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Extensively drug-resistant (XDR) tuberculosis (TB) has extremely poor treatment outcomes in adults and very limited pediatric data are available. We report on the presentation, treatment and outcome of children (

This study investigated the influence of thermal cycling on the enamel bond strength of single-step self-etch adhesive systems. The systems used were Absolute, Clearfil tri-S Bond, G-Bond and One-Up Bond F Plus. Bovine mandibular incisors were mounted in self-curing resin, and the facial surfaces were wet ground with #600 SiC paper. Adhesives were applied on the prepared enamel surfaces and light irradiated according to each manufacturer's instructions. Resin composites were condensed into a mold (ø4x2 mm) and light irradiated for 30 seconds. Thirty specimens per adhesive systems were divided into 1 of 3 test groups (n=10) following storage in water at 37 degrees C for 24 hours. The specimens were then stored in 37 degrees C water for 24 hours, followed by thermal cycling 10,000 and 20,000 times between 5 degrees C and 60 degrees C. After each storage condition, the specimens were tested in shear mode at a crosshead speed of 1.0-mm/minute. One-way ANOVAs and Tukey HSD test at a level of 0.05 were conducted. After 24 hours of water storage, the mean enamel bond strengths ranged from 11.3 to 16.9 MPa, and Clearfil tri-S Bond showed significantly higher bond strength. After thermal cycling, the mean bond strengths ranged from 8.3 to 20.7 MPa. The changes in enamel bond strengths were different among the adhesive systems tested. Failure modes after the test were commonly adhesive failure associated with partial cohesive failure adhesive in resin. With a careful choice of adhesive systems, the benefit to using single-step self-etch systems in terms of simplifying the clinical procedure might be acceptable, even after thermal stresses.

Objectives. Adhesion of resin-bonding agents to dentin is currently believed to result from impregnation of adhesive resin into superficially demineralized dentin. The purpose of this study was to investigate the chemical composition of the resin-impregnated dentin (hybrid) layer using a micro-Raman spectroscopy. Methods. Resin composites were bonded to bovine dentin with the two-step bonding systems, and specimens were sectioned parallel to dentinal tubules. These surfaces were then polished down to 1 μm diamond pastes. Raman spectra were successively recorded along a line perpendicular to the dentin–adhesive interface by steps of 0.2 μm on a computer controlled X–Y stage. The relative amounts of hydroxyapatite (960 cm−1, P–O), adhesive resin (640 cm−1, aromatic ring), and organic substrate (1450 cm−1, C–H) in the dentin–adhesive bonding area were calculated. Results. From the Raman spectroscopy results, the hybrid layer represents a gradual transition in the relative amount of adhesive from the resin side to dentin side. Evidence of poor saturation of the adhesive resin in the demineralized dentin with the one-bottle adhesive system was detected. Significance. From the results of this study, inhomogeneity of the hybrid layer composition was detected, and the degree of resin impregnation was found to be different between the bonding systems tested.

The corrosion of 2205 duplex stainless steel was compared with that of AISI type 316L stainless steel. The 2205 stainless steel is a potential orthodontic bracket material with low nickel content (4 to 6 wt%), whereas the 316L stainless steel (nickel content: 10 to 14 wt%) is a currently used bracket material. Both stainless steels were subjected to electrochemical and immersion (crevice) corrosion tests in 37 degrees C, 0.9 wt% sodium chloride solution. Electrochemical testing indicates that 2205 has a longer passivation range than 316L. The corrosion rate of 2205 was 0.416 MPY (milli-inch per year), whereas 316L exhibited 0.647 MPY. When 2205 was coupled to 316L with equal surface area ratio, the corrosion rate of 2205 reduced to 0.260 MPY, indicating that 316L stainless steel behaved like a sacrificial anode. When 316L is coupled with NiTi, TMA, or stainless steel arch wire and was subjected to the immersion corrosion test, it was found that 316L suffered from crevice corrosion. On the other hand, 2205 stainless steel did not show any localized crevice corrosion, although the surface of 2205 was covered with corrosion products, formed when coupled to NiTi and stainless steel wires. This study indicates that considering corrosion resistance, 2205 duplex stainless steel is an improved alternative to 316L for orthodontic bracket fabrication when used in conjunction with titanium, its alloys, or stainless steel arch wires.

In Part I, it was found that (i) 2 vol.% admixture of reinforcing elements in PMMA (Jet) resin matrix had a significant beneficial effects on the mechanical properties, and (ii) among these, zirconia exhibited the greatest improvements in modulus of elasticity, transverse strength, toughness, and hardness number. Using the best combination (i.e., PMMA resin matrix and 2 vol.% ZrO2), exothermic temperature raise and polymerization shrinkage were further investigated. Deterioration in mechanical properties due to prolonged water sorption were also studied for 5 weeks. The following can be concluded: (1) By increasing liquid/powder ratio for PMMA control samples, the peak temperature occurrence was retarded by 3 min and raised by 8 degrees C. (2) The effect of admixed oxide particles to PMMA resin matrix or the heat generated during polymerization was not significant. (3) The polymerization volumetric shrinkage was influenced by the a mixture of particles, with increases as large as 0.9% (or 0.3% in linear shrinkage). (4) PMMA resin admixed with 2 vol.% of zirconia particles showed a continuous weight gain due to water sorption, mechanical properties appears to be increasing up to 1-week sorption, followed by rapid drop of all properties. (5) Autopolymerizing acrylic resins are a resin-resin composite material of pre-polymerized beads embedded in a newly formed acrylic matrix. The main fracture modality appears to occur through the matrix and at the interface, although some trans-beads fractures were identified. (6) It was suggested that incorporating certain type of oxide particles into the pre-polymerized beads would provide stronger resin matrix.

Articulating paper/film is a sheet strip that is coated with ink- or dye-containing wax and is used for marking occlusal contacts and monitoring the results. New types of occlusal film systems have been developed recently, which are capable of being computer-interfaced to identify the occlusal contact points and digitize the occlusal force. The mechanical ductility and thickness of these occlusal sheets constitute some of their important properties. The objective of this study was to evaluate seven different occlusal sheets and compare their bulge ductility and thickness. A custom-designed photo-sensing bulge tester was used. Three paper-based sheets (BAP, BET and SFA), two plastic-based sheets (ACF and AOS), and advanced systems (TSS and FDP) were tested. The specimen size was 20 mm square. Fifteen samples were tested for each material. The sheet film thickness with coated layers was as follows: BAP, 62 microns; BET, 46 microns; SFA, 133 microns; ACF, 23 microns; AOS, 14 microns; TSS, 134 microns; and FDP, 82 microns. Ductility (standard deviation) was as follows: BAP, 2.10 (0.0060)%; BET, 2.14 (0.008)%; SFA, 5.19 (0.57)%; ACF, 8.68 (0.05)%; AOS, 16.26 (0.41)%; TSS, 16.26 (0.41)%; and FDP, 6.37 (0.09)%. One-way ANOVA analysis indicated that (1) there in no statistical difference between BAP and BET (p > 0.001), (2) there is a statistical difference (p < 0.001) among all the rest of the tested occlusal sheets, and (3) bulge ductility appears to be linearly related to film thickness, its correlation depending upon types of base materials.

Acrylic resins are commonly used in many dental applications; especially in the fabrication of provisional fixed partial dentures. Among noticed technical drawbacks associated with this material are unsatisfactory mechanical properties. Moreover, if acrylic resins are exposed to moist environment, water sorption results in further mechanical deterioration. In order to improve the mechanical properties, aluminum, magnesium, and zirconium oxide powders and pulverized E-glass particles were separately admixed with pre-polymerized acrylic resin beads prior to mixing with monomer liquid. Particle loading ratios were 1, 2 and 3 vol.% with respect to pre-polymerized beads. Poly(methyl methacrylate), poly(ethyl methacrylate) and poly(isobutyl methacrylate) were used as resin matrices. Furthermore, a metal primer agent was employed in order to form a strong interphase between admixed particles and polymer matrix phase. Samples were subjected to three-point transverse bending tests at a crosshead speed of 10 mm/min. It was concluded that (1) addition of particles generally increases the water sorbed by the composite resins systems, (2) however, two vol.% admixtures in a PMMA resin matrix showed significant improvements in the mechanical properties (p < 0.05), (3) among the oxide particles, zirconia exhibited the greatest improvements in modulus of elasticity, transverse strength, toughness and hardness, and (4) mechanical properties (transverse strength, 0.2% offset yield strength and modulus of elasticity) were linearly correlated to hardness numbers.

A gallium-based alloy (GA) that was developed as a substitute for dental amalgam was investigated for anodic polarization behavior in deoxygenated Ringers solution, 37 degrees C. The related microstructures were examined and microanalyses were conducted. Four polarization tests were conducted by scanning from -300mV to +1,000 mV (vs. SCE) at 2 mV/s. Polarization of the first sample (GA-1) was stopped after the first anodic dissolution peak (-100 mV, 1.5-2.0 x 10(-3) A/cm2). The fourth sample (GA-4) was interrupted at the secondary peak (+1000 mV, 0.3 A/cm2). It was found that (1) the early stage of the first peak is related to selective dissolution of divalent tin ions, followed by a dissolution of Ga. Transmission electron diffraction (TED) identified the brown corrosion product as Ga2O3; (2) the GA-4 sample was covered with the white corrosion product of mainly Sn+4, identified as SnO2. In addition, the current density of the GA sample when coupled with a high-copper dental amalgam was 0.03 A/cm2 (with +1,000 mV) at the second peak which was about a ten times lower value than for the uncoupled sample; (3) the uncoupled gallium alloy and gallium alloy coupled with a high-copper dental amalgam showed 10(3)-10(4) times higher anodic current density than that of an uncoupled high-copper dental amalgam, suggesting that the gallium alloy is more corrosion prone.

The optimal degree of curing throughout the bulk of a visible light-activated dental resin composite is acknowledged to be important to the clinical success of a resin composite restoration. Unfortunately, the dentist has no means of monitoring the cure of the resin surfaces not directly exposed to the curing light. Techniques, such as the layered buildup of restorations in 2 mm increments with longer activation times than 20 seconds, have been suggested. This study investigated the depth of cure (DOC) of a commercial resin composite in three types: flowable, hybrid and packable and in three shades: B1, A3 and D3 after 20 second activation with a quartz halogen light (620 mW/cm2). Depth of cure was measured by scraping the uncured material and by using a Knoop Hardness profile, starting from the surface exposed to the light. Using a minimum Knoop Hardness ratio of 0.8 bottom/top only, the flowable in shade B1 achieved a 2 mm DOC. Using the less restrictive scraping test, only the B1 shade of flowable and hybrid significantly exceeded a 2 mm DOC. Knoop Hardness at the DOC obtained by scraping ranged from 55%-70% of the top surface hardness. These data suggest that a 2 mm buildup layering technique may not result in adequate curing of the bottom layer for such a wide range of materials and that manufacturers need to provide quantitative information about DOC at specific activation times and light intensities for their entire range of resin materials and shades so that the dentist can devise a placement technique that will ensure adequate cure of the bulk of a restoration.

This study investigated the influence of thermal cycling on the dentin bond strengths of single-step self-etch adhesive systems. The Absolute, Clearfil Tri-S Bond, G-Bond and One-Up Bond F Plus systems were used. Bovine mandibular incisors were mounted in self-curing resin, and the facial surfaces were wet ground with #600 SiC paper. Adhesives were applied to the prepared dentin surfaces, and they were light irradiated according to each manufacturer's instructions. Resin composites were condensed into a mold (4 mm in diameter and 2 mm in height) and light irradiated for 30 seconds. Bonded specimens were divided into three groups and subjected to different storage conditions as follows: 37 degrees C water for 24 hours; 37 degrees C water for 24 hours followed by 10,000 thermal cycles between 5 degrees C and 60 degrees C or 37 degrees C water for 24 hours followed by 20,000 thermal cycles between 5 degrees C and 60 degrees C. Ten samples per group were tested in a shear mode at a crosshead speed of 1.0 mm/minute. Analysis of variance and Tukey's HSD test at the 0.05 significance level were used to compare the three storage conditions for each adhesive system. After 24 hours storage in water, the mean dentin bond strengths ranged from 11.4 MPa to 17.1 MPa. The Clearfil Tri-S Bond system showed the highest bond strength. After 10,000 thermal cycles, the mean bond strengths remained unchanged except for those of the Clearfil Tri-S Bond system, which significantly increased. Significant decreases in bond strength were observed for the Absolute and One-Up Bond F Plus systems after 20,000 thermal cycles. Failure mode was commonly due to adhesive breakdown associated with partial cohesive failure of the adhesive resin. From the results of this study, in terms of simplifying the clinical procedure, the benefit of using single-step self-etch systems might be acceptable.

This study examined the effect of air-drying time of adhesives on the dentin bond strength of several single-application self-etch adhesive systems. The adhesive/resin composite combinations used were: Adper Prompt L-Pop/Filtek Z250 (AP), Clearfil Tri-S Bond/Clearfil AP-X (CT), Fluoro Bond Shake One/Beautifil (FB), G-Bond/Gradia Direct (GB) and One-Up Bond F Plus/Palfique Estelite (OF). Bovine mandibular incisors were mounted in self-curing resin and wet ground with #600 SiC to expose labial dentin. Adhesives were applied according to each manufacturer's instructions followed by air-drying time for 0 (without air-drying), 5 and 10 seconds. After light irradiation of the adhesives, the resin composites were condensed into a mold (phi4x2 mm) and polymerized. Ten samples per test group were stored in 37 degrees C distilled water for 24 hours; they were then shear tested at a crosshead speed of 1.0 mm/minute. One-way ANOVA followed by Tukey's HSD tests (alpha = 0.05) were done. FE-SEM observations of the resin/dentin interface were also conducted. Dentin bond strength varied with the different air drying times and ranged from 5.8 +/- 2.4 to 13.9 +/- 2.8 MPa for AP, 4.9 +/- 1.5 to 17.1 +/- 2.3 MPa for CT, 7.9 +/- 2.8 to 13.8 +/- 2.4 MPa for FB, 3.7 +/- 1.4 to 13.4 +/- 1.2 MPa for GB and 4.6 +/- 2.1 to 13.7 +/- 2.6 MPa for OF. With longer air drying of adhesives, no significant changes in bond strengths were found for the systems used except for OF. Significantly lower bond strengths were obtained for the 10-second air-drying group for OF. From FE-SEM observations, gaps between the cured adhesive and resin composites were observed for the specimens without the air drying of adhesives except for OF. The data suggests that, with four of the single-application self-etch adhesive systems, air drying is essential to obtain adequate dentin bond strengths, but increased drying time does not significantly influence bond strength. For the other system studied, the bond strength of the non-air dried group was not significantly different from the five second drying time, but prolonged drying was very detrimental to bond strength. For all five of the systems studied, a five-second air-drying time appeared to be appropriate.

This study examined the relationship between delay in composite placement over cured adhesives and the dentin bond strength of several single-application self-etch adhesive systems. The adhesive system/resin composite combinations used were: Adper Prompt L-Pop/Filtek Z250 (AP), AQ Bond Plus/Metafil C (AQ), Fluoro Bond Shake One/Beautifil (FB), G-Bond/Solare (GB), One-Up Bond F Plus/Palfique Estelite (OF), Xeno IICF Bond/Xeno CF (XE). Bovine mandibular incisors were mounted in self-curing resin and wet ground with #600 SiC to expose labial dentin. The adhesives were applied according to each manufacturer's instructions, and resin pastes were condensed into a mold (o4x2 mm) immediately, and 1, 2, 5 and 10 minutes after light irradiation of the adhesives. Ten samples per test group were stored in 37 degrees C water for 24 hours, then shear tested at a crosshead speed of 1.0 mm/minute. One-way ANOVA followed by Tukey's HSD test (alpha = 0.05) was done. SEM observations of the dentin surface after the tests were also conducted. Dentin bond strength ranged from 9.5 +/- 2.2 to 14.0 +/- 2.4 MPa for AP, 7.3 +/- 2.2 to 12.2 +/- 3.1 MPa for AQ, 10.0 +/- 3.5 to 16.3 +/- 2.4 MPa for FB, 11.4 +/- 1.5 to 16.3 +/- 1.2 MPa for GB, 14.2 +/- 3.4 to 15.1 +/- 3.0 MPa for OF and 11.5 +/- 2.4 to 15.9 +/- 2.2 MPa for XE. Except for OF, no significant differences were found among the 2 to 10 minute delayed placement groups for the systems used. Significant lower bond strengths were obtained for the immediate placement groups except for OF. From SEM observations, cohesive failure of the dentin surface was more pronounced with the longer delay in placement. The data suggest that delayed composite placement over the cured adhesives are suggested for optimum dentin bond strength of single-application self-etch adhesive systems.