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An in vitro comparison of the sealing ability of materials placed in lateral root perforations.

The in vitro sealing ability of Tytin amalgam, Ketac-Silver, and Prisma VLC Dycal was compared. Roots of extracted teeth were perforated laterally. After the defects were repaired, the teeth were immersed in dye for 10 days and then sectioned, and the linear extent of dye penetration was measured. Statistical analysis showed that the Prisma VLC Dycal group exhibited significantly less dye penetration than the other two groups (p less than 0.01). No difference was found between the Tytin and Ketac-Silver groups.

Calcium Hydroxide↗

An ex-vivo evaluation of vascular catheters for continuous hemofiltration.

OBJECTIVES: To measure outflow and inflow hydraulic resistance in double-lumen catheters used for hemofiltration under standardized laboratory conditions. SETTING: ICU Laboratory of tertiary unit. METHODS: Heparinized spent red cells diluted in polygeline solution to a constant hematocrit of 32% at 37 degrees C were pumped using a standard Prisma M60 circuit through several hemofiltration catheters. Blood pump speed was increased and decreased in steps of 30mL/min (30, 60, 90, 120, 150, and 180 mL/min) and catheter outflow and inflow pressures recorded and used to define the pressure flow relationship (line of hydraulic resistance) for each. RESULTS: Double-lumen catheters posed different resistances to outflow or inflow. Among the < 15 cm long catheters, the 11.5 Fr Quinton-Mahurkar (0.56 mmHg/mL/min) catheter offered the least resistance to outflow, while the Medcomp 11.5 Fr catheter offered the least resistance to inflow (0.78 mmHg/mL/min). Among the >19 cm long catheters, the 13.5 Fr Vascath Niagara catheter showed the lowest blood flow resistance to both outflow (0.63 mmHg/ mL/min) and inflow (0.83 mmHg/mL/min). Longer catheters did not pose statistically greater resistance to both outflow and inflow. Resistance to inflow was consistently greater than resistance to outflow (p = 0.003). Overall, the Prisma M60 blood circuit alone accounted for 40% of the total extracorporeal circuit blood flow resistance. CONCLUSIONS: Proprietary hemofiltration catheters have variable resistance to blood flow under standard ex-vivo conditions. This ex-vivo information might be useful to clinicians in guiding their choice of catheters for clinical use.

Blood Flow Velocity↗

The effect of smear layer removal on marginal contraction gaps.

The presence of the smear layer prevents direct contact between dentine and a dentine adhesive. The use of agents to remove the smear layer theoretically should improve the bonding of composite resins to dentine. This study examined the effect of smear layer removal on the effectiveness of a dentine bonding agent in reducing marginal contraction gaps. The agent used for smear layer removal in this study was ethylenediamine tetra-acetic acid (EDTA). Eighty cavities measuring 2 mm in diameter and 1.5 mm in depth were prepared in dentine and randomly assigned to two equal groups. The control group was restored with Prisma Universal Bond 2 Adhesive and Prisma Fil Resin. The experimental group was similarly restored after pretreatment of dentine with 0.5% EDTA for 60 s. All specimens were thermocycled and the marginal contraction gaps were assessed using a Nikon Measurescope. The mean contraction gap was expressed as a percentage of the cavity diameter. Results showed that the experimental group registered smaller contraction gaps (mean: 0.021%) than the control group (mean: 0.027%). No penetration of material into dentine was observed. Pretreatment with EDTA did not significantly improve the effectiveness of the dentine bonding agent used in terms of reduction of marginal contraction gaps.

Acid Etching, Dental↗

The alkalizing properties of calcium hydroxide compounds.

Calcium hydroxide compounds are available in various forms, such as in aqueous suspensions or as cements, liners, pastes or filled resins. When such compounds are exposed to water, the calcium hydroxide dissociates and the pH value shifts to the basic. In this study the compounds Pulpdent, Dycal, Hydroxyline, Gangraena Merz and Prisma VLC-Dycal were subjected to analysis, including quantitative measurement of the amount and the chronological course of ion release following exposure to water, qualitative analysis of the alkalizing effects at the dentin surface and examination of antimicrobial properties. The results showed that calcium hydroxide compounds differed greatly. The strongest degree of ion release, combined with definite antimicrobial properties, was found for the aqueous calcium hydroxide suspension (Pulpdent). The cement (Dycal) demonstrated significantly weaker activity. The liner and the paste (Hydroxyline and Gangraena Merz), as well as the calcium hydroxide filled resin (Prisma VLC-Dycal), were largely lacking in both ion release and antimicrobial properties under the experimental conditions.

Calcium Hydroxide↗

Shear bond strength of Dicor using resin adhesive systems and light activated cement.

A laboratory study was conducted to determine the shear bond strength to dentin of etched and silane-treated Dicor castable ceramic glass using a resin cement and newer generation adhesive systems. Scanning electron microscopy (SEM) examinations were also completed to evaluate the failure sites. The mean shear bond strength of the control (resin cement only, no adhesive system) was 2.1 +/- 1.2 MPa. The shear bond strength values determined for the adhesive systems and resin cement are as follows: Prisma Universal Bond 2, 18.7 +/- 2.9; XR Primer/XR Bond, 16.9 +/- 6.4; Scotchbond 2, 15.8 +/- 6.2; Tenure Solution, 15.4 +/- 4.5; and Gluma, 14.8 +/- 5.5 MPa. SEM examinations of the debonded specimens attached with Prisma Universal Bond 2 and Tenure Solution showed a complex failure pattern with cohesive failure in the glass ceramic material and adhesive failure between the resin cement and the etched and silane-treated glass surface. The debonding pattern of specimens attached with XR Primer/XR Bond, Scotchbond 2 and Gluma were primarily adhesive between the dentin and resin materials. The results of this study support the use of an adhesive system in conjunction with a resin cement for placement of Dicor castable ceramic restorations.

Ceramics↗

Effect on dentinal adhesives on marginal adaptation and cavity sealing with resin restorations in vitro.

In a companion article in this issue and a previous article in this journal, two experimental enamel dentin adhesive systems were evaluated and compared with four commercially available resin bonding agents by SEM investigation of the tooth adhesive interfaces and by determination of bond strengths to enamel and dentin under various conditions. In continuation of these screening investigations, the present article describes the results of cavity tests for assessment of marginal adaptation by measurement of gap dimensions, and of cavity sealing by rating of microleakage, when standardized dentin cavities were treated with the adhesive restorative systems. Both tests resulted in the same ranking of the six materials. Gluma, Clearfil Photo Bond, and two experimental compounds showed very narrow gaps and moderate microleakage. In contrast, Prisma Universal Bond 2 (the material has been replaced in the market by Prisma Universal Bond 3) and Scotchbond 2 showed significantly wider marginal gaps and more pronounced microleakage. Final discrimination between the efficacy of adhesive restorative materials by any of the currently used in vitro tests is disputable and prediction of long-term clinical performance by laboratory test data remains questionable.

Adhesives↗

One-year clinical evaluation of three dentine bonding agents.

One hundred and twenty-five composite restorations were placed in non-undercut, non-enamel-etched Class V abrasion lesions in 20 patients using the dentine bonding agents Scotchbond 2, Tripton, and Prisma Universal Bond 2. Patients were recalled at approximately 3 months, 6 months, and 1 year. After 1 year the cumulative per cent survival of restorations was Scotchbond 2, 8 per cent; Scotchbond 2 with dentine roughening, 16 per cent; Tripton, 16 per cent; Prisma Universal Bond 2, 75 per cent.

Age Factors↗

Antimicrobial action of new, proprietary lining cements.

The antibacterial activity of innovative, commercial lining cements was investigated. A liner which contains calcium hydroxide and is polymerized by visible light (Prisma VLC Dycal) and a glass-ionomer lining cement (GC lining cement) were compared with two more established lining cements (Advanced Formula II Dycal and Life). Antibacterial activity and hemolysis-like agar change at 24, 48, and 72 hours were measured on blood agar plates inoculated with Streptococcus mutans KPSK 2 (serotype c), Lactobacillus casei ssp rhamnosus ATCC 11981, and chewing-stimulated saliva. Prisma VLC Dycal did not affect bacteria or agar. The glass-ionomer lining cement, with an acidic pH at setting, had the most pronounced effect on all test organisms and on the agar. Even after 48 hours' setting, it inhibited growth of S. mutans. The control lining cement (AFII Dycal) showed antibacterial activity toward both specific micro-organisms as well as some activity against the salivary organisms. The material Life showed only partial inhibition of microbial growth. For all lining cements, the hemolytic-like agar change correlated with antibacterial effects. The surface pH of the freshly-set cements containing calcium hydroxide was alkaline. It would seem that a simple correlation between high surface pH and antibacterial activity among these cements does not exist. Also, further biological characterization of new lining cements is required to direct their appropriate clinical use.

Anti-Infective Agents, Local↗

Influence of dentinal fluid and stress on marginal adaptation of resin composites.

The influence of dentinal fluid and of a number of stress procedures on the quality of the margins of class V restorations located in both enamel and dentin was quantitatively assessed in vitro with the aid of a scanning electron microscope. The materials tested were GLUMA 2000 experimental, Prisma Universal Bond 3, and Syntac, together with the fine hybrid composites supplied by the respective manufacturers (Pekafill, AP.H, and Tetric). All materials achieved over 95% of "continuous margin" in enamel before and after stressing. In dentin, the initial values, with as well as without dentinal fluid simulation, were situated between 93.2 and 98.2%. With GLUMA 2000 experimental after stressing, a "continuous margin" occurred in only 50.2%, but with Prisma Universal Bond 3 and Syntac, the value was 79.0%. The influence of dentinal fluid simulation was dependent on the dentinal adhesive used. The effects of the various stress procedures were not significantly different.

Body Fluids↗

Studies on microleakage associated with visible light cured dental composites.

The objective of this investigation was twofold: 1) to determine the extent of microleakage associated with two visible light cured dental composites, one of which is an indigenously developed light cure composite (chitra light cure system) compared with a commercially available control material (Prisma APH light cure system), and 2) to study the effect of using bonding agents upon the above phenomena. The bonding agents used along with the above composites during restoration were chitra bonding agent system containing chitra primer/chitra resin and a control (Probond) which was purchased commercially. A comparison of microleakage in freshly restored human premolar teeth by silver nitrate staining technique was made during the above study. Cavities were restored with both composites with and without bonding agents, stored in 50 percent silver nitrate, and sections were cut after developing. The microtomed sections were observed under the optical light microscope and scanning electron microscope. Results indicate that bonding agents are mandatory for effective bonding at the tooth/resin interface and subsequent reduction in marginal leakage. Chitra bonding agent showed excellent adhesive bonding characteristics at the dentine/composite interface with minimal marginal leakage compared to the control bonding system. The chitra light cure composite material also showed lower shrinkage characteristics compared to Prisma APH composite.

Bicuspid↗

New composite resins: comparison of their resistance to toothbrush abrasion and characteristics of abraded surfaces.

Two of the newer composite resins, Miradapt and Visar-Fil, have resistance to toothbrush abrasion similar to that of Concise. After abrasion, the surface of these two resins appeared to be as rough as that of Concise. Prisma-Fil, Finesse, and Silar were abraded approximately six times as much as Concise. The abraded surface of Prisma-Fil was slightly granular, but the surface of Finesse and Silar was quite smooth. Surface characteristics after abrasion are attributable to the size of the largest particles used to make the composite resin. The blending of large and submicron particles may produce a composite that can initially be finished to an enamel-like smoothness, but eventually, toothbrush abrasion will produce a surface similar to that of a large particle resin, with the same potential for trapping stains and causing gingival irritation.

Composite Resins↗

Remotely Supervised, Home-Based Transcranial Direct Current Stimulation for Major Depressive Disorder: Systematic Review and Meta-Analysis.

BACKGROUND: Major depressive disorder affects over 280 million people worldwide, and access to effective treatment remains limited. Transcranial direct current stimulation (tDCS) is a noninvasive option, and portable devices now allow for home-based delivery under varying degrees of remote supervision. OBJECTIVE: This study aimed to systematically review and meta-analyze the efficacy, safety, feasibility, and acceptability of home-based and remotely supervised tDCS for depressive disorders. METHODS: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 and PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta-Analyses literature search extension) guidelines, we searched MEDLINE, Embase, Web of Science, the Cochrane databases, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform up to July 2025, with backward and forward citation searching. Two reviewers independently screened records, extracted data, and assessed risk of bias (version 2 of the Cochrane risk-of-bias tool for randomized trials, Newcastle-Ottawa Scale for observational studies, and Critical Appraisal Skills Programme for qualitative studies) and certainty of evidence (Grading of Recommendations Assessment, Development, and Evaluation; GRADE). RESULTS: This review included 12 distinct studies (16 reports), of which 6 (50%) were randomized sham-controlled trials forming the meta-analytic pool. Active home-based tDCS produced a small, statistically significant improvement over sham (pooled Hedges g=0.36, 95% CI 0.06-0.66; P=.03; I2=34.3%). The effect was not robust to removal of the single largest positive trial (omitting the one study from 2025: g=0.39, 95% CI -0.12 to 0.91), and trial-level results were mixed: the 2 largest trials (one unsupervised [n=210] and one self-administered [n=141]) were negative on their primary depression outcomes, whereas the largest real-time supervised trial (n=174) was positive (between-group 95% CI 0.51-4.01; P=.01). This estimate was concordant in direction with an independent peer-reviewed meta-analysis of overlapping trials, which reported a pooled Montgomery-&#xc5;sberg Depression Rating Scale reduction (weighted mean difference -2.74, 95% CI -4.19 to -1.29) and Hamilton Depression Rating Scale reduction (weighted mean difference -2.24, 95% CI -4.16 to -1.49), attenuating to nonsignificance (P>.05) in major depressive disorder without comorbid cognitive impairment. The pooled effect fell at or near the minimal clinically important difference. GRADE certainty was moderate. Adverse events were predominantly mild: one pilot study was terminated early for skin lesions, and one nonfatal suicide attempt occurred in an unsupervised trial. CONCLUSIONS: Home-based and remotely supervised tDCS produces a small, statistically significant but clinically modest antidepressant effect that is sensitive to the inclusion of the largest positive trial, with the 2 largest trials being negative. The available controlled evidence does not establish supervision intensity as a determinant of efficacy. Current data are insufficient to recommend routine clinical adoption; adequately powered trials with standardized supervision and longer follow-up are needed.

Humans↗

Effectiveness of Wearable Digital Therapeutics in Improving Sleep Outcomes Among Individuals With Insomnia: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Wearable devices are increasingly used for sleep monitoring and as adjunctive treatment. Existing meta-analyses mostly pool composite digital therapies and rarely isolate stand-alone wearables or distinguish between objective and subjective end points. Whether stand-alone wearable interventions improve sleep outcomes in adults with insomnia, and which factors moderate treatment heterogeneity, remains unclear. OBJECTIVE: This study aims to evaluate the effectiveness of wearable digital interventions on sleep outcomes in adults with insomnia versus control strategies and explore moderators of effectiveness, including device-wearing position, intervention duration, and control type, using meta-regression. METHODS: This systematic review and meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta&#x2011;Analyses) 2020 statement and the PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta&#x2011;Analyses Literature Search Extension) guideline. Five electronic databases and clinical trial registries were searched from inception to May 18, 2026. Eligible studies were randomized controlled trials (RCTs) evaluating wearable digital interventions in adults with insomnia compared with sham, waitlist, usual care, or active control conditions and had an intervention duration of at least 1 week. Study screening, data extraction, and risk-of-bias assessment were carried out independently by 2 reviewers. Pooled estimates were calculated using a restricted maximum likelihood random-effects model with the Hartung-Knapp-Sidik-Jonkman correction. Heterogeneity was assessed using the I&#xb2; statistic, and 95% prediction intervals (PIs) were calculated for the primary analyses. The certainty of evidence was rated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. RESULTS: Sixteen RCTs (N=910) were included. Wearable digital interventions were associated with a significant reduction in objective sleep-onset latency (SOL; mean difference [MD] -4.52, 95% CI -8.38 to -0.67, PI -9.52 to 0.47 min) and a significant improvement in subjective sleep efficiency (SE; MD 2.00%, 95% CI 1.90%-2.11%, PI 1.85%-2.15%). Subjective total sleep time (TST) also showed a significant increase (MD 19.11, 95% CI 2.98-35.24, PI -16.20 to 54.43 minutes). Meta-regression showed that control type, intervention duration, and device location did not explain the heterogeneity of the insomnia severity index (ISI) (R&#xb2;=0). Sensitivity analysis confirmed the robustness of pooled ISI estimates, and an Egger test indicated no small-study effects (P=.07). Certainty of evidence ranged from moderate to high. CONCLUSIONS: Wearable digital interventions provide selective benefits for objective SOL, subjective SE, and subjective TST in adults with insomnia, with no improvement in overall ISI. Despite statistically significant effects on several sleep parameters, wide PIs, substantial heterogeneity, and limited study numbers indicate preliminary, nonconclusive findings. Wearables should be viewed as affordable adjunctive tools requiring further validation, not substitutes for first-line cognitive behavioral therapy for insomnia. Large-scale, long-term RCTs with standardized protocols and patient-level external validation are required to consolidate the evidence base.

Humans↗

Gut Dysbiosis in Selected Gynecological Diseases Associated with Female Infertility: A Scoping Review.

Background/Objectives: Female infertility represents a significant public health issue. Available evidence supports the hypothesis that the gut microbiota may play an essential role in women's reproductive health and may serve as a diagnostic or prognostic biomarker in specific gynecological disorders. A substantial part of current research concerns disturbed communication between the hypothalamic-pituitary-ovarian axis and the gut microbiota, providing the basis for analyzing this phenomenon as the gut-ovary axis or the gut-vagina-ovary axis. The primary aim of this scoping review was to map the available evidence on the relationship between gut microbiota composition and female infertility, with particular emphasis on polycystic ovary syndrome (PCOS, currently polyendocrine metabolic ovarian syndrome, PMOS) endometriosis, and uterine fibroids. Methods: The review was conducted in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). PubMed, Scopus, and Google Scholar were searched using terms related to gut microbiota, female infertility, PCOS, endometriosis, and uterine leiomyomas. Peer-reviewed publications in English published between 2015 and 2025 were considered. The included studies were descriptively synthesized to identify recurring microbiota patterns and research gaps. Results: The reviewed evidence indicates that gut dysbiosis may be associated with selected gynecological disorders affecting fertility, including PCOS, endometriosis, and uterine fibroids. The gut microbiome may have potential value as a biomarker supporting diagnosis, treatment selection, and prognosis. Conclusions: The gut microbiome represents a promising but still insufficiently validated area in the management of gynecological diseases associated with female infertility. Further high-quality clinical studies are needed to verify the effectiveness of microbiome-based therapies and to develop evidence-based guidelines for managing infertility associated with gut dysbiosis.

dysbiosis↗

Effect of sealant viscosity on the penetration of resin into etched human enamel.

This study was designed to investigate the relationship between the etched depth, penetration of sealants and marginal seal. Sixty unerupted lower first premolars extracted from patients for orthodontic reasons were thoroughly cleaned and stored in an antiseptic Ringer's solution at 4 degrees C. A "window" on the occlusal of 15 of the premolars, including both mesial and distal pits, was developed by painting nail varnish around the border of the occlusal surfaces. Etching was then done with 35% phosphoric acid for 60 seconds to all 60 premolars. Five of the "window" teeth were evaluated by microradiography to determine the etched depth of the superficial and subsurface enamel. Five were prepared for SEM analysis to observe the change of the superficial etched enamel surface. Another five "window" teeth were embedded in epoxy resin and sectioned parallel to the long axis of the tooth through the fissures in order to observe the subsurface depth of the etch by SEM analysis. The other 45 teeth were divided into three groups of 15 teeth each. Fissures of each group of teeth were sealed using Prisma-Shield (LD Caulk), Concise White Sealant (3M Dental Products) or Teethmate A (Kuraray) sealants and stored in water (37 degrees C) for 24 hours. They were then sectioned and demineralized before being examined by a scanning electron microscope. Photographs of secondary electron image (SEI) were done to gradate the resin-infiltrated enamel and resin tags for these sealants. After SEM observation, the 15 samples of each applied sealant were polished to a high gloss again and placed in a silver nitrate solution for 24 hours before being examined under the SEM equipped with a back-scatter electron detector. Data were then analyzed using the Welch and Student t-tests. Results showed that fissured enamel of unerupted human lower first premolars became porous after etching with 35% phosphoric acid. The low viscosity sealant Teethmate A (approximately 260 mPa.s), penetrated fully and formed a resin-infiltrated layer in enamel beyond the etched depth. However, the high viscosity sealants (Prisma-Shield and Concise White Sealant) did not penetrate enough to ensure that the acid-etched enamel was infiltrated sufficiently by the sealant to insure good marginal seals.

Acid Etching, Dental↗

The role of cavity preparation and conditioning in the leakage of restorations.

PURPOSE: Restoration microleakage is thought to be determined by the method and location of cavity preparation, enamel etching, and dentin conditioning, as well as the restorative material. This study compared the microleakage of composite restorations placed in preparations cut with carbide and diamond burs and those treated with different bonding/conditioning agents. MATERIALS AND METHODS: Class V preparations (3 x 2 x 2 mm) were cut wholly in enamel or in enamel and cementum in 100 human premolars. Twenty teeth were prepared with carbide burs and the preparations etched and conditioned with Prime&Bond NT but not restored. A second set of 20 teeth had enamel-only preparations cut with carbides (n = 10) or diamonds (n = 10), and the preparations etched, conditioned (Prime&Bond NT) and restored with Prisma TPH. The other 60 teeth were divided into 3 groups of 20 teeth each with enamel-only (n = 10) or enamel/cementum preparations (n = 10). The 3 groups of teeth were conditioned with Optibond Solo, Clearfil SE Bond or Prompt-L-Pop prior to restoration with Prisma TPH. Two mm of root was resected from all teeth, pulpal tissue removed, and insulated copper wires inserted via the root canals to contact with the pulp chamber roof before the tooth-wire interfaces and root surfaces were sealed. The teeth were immersed in 0.9% NaCl and leakage assessed over 30 d by iR drop across a resistor in series with a DC source and stainless-steel counter electrode. RESULTS: Differences (p < 0.05) in leakage were found for enamel preparations cut with carbides and diamonds, and the relationship of leakage vs time was linear. Enamel/cementum preparations showed greater leakage, and the relationship of leakage vs time was sigmoidal. Conditioned-only preparations showed the same leakage as those conditioned and restored, while preparation leakage varied with the conditioning agent. CONCLUSION: Cavity preparation location, method of cutting, and the conditioning agent markedly affect leakage behavior.

Acrylic Resins↗

Shear bond strength of composite resin to amalgam: an experiment in vitro using different bonding systems.

The shear bond strength between amalgam and composite resin with and without the use of adhesive systems was evaluated. It was found that the application of Cover-Up II or Prisma Universal Bond prior to placement of composite resin enhanced the shear bond strength between amalgam and composite resin more than five times; and a shear strength of 4.34 and 4.30 MPa was measured respectively. Acid-etching of the roughened amalgam surface prior to application of Prisma Universal Bond decreased the bond strength by nearly 45%.

Adhesiveness↗

[Hardness of composite materials used for restoration of front teeth].

The evaluation comprised four anterior two-components composite materials: concise-"B", concise-"T", adaptic and silar and six anterior one-component composite materials: heliosit, visio-dispers, visio-fill, durafill, estilux and prisma-fill. The Amsler press of 600-2000 kg was used for evaluation of hardness on pressure, flexion and extension of 10 composite materials using the original "accessory apparatus" PAC-s and PAC-e. For evaluation of hardness 15 samples of each material were made. On the basis of the results obtained it has been concluded that no evenly regular dependence exists among the evaluated hardness of different composite materials so it is necessary to evaluate all three hardness for their adequate categorization. Taking into account levels of all three hardness, AJKM was recommended as better material than ADKM, while some of them are much better (such as estilux, prisma-fill and visio-fill) for restoration of angular defects of teeth structures of crowns of anterior teeth.

Dental Materials↗