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At least 19 recordsLinked to original sources

The effect of repeated bonding on the shear bond strength of a composite resin orthodontic adhesive.

One of the problems clinicians face during treatment is bracket failure. This is usually the result either of the patient's accidentally applying inappropriate forces to the bracket or of a poor bonding technique. As a result, a significant number of teeth have to be rebonded in a busy orthodontic practice. The purpose of this study was to evaluate the effect of repeated bonding on the shear bond strength of orthodontic brackets. Fifteen freshly extracted human molars were collected and stored in a solution of 0.1% (wt/vol) thymol. The teeth were cleaned, polished, and etched with a 37% phosphoric acid gel. The brackets were bonded with the adhesive and light cured for 20 seconds. The teeth were sequentially bonded and debonded 3 times with the same composite orthodontic adhesive. At each time, all 15 teeth were debonded within a half hour after bonding to simulate the clinical condition at which a newly bonded bracket is attached to the arch wire. The results of the analysis of variance comparing the shear bond strength at the 3 debonding attempts indicated the presence of no significant differences among the 3 groups (P = .104). However, when the overall change in shear bond strength within each tooth was evaluated between debonding sequences 1 and 3, 10 teeth had a significant (P = .001) decrease (mean +/- SD, -4.6+/-2.5 MPa) in bond strength, whereas 5 teeth had a significant (P = .02) increase (mean +/- SD, 2.8+/-1.6 MPa). The present findings indicated that in general, the highest values for shear bond strength were obtained after the initial bonding. Rebonded teeth have significantly lower and inconsistent shear bond strength; ie, bond strength may further decrease or increase after the second debonding, and the changes in bond strength may be related to the changes in the morphologic characteristics of the etched enamel surface as a result of the presence of adhesive remnants.

Analysis of Variance↗

Torsional fatigue and endurance limit of a size 30.06 ProFile rotary instrument.

AIM: To evaluate the torsional cyclic fatigue characteristics and specifically the endurance limit (EL) of a nickel-titanium rotary instrument. METHODOLOGY: Size 30.06 taper ProFile instruments were evaluated. The equipment was assembled according to the ANSI/ADA Specification No. 28. The motor was programmed to repeatedly rotate to a selected deflection angle (DA) and then return to zero (cycle). Testing started at 200 degrees and was continued at decreasing angles until 10(6) cycles were reached without instrument fracture. Ten instruments were tested at each DA. The mean log number of cycles to fracture and standard deviation were determined for each DA at which fracture occurred. The DA at which 10(6) cycles were reached without instrument fracture corresponded by definition to the EL. Analysis of variance and pairwise comparisons using Duncan's multiple range test were performed to detect significant differences among the mean log number of cycles of the different DA. Significance was determined at the 95% confidence level. RESULTS: Instruments cycled at larger DA consistently demonstrated fewer cycles to fracture than those cycled at smaller DA. The differences among the mean log number of cycles of the different DA were statistically significant (P < 0.001). Cycles of 10(6) were completed without instrument fracture at 2.5 degrees. CONCLUSIONS: A torsional fatigue profile was generated for a specific NiTi rotary instrument. The EL was 2.5 degrees.

Analysis of Variance↗

Experimental and numerical predictions of the ultimate strength of a low-cost composite transtibial prosthesis.

Saito et al. (Modern Plastics 1997;74:175-7) have developed a low-cost transtibial prosthesis made of fiber-reinforced plastic (FRP). The prosthesis is comprised of an aluminum pylon, a cosmetic cover, and a constant cross-section composite foot into which aluminum supports are screwed to increase load-bearing capacity. Replacing these supports with a single integrated FRP stiffener significantly reduced manufacturing cost while providing high strength, great durability, and smooth walking. The optimal location and orientation of the proposed FRP stiffener were determined by finite element (FE) analysis. When a replica of this component was tested according to ISO standard 10328, the experimental prosthesis catastrophically failed under 6,600 N of force. Maximum percent error of strain between experimental and numerical results was 18.6%, showing good correlation between the two data sets. The optimized design provides sufficient strength and reduces the cost of manufacturing and thus can be used to replace the original design.

Artificial Limbs↗

The Australian Incident Monitoring Study. Equipment failure: an analysis of 2000 incident reports.

Of the first 2000 incidents reported to the Australian Incident Monitoring Study, 177 (9%) were due to "pure" equipment failure according to pre-defined criteria. Of these 107 (60%) involved anaesthetic equipment, 42 (24%) involved monitors, 17 (10%) other theatre equipment and 11 (6%) the gas or electricity supply. Ninety-seven (55% of the 177) were potentially life-threatening; of these two-thirds would be detected by the array of monitors recommended by the Australian and New Zealand College of Anaesthetists and all but 9 of the remainder would be handled by application of the crisis management algorithm recommended elsewhere in this symposium. Of the 9 remaining, 2 were electrical shock, 3 overheating of a humidifier or blood warmer, 2 the unavailability of a spare laryngoscope and 1 the consequence of a power failure. Meticulous adherence to the equipment checking and monitoring guidelines of the Australian and New Zealand College of Anaesthetists and application of a suitable crisis management algorithm should protect the patient from potentially life-threatening equipment failure in virtually all cases except electric shock, power failure and overheating of warming devices.

Anesthesiology↗

Cost analysis of equipment failure of a radiology department and possible choices about maintenance.

PURPOSE: Our aim was to evaluate the economic impact of equipment failures in a radiology department with a view to guiding maintenance policy decisions. MATERIAL AND METHODS: We assessed the negative economic impact caused by the interruption of activity of a radiodiagnostics section due to equipment failure, taking into account: the effects occurring during the first day of equipment down-time (assuming that the equipment failure occurs in the middle of the shift) and the effects during the following days until the repair of the failure; the effects occurring in the short- and long-term. To exemplify the negative impact of inactivity due to equipment failure, we chose three radiology sections with different levels of technological and operational complexity (chest radiology, gastrointestinal radiology and remote-controlled diagnostics). For each, we evaluated the loss of contribution margin and the idle capacity costs (short- and long-term impact). RESULTS: The negative economic effects were: for thoracic radiology, 496,77 Euro in the first day, and 30,99 Euro from the second day onwards; for gastrointestinal radiology, 526,40 Euro for the first day, and 730,39 Euro from the second day onwards; for remote-controlled diagnostics, 786,25 Euro for the first day, and 927,67 Euro from the second days onwards. DISCUSSION: Our results indicate that the level of idle capacity costs (mainly equipment and staff) increases with the complexity of the equipment, whereas the contribution margin appears to fluctuate, because the charges are state-imposed and do not vary with the complexity of equipment. Moreover, our analysis shows that if the workload of a broken machine can easily be assigned to an additional shift using another machine, losses are considerably reduced from the second day onwards. Once the negative economic impact of equipment failures has been evaluated, the second step is to choose the best kind of maintenance. CONCLUSIONS: A sound calculation of the economic impact of equipment failures is very useful for guiding the head of department and the hospital manager in deciding whether to purchase maintenance services (or a long-term guarantee) from the equipment manufacturer, to set up an auxiliary centre for maintenance and repair, or to purchase a third-party maintenance contract.

Costs and Cost Analysis↗

Relationship between static chemical and cyclic mechanical fatigue in a feldspathic porcelain.

OBJECTIVES: The goal of this study was to determine if static chemical and cyclic mechanical fatigue are independent, or if they interact to produce greater than additive strength loss in a feldspathic porcelain. METHODS: A blunt indentation technique was used to investigate the response of a feldspathic dental porcelain to cyclic mechanical fatigue and static chemical fatigue. All specimens were fabricated in a dry inert environment and then mechanically fatigued by cyclic loading and strength-tested in dry inert nitrogenous, ambient or wet environments. A series of experiments were performed to evaluate the effects of chemical and mechanical fatigue, and their interaction on strength loss; to determine the effects of, and interaction between, the factors of cyclic fatigue environment and strength test environment on strength; to ascertain if the type of environment during strength testing influenced specimen strength; and to distinguish between chemical damage caused by exposure to moisture alone and stress corrosion damage resulting from the strength testing environment, using a pair of two-way analysis of variance, a single one-way analysis of variance and a t-test (p < 0.05). RESULTS: These experiments indicated that both static chemical fatigue and cyclic mechanical fatigue significantly reduced specimen strength, but they did not interact to produce greater than summative effects. It was also learned that chemical fatigue was not detected on initial exposure to moisture and that it occurred to a small extent during mechanical fatigue cycling, and primarily occurred during strength testing through a stress-corrosion phenomenon. Micrographs visually evaluated the effects of mechanical and chemical fatigue on surface contact damage. SIGNIFICANCE: As both static chemical and cyclic mechanical fatigue influenced porcelain strength, they should both be considered in future evaluations. However, because they largely acted independently, they can be studied separately.

Aluminum Silicates↗

Micromotion and dynamic fatigue properties of the dental implant-abutment interface.

STATEMENT OF PROBLEM: Clinical loading may result in micromotion and metal fatigue in apparently stable implant screw joints. This micromotion may contribute to tissue inflammation and prosthesis failure. PURPOSE: This study investigated dental implant screw joint micromotion and dynamic fatigue as a function of varied preload torque applied to abutment screws when tested under simulated clinical loading. MATERIAL AND METHODS: Fifteen noble alloy single-tooth implant restorations, each containing a hexed UCLA-style gold cylinder, were randomly assigned to 3 preload groups (16, 32, and 48 N.cm). Each group consisted of 5 implants (each 3.75 x 15 mm) and 5 square gold alloy abutment screws. A mechanical testing machine applied a compressive cyclic sine wave load between 20 and 130 N at 6 Hz to a contact point on each implant crown. A liquid metal strain gauge recorded the micromotion of the screw joint interface after 100, 500, 1,000, 5,000, 10,000, 50,000, and 100,000 cycles. Baseline data at 0 N.cm were collected before the application of the specified preload torque. RESULTS: The 16 N.cm group exhibited greater micromotion (P<.001) than both the 32 and 48 N.cm groups at all cycle intervals (2-way ANOVA, Tukey HSD). Micromotion of the implant-abutment interface remained constant (P=.99) for each of the preload groups through 105 cycles. CONCLUSION: Under the loading parameters of this study, no measurable fatigue of the implant-abutment interface occurred. However, dental implant screw joints tightened to lower preload values exhibited significantly greater micromotion at the implant-abutment interface.

Analysis of Variance↗

Investigation of the fracture resistance of three types of zirconia posts in all-ceramic post-and-core restorations.

PURPOSE: All-ceramic post-and-core restorations offer a number of advantages compared with systems that use metal cores. In certain clinical cases, however, fractures at the junction between the post and the core have been reported. The objective is therefore to improve the strength between the post and the core. MATERIALS AND METHODS: Three different methods were used to fabricate all-ceramic post-and-core restorations: pressing IPS Empress cores directly to CosmoPost zirconia posts, adhesively luting IPS Empress cores to CosmoPost zirconia posts, and Celay milling In-Ceram zirconia blanks to one-piece post-and-core restorations. Ten restorations were prepared with each of the three methods. The post-and-core complexes were tested to failure with the load applied perpendicular to the post axis. The load and deflection at fracture were recorded. RESULTS: The highest breaking load and highest deflection were recorded for the luting technique, with values of 25.3 N and 394 microns, respectively. The corresponding values for the pressed cores and the milled zirconia cores were 22 N and 301 microns, and 13 N and 160 microns. All differences were statistically significant at P < .05. Regarding the load dependence of the deflection, the luted cores again demonstrated the highest mean value, with 15.5 microns/N, while this value was 13.6 microns/N and 13 microns/N for the pressed-on and milled cores, respectively. These differences were not statistically significant. CONCLUSION: Adhesively luted all-ceramic cores on zirconia posts offer a viable alternative to the conventional pressed technique.

Aluminum Oxide↗

An assessment of the clinical effectiveness of surgical drapes.

Questioning whether a 'sterile' material is actually sterile is something that many clinicians may not have considered. The equipment that comprises a sterile field for a major surgical or invasive procedure may also be taken for granted as the sterile pack would normally include sterile drapes. Under discussion is whether using sterile drapes is more effective than not using them. In furthering the debate, examination of the literature is centred on the degree of effectiveness of sterile drapes.

Bedding and Linens↗

Improved dialyzer reuse after use of a population pharmacodynamic model to determine heparin doses.

Anticoagulation with heparin is performed to prevent clotting during dialysis. However, heparin doses are usually determined empirically, and dialyzer clotting is a common reason for discarding reused dialyzers. We hypothesized that using a population pharmacodynamic model to determine individual heparin doses would improve dialyzer reuse rates. A previously published model was used to determine the loading dose and infusion rate of heparin needed to increase the intradialytic whole-blood clotting time to 150% of the predialysis value. The effectiveness of the model was assessed by comparing dialyzer reuse rates and delivered Kt/V(urea) before and after implementation of the model in 22 chronic hemodialysis patients. As an additional control, a similar group of 22 patients were followed up during the same period without adjustment of their heparin doses. Implementation of the model resulted in no change in the average loading dose (2,382 +/- 628 versus 2,425 +/- 908 IU; P = not significant) or average infusion rate (1,398 +/- 367 versus 1,393 +/- 532 IU/h; P = not significant) of heparin. However, individual patients required changes in loading dose or infusion rate. Dialyzer reuse rates increased significantly over time in the treatment group but remained unchanged in the control group (P < 0.003). Kt/V(urea) remained unchanged throughout the study period in both patient groups. From these data, we conclude that the use of a heparin model can improve dialyzer reuse rates without compromising the delivered dose of dialysis.

Aged↗

Comparison of various safety guidelines for electronic article surveillance devices with pulsed magnetic fields.

The paper uses the two methods suggested in both the ICNIRP and proposed IEEE safety guidelines for compliance testing of security systems based on time-varying magnetic fields being introduced for electronic article surveillance (EAS), radiofrequency identification, and other applications. For nonsinusoidal pulses that are often used, the two procedures are to treat the exposure as a multifrequency exposure with various frequency components or to calculate the peak induced current densities or electric fields treating the highest of the pulses of duration t(p) as a single frequency, half sinusoid of the same duration and frequency 1/(2t(p)). Using either of the procedures, the induced current densities (J) or electric fields (E) are compared to the basic restrictions on J or E for compliance testing. Using a heterogeneous, tissue-classified anatomic model of the human body, we calculate the induced J and E for the various tissues for a realistic, EAS system for two typical nonsinusoidal pulses to show that the two methods give substantially different results. While the approximate but simpler method of treating the pulse as a half sinusoid results in peak induced J or E that may be compliant with safety guidelines, the rigorous method of treating such exposures as multifrequency exposures gives induced current densities or electric fields that may be up to twice as large, thus making such systems potentially noncompliant with the safety guidelines. Since it is more accurate, it is suggested that safety assessment based on the Fourier analysis leading to multifrequency components be used for compliance testing of such devices.

Computer Simulation↗

Analysis of strength properties of light-cured resin composites.

OBJECTIVES: To determine and correlate the compressive and tensile strengths of resin composites, to scale their failure probability and to analyze their failure mode under combined state of stresses. METHODS: Ten brands of composites were tested for compressive and diametral tensile strengths. A recently introduced device for testing of pure shear stresses was modified to adapt to smaller specimens. Uniformity of pure shear stress distribution in the significant section was verified by a photoelastic model. Loading specimens in pure shear up to failure determined their mode of fracture under combined state of stresses. RESULTS: Diametral tensile strength yielded values that were 20% of their respective compressive strength. Multiple comparison test indicated that strength properties of the tensile strength test were much more sensitive in predicting differences between resin composites when compared to a compressive strength test. Pertac (Espe) had the highest compressive strength, Graft LC (GC) and Z-100 (3M) had the highest diametral tensile strength. No correlation was found between tensile and compressive strengths. The Weibull modulus disclosed differences in the liability of the materials to fracture. When combined state of stresses were applied through the pure shear test, failure of each specimen occurred at the principal tensile planes. SIGNIFICANCE: Compressive strength cannot predict the ability of the resin composite to withstand tensile stresses. The importance of compressive strength is limited as failure of a brittle material occurs in tension.

Analysis of Variance↗

Suture closure of the femoral arteriotomy following invasive cardiac procedures: a detailed analysis of efficacy, complications, and the impact of early ambulation in 1,200 consecutive, unselected cases.

The purpose of this study was to assess the efficacy and safety of using a percutaneous suture device to close femoral arteriotomies following invasive cardiac procedures. All patients presenting for invasive cardiac procedures performed from the femoral artery were considered for suture closure. Patients were carefully assessed for access site complications, oozing, and the impact of suture closure on the safety of early ambulation. Clinical follow-up at 3-6 months was performed to assess for late complications. Femoral artery suture closures were performed in 1,200 consecutive cases in 1,097 patients. In 12.8% of cases, the patients ambulated within 1 hr. The success rate was 91.2% and the complication rate was 3.4%. Complications included the development of a hematoma (2.1%), the need for vascular surgery (0.6%), retroperitoneal hemorrhage (0.3%), blood transfusion (0.7%), local infection (0.5%), and pseudoaneurysm formation (0.1%). Factors found to be independently predictive of procedural failure were an age > 70 years, an ACT > 300 sec, left femoral artery access, and the performance of primary angioplasty. Follow-up at 3-6 months revealed no major hemorrhagic complications. We conclude that percutaneous suture closure effectively achieves femoral artery hemostasis in patients undergoing invasive cardiac procedures. The technique permits early ambulation and is associated with a relatively low incidence of complication.

Aged↗

A comparison of mandibular angle fracture plating techniques.

OBJECTIVE: The purpose of this investigation was to compare the conventional technique of mandibular angle fracture plating with two biomechanically dissimilar techniques in their abilities to resist vertical loads similar to masticatory forces. STUDY DESIGN: Three groups of five synthetic hemimandibles with simulated fracture repairs were compared for their capabilities to resist vertical deformation. The conventional group was stabilized with a thin tension band system at the superior border and thick stabilization plate system at the inferior border. The nontraditional group was stabilized with a thick tension band system at the superior border and thin stabilization plate system at the inferior border. The two miniplate group was stabilized with a thin tension band system at the superior border and thin stabilization plate at the inferior border. A cantilever beam design was used. Testing was performed with an instron 8511.20 (Instron Corp., Canton, Mass.) mechanical testing device. The three groups were compared with a two way analysis of variance. RESULTS: The forces resisted by the conventional group (167.6 +/- 18.2 N), the nontraditional group (156.3 +/- 33.9 N), and two miniplate group (154.0 +/- 18.4 N) were not statistically different (F = 0.44, p > 0.66). All failures occurred at the tension bands secured with monocortical screws. CONCLUSIONS: Under the conditions described in this in vitro investigation, plate thickness or pattern made no difference. All failures in this experiment occurred with monocortical screws in the superior border tension band system.

Analysis of Variance↗