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Objective The purpose of this study is to compare the tensile bond strength values to composite substrate pre- and post-aging between IPS E.max CAD and Initial LiSi. Methods The study utilized four blocks of IPS E.max CAD LT/B1 C14 (Ivoclar Vivadent, Liechtenstein, Germany) (referred to as E) and four blocks of Initial LiSi LT/B1 (GC, Tokyo, Japan) (referred to as L). These blocks were milled to produce 76 ceramic bars measuring 2 mm × 2 mm × 10 mm (E = 38, L = 38/n = 19). After acid etching with hydrofluoric acid (BISCO, Schaumburg, IL, USA) and silane application (BIS-SILANE, BISCO), the specimens were embedded in putty (Express STD, 3M, Decatur, AL, USA) to create a mold for the resin cement (RelyX U200, 3M). Subsequently, one group of each brand underwent mechanical tensile testing (E0 and L0), while the other groups were subject to tensile testing after artificial aging involving 500 thermal cycles between 5 and 55°C (E5 and L5). The mean tensile strength for each group (E0, E5, L0, and L5) was determined using the Brown-Forsythe one-way ANOVA and Tamhane's post hoc tests. Results Initial LiSi showed a superior pre-aging mean (11.7 MPa). However, both materials had identical post-aging means (7.6 MPa). There were no statistically significant differences, except between the dependent Initial LiSi groups (L0-L5). Most failure modes were mixed (cohesive cement and adhesive). There were no cohesive failures on the cement side except in three specimens of Initial LiSi post-aging. Conclusion The tested conditions have shown that Initial Lisi exhibited the highest pre-aging mean; however, it exhibited inferior bond stability under aging conditions compared to IPS E.max CAD. Analyzing the microstructure before and after aging may provide insights into the greater decrease in bond strength observed in the Initial LiSi specimens., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alsulimani et al.)

Objectives: Resin cements are light polymerized, but the light may not reach all areas of root canals. The purpose of this study was to determine the best predictor of transmitted light radiant exposure (TLRE) from posts' sides., Materials and Methods: Fiber posts were placed in a custom-made apparatus and advanced by 1-mm increments. The LED curing probe tip was activated for 40 s on the coronal end of the post. The TLRE was measured with an LED radiometer detector positioned on the side of the post exposed by an opening in the apparatus. Hierarchical multiple linear regression analysis was performed., Results: Post system explained an additional 23.62% of the variation in TRLE. Adding actual post diameter explained an additional 62.64% of the variation in TRLE. While adding post length explained an additional 0.67%. Changing post system from FiberKleer to Postec Plus will decrease the mean value of TRLE by 4.90 units on average. Also, a one-unit increase of actual post diameter and length will decrease the value of TRLE by 44.96 and 0.44 units respectively. The TLRE ranged from 46 to 290 mJ/cm 2 , which was between 0.73% and 6.63% of the original emanating light., Conclusions: The changes in post system, posts' diameter and length can be used to predict the unit changes in TLRE on the side of a translucent fiber post. Emanating radiant exposure from the side of the post was lower than 6.63% of the exposure entering the post., Clinical Relevance: Fiber post diameter and length and post system can influence light radiant exposure transmitted from posts' sides, transmitting minimal radiant exposure, which can be increased by increasing curing duration., (© 2023 Wiley Periodicals LLC.)

Introduction . Using rapid antigen diagnostic tests (RADTs) in clinical practice has shown excellent specificity but often has diminished sensitivity. Gap Statement . Local data for evaluating the diagnostic performance of a new fluorescence-based RADT and its influence on the antibiotic prescription rate are not available. Aim . To evaluate the accuracy of fluorescent immunoassay (FIA)-RADTs for diagnosing group A streptococcal (GAS) pharyngitis among children and its estimated effect as a point of care test (POCT) on the antibiotic prescription rate at the paediatric emergency department. Methodology . A prospective study was conducted, comprising children 3 to 14 years old presenting with pharyngitis. Throat swab culture and FIA-RADTs were performed on all samples. Conventional PCR was performed on the discordant samples. Results . A total of 246 children were included in this study. The sensitivity, specificity, and positive and negative predictive values of the FIA-RADT, based on culture results and PCR detection combined, were 95.6, 96.8, 94.6 and 97.4 %, respectively. Antibiotics have been prescribed to 162 (65.9 %) children; however, if FIA-RADTs had been added in the clinical practice as a POCT, only 92 (37.4 %) children would have received antibiotics in total. Additionally, implementation of FIA-RADTs would significantly reduce the antibiotic prescription rate from 48.8 and 60.6 % to 9.5 and 31.9 % among patients with clinical scores of 2 and 3, respectively. Conclusion . The new FIA-RADT is simple, prompt and reliable. It is helpful in clinical settings and may be used to reduce antibiotic overprescription, especially for children who have a low risk for GAS pharyngitis, according to the clinical score.

Background: Extracorporeal membrane oxygenation (ECMO) has been used as a rescue strategy in patients with severe with acute respiratory distress syndrome (ARDS) due to SARS-CoV-2 infection, but there has been little evidence of its efficacy., Objectives: To describe the effect of ECMO rescue therapy on patient-important outcomes in patients with severe SARS-CoV-2., Methods: A case series study was conducted for the laboratory-confirmed SARS-CoV-2 patients who were admitted to the ICUs of 22 Saudi hospitals, between March 1, 2020, and October 30, 2020, by reviewing patient's medical records prospectively., Results: ECMO use was associated with higher in-hospital mortality (40.2% vs. 48.9%; p = 0.000); lower COVID-19 virological cure (41.3% vs 14.1%, p = 0.000); and longer hospitalization (20.2 days vs 29.1 days; p = 0.000), ICU stay (12.6 vs 26 days; p = 0.000) and mechanical ventilation use (14.2 days vs 22.4 days; p = 0.000) compared to non-ECMO group. Also, there was a high number of patients with septic shock (19.6%) and multiple organ failure (10.9%); and more complications occurred at any time during hospitalization [pneumothorax (5% vs 29.3%, p = 0.000), bleeding requiring blood transfusion (7.1% vs 38%, p = 0.000), pulmonary embolism (6.4% vs 15.2%, p = 0.016), and gastrointestinal bleeding (3.3% vs 8.7%, p = 0.017)] in the ECMO group. However, PaO 2 was significantly higher in the 72-h post-ECMO initiation group and PCO 2 was significantly lower in the 72-h post-ECMO start group than those in the 12-h pre-ECMO group (62.9 vs. 70 mmHg, p = 0.002 and 61.8 vs. 51 mmHg, p = 0.042, respectively)., Conclusion: Following the use of ECMO, the mortality rate of patients and length of ICU and hospital stay were not improved. However, these findings need to be carefully interpreted, as most of our cohort patients were relatively old and had multiple severe comorbidities. Future randomized trials, although challenging to conduct, are highly needed to confirm or dispute reported observations., (© 2021. The Author(s).)

Objectives: Many countries have enforced lockdowns on their populations due to the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess the effects of the lockdown on dental students., Methods: A longitudinal, repeated cross-sectional study was conducted to evaluate psychological problems experienced by dental students during the COVID-19 lockdown in Saudi Arabia. The dental students were selected from different universities using 2-stage cluster sampling. The validated Arabic version of the 21-item depression, anxiety, and stress scale questionnaire was distributed at the beginning and end of the lockdown. Mann-Whitney U and Kruskal-Wallis tests were used as appropriate. Chi-square test was used to compare the proportions between the sociodemographic data, and logistic regression analysis was used to identify variables associated with the students' responses., Results: A total of 1287 respondents participated in this study (695 first-survey respondents, 592 second-survey respondents). There were longitudinally significant differences in the students' mental health outcomes based on gender, university, class year, and survey time during the COVID-19 lockdown. The lockdown increased the likelihood of female, single, and junior students experiencing stress. The students who lived alone recorded a high chance of elevated levels of depression, anxiety, and stress, which showed a significant longitudinal reduction during the lockdown. Moreover, the lockdown increased the likelihood of mental health problems among the students staying in households of two persons or two-five persons., Conclusions: This study indicates the importance of considering the detrimental mental health consequences on dental students in the event of future pandemics., (© 2021 American Dental Education Association.)

Dentinal hypersensitivity (DH) is a condition that causes patient discomfort. To evaluate the clinical efficacy of Gluma, fluoride varnish and Tetric N-Bond self-etch system in relieving DH immediately and over 30 days following a single topical application. The present randomized clinical trial was conducted on 55 patients with an age range 20-49 years. 70 teeth in total were incorporated and randomly assigned to the three groups. Parameters examined were: Tactile, air blast, and cold stimuli. VAS was used to assess tactile stimulus whereas the Schiff Cold Scale for air blast and cold stimuli. DH was evaluated immediately, at two weeks and 1 month follow up. Gluma showed a statistically significant reduction in DH scores over other materials. It was concluded that Gluma have statistically significant results over other materials in relieving DH immediately and over 30 days following a single topical application.Trial Registration: Clinical Trials.gov Identifier: NCT04351412, King Abdulaziz University Protocol Record 129-09-19. Registered 17 April 2020 - Retrospectively registered. http://ClinicalTrials.gov/NCT04351412 .

Background: Surgical root canal retreatment is required when peri-radicular pathosis associated with endodontically treated teeth cannot be treated by non-surgical root canal therapy (retreatment), or when retreatment was ineffective, not feasible or contraindicated. Endodontic failures maybe happen when irritants remain within the confines of the root canal, or when an extra-radicular infection cannot be eradicated by orthograde root canal treatment. Following enhanced microsurgical techniques in the last years, the success rates of surgical root canal retreatment have improved considerably., Objective: The aim of this systematic review is to gather updated data in regard to the surgical root canal (retrograde) retreatment to heal the periapical lesions., Materials and Methods: The electronic databases PubMed and Google Scholar were searched in this review using specific inclusion and exclusion criteria. The search was performed in June 2019 and updated in November 2019. Among 3900 studies, 10 studies satisfied the eligibility criteria and were included in the review to be analyzed., Results: The 10 studies showed the importance of surgical root canal retreatment as a treatment option in removing infections within the root canal system and its efficiency in periapical tissue healing. These studies investigated different aspects of healing of periapical lesion after surgical (retrograde) retreatment including success rates, follow-up duration, and updated studies in surgical (retrograde) retreatment., Conclusions: Surgical root canal (retrograde) retreatment demonstrates its efficiency in reducing the period needed for healing of the periapical lesions in short-term follow-up compared to conventional orthograde retreatment., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Alghamdi et al.)