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PubMedDate not supplied

Effect of age of sample on the shear bond strength of dentin bonding agents to dentin.

The effect of sample age on the shear bond strengths of two dentin bonding agents to human dentin was evaluated by bonding composite resins to human dentin treated with either Imperva-Bond or Prisma Universal Bond 3. One-half of the specimens were tested at 5 minutes, while the remainder were thermocycled and tested at 2 weeks. Results were analyzed using two sample t tests at the 0.05 probability levels. Failures were evaluated using light microscopy and categorized as adhesive, cohesive within resin, cohesive within tooth, or mixed. The bond strengths were significantly higher for Imperva-Bond than for Prisma Universal Bond 3 at both time periods. For both bonding agents, the 2 week bond strengths were significantly higher than the 5 minute bond strengths. The 2 week bond strength of Imperva-Bond approaches that of unfilled resin to etched enamel.

Adhesives↗

PubMed1991

[In vitro effect of topical fluoride gels on the surface of composite resins].

This study was designed to compare the surface change in 6 brands of composite resins immersed in 4 topical fluoride gels of various pH. The result was evaluated by visual change in light reflectance and SEM. The findings were as follows: 1) five 4-minute immersions in acidic fluoride gels increased surface roughness and decreased the light reflectance of Prisma-Fil, Prisma APH, Brillant D and P-30, 2) Silux-Plus and Heliomolar were not affected by acidic fluoride gels, and 3) the surface texture of all resin samples was not changed when immersed in neutral fluoride gels. The findings suggested that a) neutral fluoride gels should be recommended for patients who have extensive composite restorations and require fluoride treatment, and b) when resin restoration is indicated, microfilled composite resin should be considered for patients who plan to use acidic fluoride gels.

Composite Resins↗

PubMed1990

[Penetration of calcium hydroxide based cements by dental enamel conditioning acids].

It was verified the penetration of phosphoric acid into 3 commercial calcium hydroxide-based cements (Life, Renew and Prisma VLC Dycal). The colorimetric method employed permitted the identidication of phosphorus amount in representative samples of 6 successive layers 0.1 mm thick of each material. The acid etching used were the commercial products Scotchbond Etching Gel--3M at 36.114% by weight and Solução Condicionadora--Johnson & Johnson at 36.054% by weight. The contact time was 60 seconds. The result showed that layers 0.1 mm tick for Life and Prisma VLC Dycal and 0.2 mm thick for Renew were able to block the penetration of phosphoric acid solution whereas layers 0.1 mm thick for the 3 cements were able to block the penetration of phosphoric acid gel.

Acid Etching, Dental↗

PubMed1978

Automated serum albumin determination by use of the immediate reaction with bromcresol green reagent.

It has been demonstrated recently that the reaction of serum samples with bromcresol green reagent proceeds in two steps, albumin being responsible for the immediate reaction and other serum proteins for the slower one. I show here that the immediate reaction, used for albumin determination, can be automated. Two different automated systems are described: the LKB 2086 Reaction Rate Analyzer and the multichannel analysis system LKB 2480 Prisma. With the first system, 60 (or 120) samples per hour were run with a within-day standard deviation of 0.3 g/liter; with the second system, a feed rate of 150 samples per hour was used (SD, 0.3 g/liter, within-day). Comparison with other methods gave the following equations: y (LKB 2086) = 1.44 + 0.97 X (immunodifussion) (n = 43; r = 0.98) and y(Prisma) = 2.04 + 0.96x (manual method) (n = 73; r = 0.98). Thus albumin determinations can be done reliably, quickly, and simply at low reagent and labor cost.

Autoanalysis↗

PubMed1994

Bond strengths of dentinal bonding systems to enamel and dentin.

Contemporary, third-generation dentinal bonding products have become highly specialized in producing high bond strengths to dentin. This investigation compared in vitro bond strengths of six dentinal bonding systems and their matched composite resins to human enamel and dentin. The effects of treatment by dentinal primers on enamel bond strengths as well as the effects of phosphoric acid on the strengths of dentinal bonds were measured. The use of dentinal primer on enamel improved the bond strengths of Prisma Universal Bond 3/Prisma APH and XR Bond/Herculite systems and had no effect on Denthesive/Charisma, Scotchbond 2/Silux, and Tenure/Perfection, while the enamel bond strengths of Gluma/Pekalux declined. Pretreatment of dentin with phosphoric acid improved the bond strengths of Denthesive/Charisma, Prisma Universal Bond 3/Prisma APH and XR Bond/Herculite, but had no effect on Gluma/Pekalux, Scotchbond 2/Silux and Tenure/Perfection.

Acid Etching, Dental↗

PubMed1994

The effects of current dentinal adhesives on the dentinal surface.

The effects of the dentinal surface treatments from six currently available commercial dentinal adhesives are presented. The adhesives are All-Bond 2, etched and unetched, Syntac, Prisma Universal Bond 3, Scotchbond Multipurpose, Tenure Solution, and Adhesive By Choice. Unerupted third molar human teeth were sectioned and treated with the appropriate adhesive according to the manufacturer's directions. After the teeth were treated, they were processed for observation by scanning electron microscopy. Scanning-electron microscopic photomicrographs were made of each step in the process to show the effects of the constituents, including the adhesives, on the dentinal surface. For All-Bond 2, unetched, the smear layer was not removed before the primer and the adhesive were applied. The primer for Prisma Universal Bond 3 altered the smear layer by reacting with it but did not produce a large demineralized zone in the dentin. All the other adhesives did remove the smear layer before the tooth was treated with the primer and adhesive.

Acid Etching, Dental↗

PubMedDate not supplied

Effect of different adhesive systems on microleakage at the amalgam/composite resin interface.

The objective of this study was to evaluate the effect of different bonding systems on teh microleakage at the amalgam/composite interface. The microleakage at the amalgam/composite resin interface was evaluated with a quantitative dye penetration method. Amalgam cylinders were made and a 2 mm composite base was added after the application of five different bonding systems to the roughened interface of the amalgam cylinders. The cylinders were filled with an exact volume of 0.05% fuchsin solution, and the total weight of the sample was measured. The cylinders were placed on a filter paper with the composite base down and evaluated for leakage after 1, 3, 6, and 24 hours. Weight loss and coloring of the filter paper represented microleakage. The results indicated that the application of Prisma Universal Bond 2 adhesive, Cover Up II, or Amalgambond (groups E, F, and G) reduced the amount of microleakage significantly as compared to the groups in which no adhesive system, 3M Porcelain Repair Kit (with and without acid etching of the amalgam surface), or Prisma Universal Bond 2 primer and adhesive (groups A, B, C or D) was applied.

Composite Resins↗

PubMed1995

Pulp reaction to a dentin bonding agent.

PURPOSE: To determine the pulpal biocompatibility of Prisma Universal Bond 2 (PUB-2). MATERIALS AND METHODS: Class V preparations were made in eight subhuman monkeys to approximately 1 mm from the pulp. In Group 1, the enamel was etched, the primer was placed and dried, PUB 2 was painted, and Prisma-Fil inserted. In Goup 2, the cavity floor was covered with visible light-cured Dycal followed by the steps as in group 1. In Group 3, IRM was used as a negative control. In Group 4, MQ55 silicate cement was used as a positive control. The animals were sacrificed at 5, 25, and 60 days and the teeth processed for histological evaluation. RESULTS: After 5 days, a mild reaction of little concern, which had dissipated in the 25- and 6-day groups, was observed. The material compared favorably to the negative control.

Analysis of Variance↗

PubMedDate not supplied

Retention of paraposts cemented with dentin-bonded resin cements.

The main purpose of this study was to assess the retention of Paraposts cemented with dentin-bonded resin cements in single-rooted teeth with elliptical canals. Forty-two mandibular premolars and canines were used in this study. The crowns of these teeth were removed 1 mm above the cementoenamel junction and the root canals instrumented to a depth of 8 mm to receive size 5 Paraposts. Prepared teeth were divided into six equal groups. Each group was assigned to a different cementation system at random. The six cementation systems used were: Fleck's Cement, Universal Post Cementation Kit, Prisma Universal Bond 3/Biomer, Scotchbond 2/Resiment, All-Bond 2/All-Bond C & B Cement, and Scotchbond Multi-Purpose/Resiment. Following post cementation, the teeth were stored in water at 37 degrees C for 24 hours, after which the posts were subjected to uniaxial tensile force on a testing machine until post separation occurred. Paraposts cemented with Prisma Universal Bone 3/Biomer or with Scotchbond Multi-Purpose/Resiment had significantly greater separation forces than posts cemented with any of the other cementation systems. Adhesive failure of the posts occurred in all of the specimens of the resin cement groups, whereas cohesive failure of the cement occurred in the majority of the specimens of the zinc phosphate cement group. The effects of thermocycling and post length (5 mm versus 8 mm) on the retention of Paraposts cemented with dentin-bonded resin cements were also investigated. Neither thermocycling nor post length had a significant effect on post separation force.

Analysis of Variance↗

PubMedDate not supplied

Shear bond strength of composite resin to microetched metal with five newer-generation bonding agents.

The purpose of this study was to determine the shear bond strength of a hybrid composite resin to a nickel-chrome-beryllium (Ni-Cr-Be) alloy, using five of the newer-generation bonding agents: Optibond, All-Bond 2, Prisma Universal Bond 3, Restobond 4, and Amalgambond Plus with HPA. For each bonding system 10 samples of metal were microetched with 50-micron aluminum oxide prior to the placement of the bonding agent and resin. The shear bond strength was tested, and the results showed that Amalgambond Plus with HPA developed the strongest bond at 18.81 +/- 3.924 MPa, followed by All-Bond 2 at 14.33 +/- 3.408, Optibond at 13.97 +/- 1.508, Prisma Universal Bond 3 at 12.51 +/- 1.845, and Restobond 4 at 10.29 +/- 1.407.

Aluminum Oxide↗

PubMedDate not supplied

The effect of three finishing systems on four esthetic restorative materials.

Previous studies have investigated the finishing and smoothness of composite and traditional glass-ionomer restorations, but few have included resin-modified glass-ionomer cements or more recent finishing systems. The results of using three different finishing systems (Sof-Lex, Enhance, finishing burs) on two composites (Silux, Prisma TPH), a traditional glass ionomer (Ketac-Fil), and a resin-modified glass ionomer (Fuji II LC) were studied. Sixty samples were condensed into sectioned acrylic tubes, covered with a Mylar matrix plus a glass slide at each surface, then cured as per the manufacturers' instructions. Samples were randomized to three groups of five for each material and testing with a Surfanalyzer 4000 of unfinished samples (cured with Mylar matrix) was done to obtain baseline average surface roughness (Ra). Samples were then finished as per the manufacturers' instructions using polishing disks, abrasive impregnated disks, and finishing burs before further surface testing. Samples finished with burs and with abrasive impregnated disks were further polished using polishing paste (Prisma Gloss) and again tested. Data were analyzed with ANOVA testing and Tukey's HSD pairwise comparison. Initial testing after randomization to groups showed no significant difference in surface roughness (P = 0.24). Two-factor analysis revealed no significant difference between materials (P = 0.34), a significant difference in method of finish (P < or = 0.00), with no significant interaction between type of material and method of finish (P = 0.11). Aluminum oxide disk and impregnated disk systems provided the best finish for microfilled composite and both glass-ionomer materials (P < or = 0.00). No significant difference in method of finish existed with the hybrid composite (P = 0.07). Overall, esthetic restorative material finishing is best accomplished using abrasive impregnated disks or aluminum oxide disks. Finishing burs gave a significantly rougher surface than the former methods.

Aluminum Oxide↗

PubMed2026

Corticosteroids as adjunctive therapy to standard treatment in Kawasaki disease: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials.

UNLABELLED: Kawasaki disease (KD) is an acute systemic vasculitis and the leading cause of acquired heart disease in children in developed countries. While IVIG plus aspirin remains standard treatment, 10-20% of patients are IVIG-resistant and face an elevated risk of coronary artery abnormalities. Corticosteroids have been explored as adjunctive therapy, though evidence on their benefit remains inconsistent. To assess the efficacy and safety of adjunctive corticosteroids in Kawasaki disease across key clinical outcomes. This PRISMA 2020-compliant systematic review and meta-analysis included RCTs identified through database searches up to April 2026. Risk of bias was assessed using Cochrane RoB 2.0. Data were pooled using random-effects models to estimate risk ratios (RRs) and mean differences (MDs) with 95% CIs. Subgroup analyses, leave-one-out sensitivity analyses, and GRADE certainty appraisal were also performed. Eight studies (n = 4106) were included. No significant differences were found in coronary artery abnormalities (CAA) within 1 month (RR 0.49, 95% CI 0.17-1.42), after 1 month (RR 0.81, 95% CI 0.43-1.55), fever duration (MD - 1.75, 95% CI - 3.71 to 0.21), or adverse events (RR 1.08, 95% CI 0.57-2.07). Hospital stay was modestly shorter with corticosteroids (MD - 0.99, 95% CI - 1.86 to - 0.11). Exploratory subgroup analyses suggested potential benefits with prednisolone-based and prolonged corticosteroid regimens for selected outcomes; however, these findings should be interpreted cautiously given multiple subgroup comparisons. Overall certainty of evidence was very low. CONCLUSION:  Adjunctive corticosteroids did not significantly improve major outcomes in KD. Prednisolone-based regimens showed some promise, but high-quality trials are still needed before any firm conclusions can be drawn. WHAT IS KNOWN: • Corticosteroids have been studied as adjunctive therapy for Kawasaki disease, but their effects on coronary outcomes and other clinical outcomes remain inconsistent. WHAT IS NEW: • This meta-analysis found no significant improvement in major outcomes with adjunctive corticosteroids, although prednisolone-based and prolonged regimens may provide benefits for selected outcomes.

Humans↗

PubMed2026

Urban Design Quality and Clinical Mental Health: A Systematic Review.

ObjectivesThis systematic review synthesizes empirical evidence on core urban design dimensions that affect clinical mental health outcomes and examines how environmental exposures mediate or moderate these relationships.BackgroundUrban design has increasingly been recognized as a determinant of psychological well-being, yet a standardized framework to evaluate its mental health impact remains underdeveloped.MethodsFollowing PRISMA 2020 guidelines, we systematically reviewed 19 quantitative empirical studies published through January 2025, examining relationships between outdoor urban design features and validated clinical mental health indicators across four major databases.ResultsFindings reveal that urban design influences clinical mental health outcomes (depression, anxiety, stress, cognitive decline) through two objective spatial scales: street-level features (imageability, enclosure, human scale, complexity) and neighborhood environments (land use mix, density, green infrastructure). Environmental exposures (traffic, noise, air pollution) operate as perceptual and experiential mechanisms that mediate or moderate the mental health effects of these spatial design features.ConclusionsWe propose an integrated three-domain conceptual framework distinguishing objective spatial design scales from subjective exposure mechanisms. This framework provides evidence-based guidance for urban planners and policymakers toward creating mentally healthier urban environments.

Humans↗

PubMed2003

Frail elderly patients. New model for integrated service delivery.

PROBLEM BEING ADDRESSED: Given the complex needs of frail older people and the multiplicity of care providers and services, care for this clientele lacks continuity. OBJECTIVE OF PROGRAM: Integrated service delivery (ISD) systems have been developed to improve continuity and increase the efficacy and efficiency of services. PROGRAM DESCRIPTION: The Program of Research to Integrate Services for the Maintenance of Autonomy (PRISMA) is an innovative ISD model based on coordination. It includes coordination between decision makers and managers of different organizations and services; a single entry point; a case-management process; individualized service plans; a single assessment instrument based on clients' functional autonomy, coupled with a case-mix classification system; and a computerized clinical chart for communicating between institutions and professionals for client monitoring. CONCLUSION: Preliminary results on the efficacy of this model showed a decreased incidence of functional decline, a decreased burden for caregivers, and a smaller proportion of older people wishing to enter institutions.

Aged↗

PubMed2025

Clinical Actionability of Genetic Findings in Cerebral Palsy: A Systematic Review and Meta-Analysis.

IMPORTANCE: Single gene variants can cause cerebral palsy (CP) phenotypes, yet the impact of genetic diagnosis on CP clinical management has not been systematically evaluated. OBJECTIVE: To evaluate how frequently genetic testing results would prompt changes in care for individuals with CP and the clinical utility of precision medicine therapies. DATA SOURCES: Published pathogenic or likely pathogenic variants in OMIM genes identified with exome sequencing in clinical (n = 1345) or research (n = 496) cohorts of CP were analyzed. A systematic literature review for evidence of effective therapies for specific genetic etiologies was performed. STUDY SELECTION: Nonstandard interventions that led to a detectable improvement in a defined outcome in individuals with variants in the gene of interest were included. DATA EXTRACTION AND SYNTHESIS: Literature was evaluated using PRISMA guidelines. A diverse, expert working group was established, scoring rubrics adapted, and scoring consensus built with a modified Delphi approach. MAIN OUTCOMES AND MEASURES: Overall clinical utility was calculated from metrics assessing outcome severity if left untreated, safety and practicality of the intervention, and anticipated intervention efficacy on a scale from 0 to 3. RESULTS: Of 1841 patients with CP who underwent exome sequencing, 502 (27%) had pathogenic or likely pathogenic variants related to their phenotype. A total of 243 different genes were identified. In 1841 patients with identified genetic etiologies of CP, 140 (8%) had a genetic etiology classified as actionable, defined as prompting a change in clinical management. Also identified were 58 of 243 genes with pathogenic or likely pathogenic variants with actionable treatment options: 16 targeting the primary disease mechanism, 16 with specific prevention strategies, and 26 with specific symptom management. The level of evidence was also graded according to ClinGen criteria; 45 of 101 interventions (44.6%) had evidence class D or below. The potential interventions have clinical utility with 98 of 101 outcomes (97%) being moderate-high severity if left untreated and 63 of 101 interventions (62%) predicted to be of moderate-high efficacy. Most interventions (72 of 101 [71%]) were considered moderate-high safety and practicality. CONCLUSIONS AND RELEVANCE: The findings indicate that actionable genetic findings occurred in 8% of individuals referred for genetic testing with CP. Evaluation of potential efficacy, outcome severity, and intervention safety and practicality indicates moderate-high clinical utility of these genetic findings. Genetic sequencing can identify precision medicine interventions that provide clinical benefit to individuals with CP. The relatively limited evidence base underscores the need for additional research.

Humans↗

PubMed2026

Navigating Social Media: Balancing Connectivity With Media Literacy to Combat Misinformation and Protect Mental Well-Being.

BACKGROUND: The pervasive use of social media has created a complex digital ecosystem where high connectivity coexists with significant challenges, including the rapid spread of misinformation, particularly regarding mental health, and documented negative impacts on psychological well-being. Platform architectures designed for engagement maximization have been identified as central factors in both issues. OBJECTIVE: This paper critically analyzes the interconnected relationships between social media use, misinformation dissemination, and mental health impacts, with particular attention to psychiatric misinformation across diagnostic categories (e.g., depression, anxiety, ADHD). A primary objective is to evaluate the potential of advanced critical digital literacy frameworks to serve as protective mechanisms against these dual threats. METHODS: A systematic search was conducted following PRISMA 2020 guidelines across APA PsycInfo, PubMed, JSTOR, and Google Scholar for literature published between January 2018 and March 2026 (updated from the original 2023 search). The search yielded 2672 records. After removing 624 duplicates, 2048 records underwent title and abstract screening, with 1802 excluded. The remaining 246 full-text articles were assessed for eligibility, resulting in 86 studies included in the final qualitative synthesis. Inter-rater reliability was established (Cohen's κ = 0.82). Quality assessment was conducted using the Joanna Briggs Institute Checklist, AXIS, and CASP tools, with findings weighted by methodological quality. A thematic analysis was undertaken to synthesize findings. RESULTS: The analysis reveals that core architectural features of social media platforms, algorithmic curation and engagement-based metrics, simultaneously foster environments ripe for misinformation spread and contribute to psychological distress, including anxiety, depression, and harmful social comparison. Psychiatric misinformation specifically (e.g., inaccurate claims about treatment effectiveness, diagnostic criteria, and medication side effects) represents a growing concern, particularly on image- and video-based platforms. The findings indicate that conventional media literacy approaches focused solely on fact-checking are insufficient. Instead, a critical digital literacy framework encompassing algorithmic awareness, data literacy, and emotional awareness is essential for building user resilience, with evidence from high-quality systematic reviews supporting this approach. CONCLUSIONS: Navigating the complexities of modern social media requires an integrated approach combining "pedagogies of play" for experiential skill development with advocacy for structural change (e.g., algorithmic transparency, well being by design principles). This dual strategy empowers individual users to critically engage with digital content while advocating for ethical platform design, thereby safeguarding both mental well-being and democratic discourse. Implications for educators, mental health professionals (including competencies for addressing patient encounters with psychiatric misinformation), policymakers, and platform designers are discussed.

Humans↗

PubMed2026

The Statistical Fragility of Saline Nasal Irrigation for Rhinosinusitis: A Systematic Review.

OBJECTIVE: To assess the statistical fragility of randomized controlled trials (RCTs) evaluating high-volume saline nasal irrigation (SNI) for rhinosinusitis using fragility analysis. DATA SOURCES: PubMed, MEDLINE, and Embase were searched for RCTs published between May 1976 and January 2026. REVIEW METHODS: This study was reported as per PRISMA guidelines. RCTs that compared high-volume SNI to non-irrigation standard care for acute, recurrent, or chronic rhinosinusitis, and reported ≥ 1 dichotomous outcome, were included. Fragility index (FI), the minimum number of event reversals needed to alter statistical significance, and fragility quotient (FQ), FI normalized to sample size, were calculated for statistically significant dichotomous outcomes. Reverse FI (rFI) and reverse FQ (rFQ) were calculated for non-significant outcomes. RESULTS: Eight RCTs were included, yielding 38 dichotomous outcomes. Eight outcomes (21.1%) were statistically significant. The overall combined median FI was 5 (FQ 0.062), with similar FI values between significant and non-significant outcomes. In over one-fifth of outcomes, loss to follow-up exceeded FI. Analysis of principal dichotomous outcomes from studies demonstrated a median FI of 6 (FQ 0.092), with five of eight (62.5%) outcomes non-significant. CONCLUSION: RCTs evaluating SNI for rhinosinusitis exhibit moderate-to-high statistical fragility, with small outcome changes capable of reversing study conclusions. Because fragility analysis was limited to dichotomous outcomes while many primary endpoints were continuous, our findings should be interpreted as complementary rather than comprehensive appraisals of RCTs. Future RCTs with larger sample sizes, reduced bias, and pre-specified fragility considerations are needed to better define the clinical role of SNI.

Rhinosinusitis↗

PubMed2026

Neuromodulation for Subjective Tinnitus: A Systematic Review and Meta-Analysis of Randomized Trials.

OBJECTIVE: To evaluate the effectiveness and safety of neuromodulation and bimodal stimulation for chronic subjective tinnitus in randomized controlled trials (RCTs). DATA SOURCES: PubMed/MEDLINE, Web of Science, and EMBASE (January 2015-December 2025) searched per PRISMA 2020. REVIEW METHODS: Adult RCTs (≥ 18 years) with chronic subjective tinnitus (> 3 months) assessing validated outcomes (THI, TFI, TQ) for neuromodulation/bimodal interventions vs. sham/controls. Two-stage screening, Cochrane RoB-2 risk-of-bias assessment. Random-effects meta-analyses (REML) were performed when ≥ 3 comparable trials were available; effects reported as standardized mean differences (SMD) with 95% CIs. Main Outcomes and measures included change in tinnitus severity (THI/TFI/TQ) while secondary outcomes included loudness (VAS/NRS), durability, and adverse events. RESULTS: Twenty-six RCTs (n = 1576) met criteria: tES (11; n = 372), rTMS (8; n = 432), acoustic coordinated reset (1; n = 100), vagus nerve stimulation (2; n = 90), and bimodal stimulation (4; n = 582). Meta-analysis showed a nonsignificant pooled effect for tDCS (SMD -0.36; 95% CI -0.75 to 0.02; I 2 = 51%) and rTMS (SMD -0.15; 95% CI -0.37 to 0.07; I 2 = 0%). Single-trial evidence for coordinated reset showed no advantage over broadband noise. VNS demonstrated modest benefits with safety concerns limited to implanted approaches. Bimodal stimulation yielded consistent, clinically meaningful reductions (often ≥ 10-20 points on THI/TFI), with durability up to 12 months. Adverse events were mild/transient across noninvasive modalities. CONCLUSIONS: Noninvasive neuromodulation appears safe with average benefits; among modalities, bimodal stimulation shows the most consistent and durable clinical improvements. Standardized, adequately powered RCTs with harmonized protocols and long-term follow-up are needed to refine targets and dosing.

Humans↗