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Most traumatic dental injuries among children and young adults involve the anterior teeth, and periapical pathologies are the most common findings in these injuries. Calcium hydroxide (Ca[OH]2) has the potential to maintain a sterile root canal and stimulate the healing of periapical pathology. This study describes the conservative endodontic management of chronic periapical infections due to trauma involving the anterior permanent teeth of two 16-year-old patients (male 1 and female 1) and the results at a 12-month follow-up. Conservative nonsurgical therapy was planned for both patients. Necrotic pulp exudates were removed, and the root canals were dressed with Ca(OH)2 paste up to the apices. The paste was changed every 3 weeks. Periapical healing was observed on control visits without surgery and continued in the 12-month review. [ABSTRACT FROM AUTHOR]

Objectives: To determine the effect of proper light-curing instruction on the radiant exposure (energy density) delivered by dentists using six dental curing lights to a posterior Class 1 restoration. Method and Materials: Twenty-five dentists attending a professional meeting were instructed to position a patient simulator (MARC-PS, BlueLight), as they would for a patient, and then to expose the simulated Class 1 maxillary second molar preparation for a specified amount of time. At this point, the dentists were unaware of the purpose of the experiment. Each participant used three different curing lights, and the irradiance and radiant exposure (J/cm2) delivered to the preparation was recorded. Participants were then informed of the purpose of the exercise, and given specific light-curing instructions and training using the patient simulator, after which they re-exposed the same preparation using the same curing lights. Pre- and post-instruction radiant exposure values were compared using one-way ANOVA (α = .05), and for each light among all operators using a two-tailed, paired Student’s t test. Results: There was a wide variation in the radiant exposure delivered by the dentists and by the six curing lights, from 2.9 to 15.4 J/cm2. Before receiving additional light-curing instruction, 68% of dentists delivered less than 10 J/cm2. The radiant exposure delivered increased significantly (P < .001) by up to 30%, as a result of training using MARC-PS. Conclusion: The results indicate that some of the dentists participating in the present study delivered an inadequate amount of radiant exposure before instruction. More energy was delivered after a short training session using the MARC-PS. Reinforcing the proper photo-curing techniques may improve the outcome when placing resin-based restorations. [ABSTRACT FROM AUTHOR]

Background/Aim: The components of calcium silicate-based materials can be identified through X-Ray Diffraction Analysis. This study aimed to determine the hydration reactions and particle size of MTA Angelus, Biodentine, and NeoMTA Plus as calcium-silicate-based materials. Material and Methods: The powder and set cement samples using divergence and scatter slits of 1○ and a receiver slit of 0.10 mm. The scanning range was set at 5○ to 70○, and ongoing scans for the theta-2theta range was performed with a scan speed of 2○/minute (-1). The patterns obtained were analyzed using search-match software. The three most substantial peaks were used to identify hydration reactions and major crystalline structures. Also, Scanning Electron Microscope (SEM) analysis was performed and the particle size of set materials were determined using an image analysis software. Results: According to X-Ray Diffraction Analysis, the main components were determined as tricalcium silicate and dicalcium silicate in the three calcium silicate-based materials. We determined that the main components of the materials were similar. We also identified the extensive presence of tricalcium aluminate in MTA Angelus, calcium carbonate in Biodentine, and calcium phosphate salts in NeoMTA Plus. Furthermore, the results of the present particle analysis show that the calcium-silicate-based materials' distribution of particle count and size varies. Biodentine has the widest, and MTA Angelus has the narrowest particle size distribution range. NeoMTA Plus has the largest number of fine, large-sized particles (p < 0.0001), while MTA Angelus and Biodentine have a more homogeneous and nonstatistically significant particle distribution range (p > 0.05). Conclusions: The present findings provide insight into variations in performance between different calcium-silicate-based materials.

Background/Aim: This in-vitro study evaluated the apical-sealing ability of MTA, MTA+10% CaCl2, Biodentine™ and RMGIC when used as retrograde material.

This study determined if dentin proteases are denatured by phosphoric acid (PA) used in etch-and-rinse dentin adhesives. Dentin beams were completely demineralized with EDTA for 30 days. We “acid-etched” experimental groups by exposing the demineralized dentin beams to 1, 10, or 37 mass% PA for 15 sec or 15 min. Control beams were not exposed to PA but were incubated in simulated body fluid for 3 days to assay their total endogenous telopeptidase activity, by their ability to solubilize C-terminal crosslinked telopeptides ICTP and CTX from insoluble dentin collagen. Control beams released 6.1 ± 0.8 ng ICTP and 0.6 ± 0.1 ng CTX/mg dry-wt/3 days. Positive control beams pre-incubated in p-aminophenylmercuric acetate, a compound known to activate proMMPs, released about the same amount of ICTP peptides, but released significantly less CTX. Beams immersed in 1, 10, or 37 mass% PA for 15 sec or 15 min released amounts of ICTP and CTX similar to that released by the controls (p > 0.05). Beams incubated in galardin, an MMP inhibitor, or E-64, a cathepsin inhibitor, blocked most of the release of ICTP and CTX, respectively. It is concluded that PA does not denature endogenous MMP and cathepsin activities of dentin matrices. [ABSTRACT FROM PUBLISHER]

The processes involved in placing resin composite restorations may degrade the fatigue strength of dentin and increase the likelihood of fractures in restored teeth. Objective The objective of this study was to evaluate the relative changes in strength and fatigue behavior of dentin caused by bur preparation, etching and resin bonding procedures using a 3-step system. Methods Specimens of dentin were prepared from the crowns of unrestored 3rd molars and subjected to either quasi-static or cyclic flexural loading to failure. Four treated groups were prepared including dentin beams subjected to a bur treatment only with a conventional straight-sided bur, or etching treatment only. An additional treated group received both bur and etching treatments, and the last was treated by bur treatment and etching, followed by application of a commercial resin adhesive. The control group consisted of "as sectioned" dentin specimens. Results Under quasi-static loading to failure there was no significant difference between the strength of the control group and treated groups. Dentin beams receiving only etching or bur cutting treatments exhibited fatigue strengths that were significantly lower (p↜0.0001) than the control; there was no significant difference in the fatigue resistance of these two groups. Similarly, the dentin receiving bur and etching treatments exhibited significantly lower (p↜0.0001) fatigue strength than that of the control, regardless of whether an adhesive was applied. Significance The individual steps involved in the placement of bonded resin composite restorations significantly decrease the fatigue strength of dentin, and application of a bonding agent does not increase the fatigue strength of dentin. [ABSTRACT FROM AUTHOR]

Identifying genetic risk factors for highly heterogeneous disorders like epilepsy remains challenging. Here, we present the largest whole-exome sequencing study of epilepsy to date, with >54,000 human exomes, comprising 20,979 deeply phenotyped patients from multiple genetic ancestry groups with diverse epilepsy subtypes and 33,444 controls, to investigate rare variants that confer disease risk. These analyses implicate seven individual genes, three gene sets, and four copy number variants at exome-wide significance. Genes encoding ion channels show strong association with multiple epilepsy subtypes, including epileptic encephalopathies, generalized and focal epilepsies, while most other gene discoveries are subtype-specific, highlighting distinct genetic contributions to different epilepsies. Combining results from rare single nucleotide/short indel-, copy number-, and common variants, we offer an expanded view of the genetic architecture of epilepsy, with growing evidence of convergence among different genetic risk loci on the same genes. Top candidate genes are enriched for roles in synaptic transmission and neuronal excitability, particularly postnatally and in the neocortex. We also identify shared rare variant risk between epilepsy and other neurodevelopmental disorders. Our data can be accessed via an interactive browser, hopefully facilitating diagnostic efforts and accelerating the development of follow-up studies., Competing Interests: Competing Interests B.M.N is a member of the scientific advisory board at Deep Genomics and Neumora. No other authors have competing interests to declare

Introduction: This study evaluates the impact of decontamination methods on Microtensile bond strength (μTBS) between resin cement and resin blocks., Methods: Twenty CAD/CAM resin blocks from two manufacturers were wet-polished, sandblasted, and ultrasonically cleaned. After blood and saliva contamination, blocks were divided into subgroups: control, water rinsing, acid etching, alkaline cleaning paste, or 10-MDP containing cleaner. Resin-based cement was then applied. After 24 hours, the blocks were sectioned to obtain bars for testing. Half of the specimens were tested immediately for μTBS, and the other half underwent artificial aging. The surfaces of the blocks were inspected with a scanning electron microscope (SEM). Three-way ANOVA was performed for μTBS values (α=0.05)., Results: In one of the substrates, the positive control subgroup obtained the highest value (56,01 MPa, SD:6,96) followed by 10-MDP cleaner and universal cleaning paste, when immediately tested, with significant differences respect to the water rinsing (p⟨0.041) and acid etching (p⟨0.048) groups. After thermocycling, higher values were found in the 10-MDP cleaner (47,57 MPa, SD:8,15), but differences were not significant. In the other substrate group, the 10-MDP cleaner subgroup showed highest bond strengths (64,46 MPa SD: 10,92) at the initial test. After thermocycling, 10-MDP cleaner (58,66 MPa, SD: 9,93) gave the highest μTBS value. Significant differences between water rinsing group and the rest of subgroups (p⟨0.001), and between 10-MDP cleaner and the positive control group (p⟨0.006) were observed., Conclusion: Cleaning after contamination improves bonding. 10-MDP containing cleaner can help to restore initial μTBS value and maintain it in the long-term., (Copyright© 2024 Dennis Barber Ltd.)

Objectives: To examine whether dentin-etching extension and/or the hydrophobic-rich content of hybrid layers would affect fatigue strengths of a mild universal adhesive after long-term aging., Methods: Twin-bonded resin-dentin interfaces were produced by etching sound midcoronal dentin beams with 32 % ortho-phosphoric acid for 15 s (OPA15s), 3 s (OPA3s) or 10 % meta-phosphoric acid for 15 s (MPA15s). Samples were bonded with a mild universal adhesive with or without additional coating using a solvent-free bisGMA-based bonding resin. Self-etch application served as control. Composite buildups were made with a nanofilled composite. Bar-shaped twin-bonded interfaces (0.9 × 0.9 × 12 mm) were aged for two years in artificial saliva at 37 ℃ and tested under 4-point flexure at quasi-static (n = 16) and cyclic loads (n = 35) until failure. The stress-life fatigue behavior was evaluated using the staircase method at 4 Hz. Crack initiation and fracture patterns were evaluated by SEM. Cyclic-loaded data was analyzed by Kruskal-Wallis on Ranks (α = 0.05)., Results: Significantly higher fatigue life distributions and higher endurance limits were observed for less aggressive etch-and-rinse protocols (OPA3s and MPA15s) after long-term ageing. Hydrophobic-rich coating produced 20-32 % higher endurance limits, prevented micrometer-sized porosities at bonded interfaces, reduced etching-associated variability and lowered crack formation. Significance Long-term hydrolysis produces detrimental effects on the fatigue strength of resin-dentin interfaces. The bond-promotion effect of less aggressive etch-and-rinse protocols and the creation of hybrid layers with higher hydrophobic-rich content are critical to extend the durability of mild universal adhesives. Therefore, current oversimplification trends in adhesive dentistry may limit resin-dentin bonding performance., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Learning tooth preparation techniques and the finesse required is an important part of preclinical dental education. Being able to practice surgical skills without loss of Frasaco® teeth while being provided with performance analysis data is a boon to students and educators. We investigated the combination of haptics-enhanced virtual reality (Simodont®) and conventional phantom head practice in a preclinical dental course, evaluating the students' performances and perceptions. Forty students were randomized into two groups: Group One began within a VR-haptic setting while Group Two worked with Frasaco® teeth. Halfway through the course the scenarios were switched. A crown preparation test on Frasaco® teeth was conducted at the end of the course. Students' performances and satisfaction were assessed anonymously. Analysis of the students' performances included clinical metrics (occlusal and axial reduction, convergence angle, damage to adjacent teeth). The perceived usefulness of VR-haptic and phantom head simulations was assessed. In Group One, the tooth preparation metrics were more in line with the requested parameters compared to Group Two. All students ranked VR-haptics highly regarding manual dexterity improvement. In conclusion, this study shows that by combining VR-haptics with conventional dental procedures, it is possible to improve important preparation metrics in fixed prosthodontics tooth preparation.

POU3F3 variants cause developmental delay, behavioral problems, hypotonia and dysmorphic features. We investigated the phenotypic and genetic landscape, and genotype-phenotype correlations in individuals with POU3F3-related disorders. We recruited unpublished individuals with POU3F3 variants through international collaborations and obtained updated clinical data on previously published individuals. Trio exome sequencing or single exome sequencing followed by segregation analysis were performed in the novel cohort. Functional effects of missense variants were investigated with 3D protein modeling. We included 28 individuals (5 previously published) from 26 families carrying POU3F3 variants; 23 de novo and one inherited from an affected parent. Median age at study inclusion was 7.4 years. All had developmental delay mainly affecting speech, behavioral difficulties, psychiatric comorbidities and dysmorphisms. Additional features included gastrointestinal comorbidities, hearing loss, ophthalmological anomalies, epilepsy, sleep disturbances and joint hypermobility. Autism, hearing and eye comorbidities, dysmorphisms were more common in individuals with truncating variants, whereas epilepsy was only associated with missense variants. In silico structural modeling predicted that all (likely) pathogenic variants destabilize the DNA-binding region of POU3F3. Our study refined the phenotypic and genetic landscape of POU3F3-related disorders, it reports the functional properties of the identified pathogenic variants, and delineates some genotype-phenotype correlations., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Due to favourable biological and physical properties, calcium silicate-based cements (CSCs) are biocompatible materials used widely for vital pulp therapies. Sealing efficacy between the adhesive system and CSC determines the clinical success of treatment. This study aimed to evaluate the shear bond strength (SBS) of CSC to composite resin with different adhesive systems and to analyse the CSC-composite interface. Mineral trioxide aggregate (MTA) (ProRoot MTA; Dentsply Tulsa Dental, Tulsa, OK), Biodentine (Septodont, Saint-Maur-des-Fossés, France) and NeoMTA Plus (Avalon Biomed Inc., Bradenton, FL) samples (n = 90) were placed in the cavities and divided into three subgroups according to the adhesive family (n = 10). SBSs were measured using a universal testing machine. The interfaces were examined using a scanning electron microscope (SEM) (×1000). NeoMTA Plus showed significantly higher SBS values than MTA and Biodentine (P < 0.0001). The application of total-etch adhesive system over Biodentine and NeoMTA Plus provided the statistically highest bond strength (P < 0.05). However, when the SBS values of MTA subgroups were compared, different adhesive families applied over MTA did not make a significant difference in SBS values (P > 0.05). Based on SEM analyses, the specimens exhibit no gaps, cracks or delamination within the adhesive layer, which indicates a good adhesion between the CSC-composite interface in all subgroups. In conclusion, the different adhesive families used over CSC did not influence interfacial gap formation., (© 2021 Australian Society of Endodontology Inc.)

Objective: To determine whether smear layer management, via conservative etching protocols, and the hydrophobic-rich content of hybrid layers would affect the fatigue strength of resin-dentin interfaces., Methods: Bar-shaped dentin beams obtained from sound third molars were wet-polished for 30 s. Dentin was etched with 32 % ortho-phosphoric acid for 3 or 15 s, 10 % meta-phosphoric acid for 15 s or by a prime-and-rinse application using a mild universal adhesive (Scotchbond Universal, 3M ESPE). Self-etch application served as control. Coating was performed with a solvent-free bisGMA-based resin. Composite buildups were made with a nanofilled composite. Resin-dentin beams with twin-bonded interfaces were sectioned and stored in deionized water for 24 h at 37 ℃ before 4-point flexural quasi-static monotonic testing (n = 16). Stress-life fatigue behavior was evaluated under cyclic loading (n = 35) by the staircase method at 4 Hz. The tension side of cyclic-loaded unfractured beams were evaluated under SEM, along with the micro-morphology of etched dentin surfaces. Monotonic data was analyzed by two-way ANOVA followed by the Tukey Test and cyclic-loaded data by Kruskal-Wallis on Ranks (α = 0.05)., Results: Etching protocols and higher hydrophobic-rich content produced significantly higher fatigue life distributions (p < 0.05). Dentin demineralization was ranked as OPA 15 s > MPA 15 s > OPA 3 s > P + R > SE. Less aggressive etching and coating reduced crack formation at hybrid layers., Significance: Current oversimplification trends in resin-dentin bonding constitute a trade-off between hybridization quality and easier adhesive handling. Controlled dentin etching and increasing the hydrophobic-rich content of hybrid layers may be necessary to extend the longevity of mild universal adhesives., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: This study aimed to determine caries prevalence, oral health practices/behaviours and dental anxiety levels amongst dental hygiene students., Materials and Methods: A self-administered questionnaire was used to determine students' oral hygiene practices/behaviours. The students were subjected to oral examinations to determine their decayed, missing, filled teeth (DMFT) scores according to the WHO criteria. In addition, the Corah's Dental Anxiety Scale (CDAS) was used to measure the students' dental anxiety levels., Results: A total of 280 students (mean age: 20.8 years) participated in this study. Amongst the students, 52.8% brush their teeth twice a day, and 17.48% and 15.17% use floss and mouthwash daily, respectively. Moreover, the defined smoking rate was 22.85%. The mean DMFT scores of the preclinical and clinical students were 3.39 ± 3.22 and 3.55 ± 3.19, respectively. Most of the students (82.6%) preferred fluoride toothpaste, and the DMFT scores of those who use and do not use fluoride toothpaste significantly differed (p = 0.031). Furthermore, junk-food consumption affected the scores for decayed teeth (p = 0.048) and missing teeth (p = 0.039). Most students had low or moderate CDAS scores (CDAS <13), and anxiety scores were lower amongst the clinical students than amongst the preclinical students., Conclusions: Although the students demonstrated favourable oral health behaviours/practices and low caries prevalence, their adherence to oral hygiene instructions and to healthy dietary and lifestyle habits should improve. The importance of this topic should be strongly emphasized in the undergraduate curriculum. For this purpose, professional behavioural control methods that suit students' individual capacities, motivations and therapeutic needs may be employed. The principal findings of similar studies should be evaluated by lecturers to help students adopt optimal oral health practices/behaviours, reducing their dental anxiety levels and improving their professional competencies., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: This study aimed to evaluate the educational concerns and awareness level among dental hygiene students during the COVID-19 pandemic., Materials and Methods: A questionnaire, created via Google Forms, was sent electronically to 240 dental hygiene students from Turkey, of which 223 replied to the survey. The questionnaire was divided into 4 parts and consisted of 24 close-ended questions., Results: The main symptoms of COVID-19 were correctly recognized by 71% of the students, and 40.2% of the students were aware of the transmission routes. Of all, 77.1% of the students expressed fear of getting infected, 96.9% believed that they would more likely get infected while performing dental procedures, and 91% believed that dental hygienists' cross-contamination risk was high. Furthermore, 69.5% of the students stated that their undergraduate education process was negatively affected, 59.6% appreciated ongoing online education, and 31.8% wanted face-to-face clinical internships., Conclusions: Although most of the students were aware of the transmission routes and preventive measures of COVID-19, concerns regarding disease transmission among them remain. Students appreciated the ongoing online education and believed that face-to-face education is risky during this current pandemic. However, they believe that this process can adversely affect their professional knowledge and especially practical skills. A balance must be struck between sustaining an effective dental hygiene education process and containing the spread of COVID-19., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Human mitochondrial disease exhibits large variation of clinical phenotypes, even in patients with the same causative gene defect. We illustrate this heterogeneity by confronting clinical and biochemical data of two patients with the uncommon pathogenic homoplasmic NC&#95;012920.1(MT-ATP6):m.9035T>C variant in MT-ATP6 . Patient 1 presented as a toddler with severe motor and speech delay and spastic ataxia without extra-neurologic involvement. Patient 2 presented in adolescence with ataxia and ophthalmoplegia without cognitive or motor impairment. Respiratory chain complex activities were normal in cultured skin fibroblasts from both patients when calculated as ratios over citrate synthase activity. Native gels found presence of subcomplexes of complex V in fibroblast and/or skeletal muscle. Bioenergetic measurements in fibroblasts from both patients detected reduced spare respiratory capacities and altered extracellular acidification rates, revealing a switch from mitochondrial respiration to glycolysis to uphold ATP production. Thus, in contrast to the differing disease presentation, biochemical evidence of mitochondrial deficiency turned out quite similar. We conclude that biochemical analysis remains a valuable tool to confirm the genetic diagnosis of mitochondrial disease, especially in patients with new gene variants or atypical clinical presentation.

Autosomal recessive cerebellar ataxias (ARCA) are characterized by the abnormal structure of the cerebellum and spinal cord. Spinocerebellar ataxia type 18 (MIM 616204), one of the ARCA, is caused by the loss-of-function mutations of the GRID2 gene due to deletions. Missense mutations in the GRID2 cause ataxia with the gain-of-function mechanism. We report a homozygous GRID2  duplication in childhood-onset ataxia in two siblings. The clinical exome sequencing was performed on one of the siblings. No disease-causing mutations were reported as a result of the clinical exome test. Chromosomal microarray analysis was performed on the entire family using Affymetrix Optima ® chips. Chromosomal microarray analysis showed a ~ 121-kb homozygous duplication of GRID2 (arr[GRCh37]4q22.2(94426536&#95;94613158) × 4), including exon 14, in both siblings. Previously, GRID2 has been associated with an autosomal recessive (loss-of-function) and autosomal semi-dominant (gain-of-function) forms of ataxia. To the best of our knowledge, this is the first study to identify a homozygous duplication of GRID2 causing loss of function of the GluRD2 protein. These findings provide us with the conclusion that copy number variation analyses should be in the diagnostic process of autosomal recessive ataxia types., (© 2020. Belgian Neurological Society.)

Kabuki syndrome (KS) is a disease characterized by distinctive facial features, skeletal anomalies and delay in neuromotor development. KS 1 is an autosomal dominant condition caused by mutations in the KMT2D gene, whereas KS 2 is an X-linked disorder caused by mutations in the KDM6A gene. In the majority of KS patients who present with hypoglycemia, KDM6A is the defective gene. A 9-month old girl was admitted to our emergency department due to a seizure. On physical examination, hypotonia, mild facial dysmorphism, brachydactyly of the 5 th finger, prominent finger pads and pansystolic murmur were detected. A fasting glucose tolerance test was performed the next day due to her history of hypoglycemia, but she had convulsions at the fifth hour of the test. Her serum glucose was 24 mg/dL, insulin 1.94 mIU/L, C-peptide 0.94 ng/mL, growth hormone 11 ng/mL, anti-insulin antibody 4.2 IU/mL, cortisol 19.8 μg/dL, and adrenocorticotropic hormone 9.3 pg/mL. A diagnosis of hyperinsulinemic hypoglycemia was considered. Given the abnormalities, genetic analysis for congenital hyperinsulinism, including the genes causing KS was performed. A heterozygous frameshift mutation (c.2579del, p.Leu860Argfs*70) was detected in the KMT2D gene. Epilepsy and other neurological symptoms may be seen in KS patients and in some of these the neurological symptoms are the result of hypoglycemia. In such cases, the detection and prevention of hypoglycemia can help prevent the progression of neurological symptoms. We suggest considering the diagnosis of KS for patients with hypoglycemia and dysmorphic features, even if the patient does not manifest all features of KS.

Objectives: The aim of this study was to evaluate the effect of the work environment and expertise/specialty degree  of dentists on their behavior, awareness, and  attitudes regarding cross-infection control during the COVID-19 pandemic., Design: The study population consisted of Turkish dentists who work in private clinics, public clinics and university hospitals. The demographic information of the participants, their awareness of the COVID-19 acute respiratory disease, and clinical measures taken against cross-infection were evaluated with an online survey. Between the 10 th  and 20 th  of November 2020, 2,400 surveys were e-mailed to dentists., Results: A total 454 professionals answered the survey. According to the results, 29.3% of the participants performed only urgent care during the pandemic period, whereas 59.9% of them performed both urgent and routine treatments. Among the responding dentists, 90.6% stated that they were worried about aerosol-generating dental procedures, but there was no differences between genders (p = 0.119). Most participants, especially specialists (p = 0.160) , applied strict cross-infection control methods during the COVID-19  pandemic (77.2%). These dentists used personal protective equipment (PPE) at rates that varied between 75.5% and 98.4%. Nonetheless, the rate of PPE use was different between genders and degrees of expertise: women used PPE more frequently than men (p = 0.025), and specialists used PPE more often than the other dentists (p = 0.04). Finally, there was a weak positive correlation between the level of PPE use and expertise (r = 0.121; p = 0.010)., Conclusions: Despite the overall knowledge of the participants regarding COVID-19 symptoms, transmission routes, and the guidelines needed to prevent the virus from spreading, the dental specialists followed infection control methods more strictly. Even though the participants were concerned about dental practices that create microbial aerosols during the pandemic period, they continued their clinical routines using high PPE levels and taking extra clinical precautions to avoid cross-infection., Competing Interests: Conflicts of interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2021 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: To characterize whether the bonding performance and fatigue strength of resin-dentin interfaces created by a universal adhesive would be affected by different H 3 PO 4 -application times to more accurately assess long-term durability., Methods: Mid-coronal flat dentin surfaces with standardized smear-layers were produced on sound third molars, etched with 32% H 3 PO 4 for 0, 3 and 15 s, bonded with a mild universal adhesive (3M-ESPE) and restored with a nanofilled composite. Bonded specimens (0.9 × 0.9 mm) were stored in deionized water for 24 h and sectioned into beams for microtensile testing (n = 10). Resin-dentin beams were tested under tension until failure (0.5 mm/min) after 24 h or 6 month storage in artificial saliva at 37 ̊C. Bar-shaped resin-dentin beams (0.9 × 0.9 × 12 mm) were tested under 4-point-flexure initially at quasi-static loads (n = 22) and then under cyclic loads (n > 50). The stress-life fatigue behavior was evaluated using the twin-bonded interface approach by the staircase method at 4 Hz. Fractured interfaces and the tension side of unfractured beams were evaluated under SEM, along with the micro-morphology of the etched dentin surfaces and hybrid layers. Data were analyzed by ANOVA and Tukey test and Wilcoxon Rank Sum Test (α = 0.05)., Results: Quasi-static loads were limited to discriminate the bonding performance of resin-dentin interfaces. Application modes significantly affected etching patterns, fatigue strength, endurance limits and hybrid layer morphology (p < 0.001)., Significance: Reductions in fatigue strength of self-etched bonded interfaces raise concerns about the true ability of universal adhesives to properly bond to dentin., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: As a measure of the leadership diversity in prosthodontics, the number and percentage of women and nonwhite Presidents of prosthodontics organizations is unknown., Purpose: The purpose of this observational study was to calculate and compare the number and percentage of women and nonwhite Presidents of 10 selected prosthodontic organizations over the past 20 years and to determine whether the number of women and nonwhite Presidents has changed over the time frame of 2000-2019 in comparison to male and white Presidents., Material and Methods: The number of women and nonwhite Presidents of the Academy of Prosthodontics (AP), American Academy of Fixed Prosthodontics (AAFP), American Academy of Maxillofacial Prosthetics (AAMP), American College of Prosthodontists (ACP), American Prosthodontic Society (APS), European Prosthodontic Association (EPA), International Association of Dental Research - Prosthodontics group (IADR-P), International College of Prosthodontists (ICP), Greater New York Academy of Prosthodontics (GNYAP), and Pacific Coast Society for Prosthodontics (PCSP) was recorded. The chi-square test was used to determine differences in the percentage of women and nonwhite Presidents over time and between organizations., Results: The range of women Presidents in the selected years was 20% (EPA) to 0% (APS) with a mean of 10%. No statistically significant differences over time and between organizations were observed. The range of nonwhite Presidents in the selected years was 25% (ICP) to 0% (AAFP, AAMP, ACP, and GNYAP) with a mean of 7.5%. No statistically significant difference over time was observed while a statistically significant difference between organizations was observed (P=.015). Multiple comparisons revealed the ICP had significantly more nonwhite Presidents in the selected years., Conclusions: The relatively low numbers of women and nonwhite Presidents in the organizations studied is compelling evidence that there are an insufficient number of women and nonwhite role models in prosthodontics and that important voices representing the diversity of members of the prosthodontic community remain unheard., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Neonatal diabetes mellitus (NDM) is a monogenic form of diabetes, usually occurring in the first 6 months of life. Here, we present a newborn, which was admitted with epileptic seizure on the postnatal second day of life. Sepsis and meningitis were ruled out. Cranial imaging and electroencephalography revealed normal. She developed transient NDM on the follow-up and was diagnosed to carry an ABCC8 mutation. Although the neurological features are more common in patients with KCJN11 mutations, patients with ABCC8 mutations could also represent with subtle neurodevelopmental changes or even with epileptic seizures. The genetic testing and appropriate therapy is important in this patient group for predicting clinical course and possible additional features., Competing Interests: Conflict of Interest None declared., (Thieme. All rights reserved.)

This study evaluated the cytotoxicity of methacrylate-based resins containing dimethyl sulfoxide (DMSO). DMSO was incorporated into hydrophobic (R2) and hydrophilic (R5) resins at weight concentrations of 0, 0.01, 0.1, 1, 5, or 10 w/w %. Resin discs (n = 10/group) were prepared. Human gingival fibroblasts (HGF-1) were exposed to resin eluates for 24 h. Furthermore, dentin barrier test was performed using 3-D cultures of odontoblast-like cells (SV40 transfected pulp derived cells) with dentin slices of 400 µm thickness (n = 8). After acid etching of dentin, DMSO-modified resins were applied into the cavity part of the device and light-cured for 20 s. Cell viability (%) was assessed by MTT and analyzed spectrometrically. Data were analyzed by ANOVA and Tukey test (α = 0.05). Resin eluates showed statistically significantly lower % cell viability for all neat and DMSO-modified resins than seen for the negative control. Moreover, DMSO-R5 eluates resulted in significantly lower % cell viability than DMSO-R2 emulates. The dentin barrier test showed that DMSO-R2 did not result in significantly lower % cell viability, whereas incorporation of 1-10 w/w % DMSO into R5 resulted in significantly lower % of cell viability. Incorporating DMSO into hydrophilic self-etching resins may increase cytotoxicity. The biocompatibility is not influenced by the addition of DMSO into hydrophobic resin., (© 2021 European Journal of Oral Sciences.)