs 3.9 g/l, P < 0.05) compared to the 31 survivors. Eight patients were excluded because of obvious inflammatory conditions. From the 23 remaining patients (mean age ± SD: 51.3 ± 13.9 years), 18 had a decrease in CRP after the water treatment system was changed. Overall, median CRP was lower with reverse osmosis than with deionization (13.2 vs 4.5 mg/l, P = 0.022, N = 23). There was no difference in albumin, cytokines, subjective global evaluation, or clinical and biochemical parameters. In conclusion, uremic patients presented a clinically significant reduction in CRP levels when dialysate water purification system switched from deionization to reverse osmosis. It is possible that better water treatments induce less inflammation and eventually less atherosclerosis in hemodialysis patients.
Maxillary lateral incisor agenesis is a condition that significantly compromises smile esthetics, which is particularly worrying in young patients. This article shows how the combination of non-invasive treatments and current restorative options may improve clinical outcomes following orthodontic treatment for symmetric and asymmetric maxillary lateral incisor agenesis and microdontia. Teeth were treated with conservative resin restorations in three separate cases: two of congenitally missing maxillary lateral incisors (i.e., unilateral and bilateral) and one of microdontia. After presenting the clinical results, this article summarizes how bleaching, enameloplasty, and bonding with composite resin can enhance esthetics and functions following orthodontic space closure. The cases reveal that carefully planned, methodically executed orthodontic and restorative approaches can achieve predictable, esthetic outcomes that will improve the patient’s self-esteem with a minimally invasive solution.
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