Background
Verneuil's disease is a chronic inflammatory skin disease of the follicles in apocrine glands rich area of the skin (axillary, inguinal, anogenital) and is associated with a deficient skin ...innate immunity. It is characterized by the occurrence of nodules, abscesses, fistulas, scars. Recently, vitamin D has been shown to stimulate skin innate immunity.
Objective
The primary objective of the study was to assess whether Verneuil's disease was associated with vitamin D deficiency. The secondary objective was to determine whether vitamin D supplementation could improve inflammatory lesions.
Methods
First, 25(OH) vitamin D3 serum levels in patients with Verneuil's disease followed at Nantes University Hospital were compared to those of healthy donors from the French Blood Bank. Then, a pilot study was conducted in 14 patients supplemented with vitamin D according to their vitamin D level at baseline at months 3 and 6. The endpoints at 6 months were decreased by at least 20% in the number of nodules and in the frequency of flare‐ups.
Results
Twenty‐two patients (100%) had vitamin D deficiency (level <30 ng/mL) of whom 36% were severely deficient (level <10 ng/mL), having correlation with the disease severity (P = 0.03268) vs. 20 controls with vitamin D deficiency (91%) of whom 14% were severely deficient. In 14 patients, the supplementation significantly decreased the number of nodules at 6 months (P = 0.01133), and the endpoints were achieved in 79% of these patients. A correlation between the therapeutic success and the importance of the increase in vitamin D level after supplementation was observed (P = 0.01099).
Conclusion
Our study shows that Verneuil's disease is associated with a major vitamin D deficiency, correlated with the disease severity. It suggests that vitamin D could significantly improve the inflammatory nodules, probably by stimulating the skin innate immunity. A larger randomized study is needed to confirm these findings.
To determine the limitations of using light-curable resin-based luting composites (RBLCs) to bond indirect ceramic/resin-composite restorations by measuring light transmittance through indirect ...restorative materials and the resulting degree of conversion (DC) of the luting-composites placed underneath.
Various thicknesses (0–4mm) and shades of LAVA Zirconia and LAVA Ultimate were prepared and used as light curing filters. A commercial, light curable RBLC, RelyX Veneer (control) was compared with four experimental RBLCs of the following composition: TEGDMA/BisGMA (50/50 or 30/70wt%, respectively); camphorquinone/amine (0.2/0.8wt%) or Lucirin-TPO (0.42wt%); microfillers (55wt%) and nanofillers (10wt%). RBLCs covered with the LAVA filter were light-cured for 40s, either with the dual-peak BluephaseG2 or an experimental device emitting either in the blue or violet visible band. The samples were analyzed by Raman spectroscopy to determine DC. Light transmittance through the filters was measured using a common spectroscopy technique.
All the factors studied significantly influenced DC (p<0.05). RBLCs with increased TEGDMA content exhibited higher DC. Only small differences were observed comparing DC without filters and filters ≤1mm (p>0.05). For thicknesses ≥2mm, significant reductions in DC were observed (p<0.05). Transmittance values revealed higher filter absorption at 400nm than 470nm. A minimal threshold of irradiance measured through the filters that maintained optimal DC following 40s irradiation was identified for each RBLC formulation, and ranged between 250–500mW/cm2.
This work confirmed that optimal photopolymerization of RBLCs through indirect restorative materials (≤4mm) and irradiation time of 40s is possible, but only in some specific conditions. The determination of such conditions is likely to be key to clinical success, and all the factors need to be optimized accordingly.
Abstract Objectives To test the influence of photoinitiator type and filler particle inclusion on the validity of exposure reciprocity law. Materials and methods 50/50 wt% Bis-GMA/TEGDMA resins were ...prepared with equimolar concentrations of camphorquinone/DMAEMA (0.20/0.80 mass%) (CQ) or Lucirin-TPO (0.42 mass%), and were used either unfilled or filled to 75 mass%. Specimens were cured with a halogen Swiss Master Light (EMS, Switzerland) using four different curing protocols: 400 mW/cm2 for 45 s as reference protocol (18 J/cm2 ), 1500 mW/cm2 for 12 s (18 J/cm2 ), 3000 mW/cm2 for 6 s (18 J/cm2 ) and 3 s (9 J/cm2 ). Degree of conversion (DC) was measured in real time for 70 s by FT-NIRS and temperature rise using a thermocouple. Depth of cure was determined with a penetrometer technique. Results With respect to DC and depth of cure, exposure reciprocity law did not hold for any tested material, except for the depth of cure of filled CQ-based materials. At similar radiant exposure, DC was significantly higher ( p < 0.05) for all unfilled and filled TPO-based materials compared with CQ-based materials. As exposure time was reduced and irradiance increased, TPO-based materials exhibited higher DC whilst an opposite trend was observed for CQ-based materials ( p < 0.05). For similar curing regimes, depth of cure of CQ-based materials remained significantly greater than that of TPO-based materials. Adding fillers generally reduced DC, except at higher irradiance for CQ-based materials where a positive effect was observed ( p < 0.05). Significance The validity of exposure reciprocity law was dependent on several factors, among which photoinitiator type and filler content were important. Lucirin-TPO is a highly reactive and efficient photoinitiator, which may allow the potential for a reduction in curing time of TPO-based photoactive materials in thin sections.
Highlights ► High irradiance cannot compensate for short curing times for effectively curing all material types. ► Resin viscosity and filler content affect the validity of exposure reciprocity law. ...► Some flowable resin composites are not cured effectively at high irradiance and short exposure times.
Abstract Objectives New commercial tricalcium silicate based cements were elaborated to improve handling properties and setting time. The goals of the present work were: (i) to determine the ...composition of the new injectable and/or fast setting calcium silicate based cements, and (ii) to investigate the impact of the differences in composition on their setting kinetics. Methods The materials considered were Angelus MTA™, Biodentine™, MM-MTA™, MTA-Caps™, and ProRoot MTA™ as control. Elemental composition of materials was studied by Inductively Coupled Plasma-Atomic Emission Spectroscopy and X-ray Energy Dispersive analysis, whereas phases in presence were analyzed by Micro-Raman spectroscopy and X-ray Diffraction analysis and cement surface by Scanning Electron Microscope. Setting kinetics was evaluated using rheometry. Results Elemental analysis revealed, for all cements, the presence of three major components: calcium, silicon and oxygen. Chlorine was detected in MM-MTA, MTA-Caps and Biodentine. Different radio-opacifiers were identified: bismuth oxide in ProRoot MTA, Angelus MTA and MM-MTA, zirconium oxide in Biodentine and calcium tungstate (CaWO4 ) in MTA-Caps. All cements were composed of di- and tri-calcium silicate, except Biodentine for which only the latter was detected. Major differences in setting kinetics were observed: a modulus of 8 × 108 Pa is reached after 12 min for Biodentine, 150 min for MM-MTA, 230 min for Angelus MTA and 320 min for ProRoot MTA. The maximum modulus reached by MTA-Caps was 7 × 108 Pa after 150 min. Significance Even if these cements possess some common compounds, major differences in their composition were observed between them, which directly influence their setting kinetics.
Summary Three types of low‐shrinkage composites are today commercially available: Ormocers, cationic ring‐opening curing systems and highly filled methacrylate‐based materials, which cure via ...free‐radical polymerization mechanisms. The aim of this study was to characterize the inorganic fraction of materials belonging to each type and to compare their mechanical properties. Two Ormocers (Admira and an experimental Ormocer V35694), one ring‐opening composite (Filtek Silorane) and five methacrylate‐based composites Filtek Supreme XT, Tetric EvoCeram, Grandio, Synergy D6 (Coltène‐Whaledent, Langenau, Germany) and an experimental material, V34930 were tested. Inorganic fillers were quantified by thermogravimetric analysis and morphologically characterized by scanning electron microscopy. Dynamic modulus was determined by an impulse excitation technique, static elastic moduli and flexural strength by a three‐point bending method. The results were analyzed using anova tests (P < 0·05) and linear correlations. Grandio, V34930 and V35694 exhibited significantly higher filler mass fractions. Both dynamic and static moduli of Grandio and V34930 were significantly higher than the other materials (P < 0·05), although no significant difference in flexural strength was observed between material type (P > 0·05). From the present findings, it was suggested that V35694 and Filtek Silorane exhibit comparable properties to conventional methacrylate‐based composites, although clinically the cavity type and location must guide material choice. Under high occlusal load, the use of Grandio and V34930 might be favoured. For small cavities, alternative technologies could be preferred as the need for mechanical resistance is lower and the potential for stress generation is greater.
This paper assesses the effects of light characteristics and irradiation time on the Vickers microhardness (VH) of a dual-photoinitiator commercial composite and on temperature increase in the pulp ...chamber (deltaT). Four recent light-emitting diodes (LEDs)--bluephaseG2 (BG2), bluephase16i (B16i), G-Light (G) and Freelight2 (F2)--and one control halogen light (XL3000-X) were tested on two shades of Tetric EvoCeram (A2 and Bleach XL), whose respective commercial formulations differed based on their concentration of camphorquinone and lucirin TPO. Three different irradiation times were applied--10, 20 and 40 seconds-and VH was measured on the upper and lower surfaces of 2-mm thick samples. The deltaT was measured by using a K-type thermocouple inserted into the pulp chamber of a molar that had been prepared to obtain a 2-mm thickness of dentin. The measurements were made either during polymerization of a 2 mm composite (Shade A2 or Bleach) or with an empty mold. The data were analyzed with the two-way ANOVA (p < 0.05) test. For shade A2, all but one irradiation condition (F2-10 seconds, lower surface) generated VH values that were statistically equal to or better than the standard chosen for this study (X-40 seconds). For Bleach shade, the VH values obtained with G and BG2-20 and 40 seconds were statistically comparable to X-40 seconds for both the upper and lower surfaces. This was not the case with either G and BG2-10 seconds or for all the procedures with other LCUs for which a VH of at least one of the surfaces was significantly lower than the reference. The results also highlight differences between the two material shades, whether the upper or lower surface is considered. Regarding temperature measurements for shade A2, B16i-20-40 seconds, BG2-40 seconds and G-40 seconds induced significantly higher deltaTs (3.98, 5.98, 5.21 and 4.95, respectively) than X-40 seconds (3.09). For Bleach shade, B16i-20 and 40 seconds, F2-20 and 40 seconds, BG2-40 seconds and G-40 seconds generated deltaTs significantly higher than the control values (2.70, 4.05, 3.03, 4.58, 2.74 and 2.44, respectively). The deltaT values obtained with uncovered tooth were generally higher than those obtained with a 2-mm layer of composite. In conclusion, this research emphasizes that a perfect correspondence between light and material spectra is of prime concern, both to insure optimal polymerization and to limit heating in the pulp chamber. Some reduction in curing time is possible, but only within certain limits.
Abstract Objectives The degree and rate of photopolymerization in resin-based dental composites will significantly affect polymer network formation and resultant material properties that may ...determine their clinical success. This study investigates the mechanical properties, the generation of stress from polymerization, tooth cusp deflection and marginal integrity of experimental resin composites that contain different photoinitiators. Methods Experimental light-activated resin composites (60 vol% particulate filled in 50/50 mass% bis-GMA/TEGDMA) were formulated using a monoacylphosphine oxide (MAPO) photoinitiator and compared with a conventional camphoroquinone (CQ)-based system. Similar radiant exposure was used (18 J cm−2 ) for polymerization of each material although the curing protocol was varied (400 mW cm−2 for 45 s, 1500 mW cm−2 for 12 s and 3000 mW cm−2 for 6 s). Degree and rate of polymerization was calculated in real-time by near infrared spectroscopy and the generation of stress throughout polymerization measured using a cantilever beam method. Flexural strength and modulus were acquired by three-point bend tests. Standardized cavities in extract pre-molar teeth were restored with each material, the total cuspal deflection measured and post-placement marginal integrity between the tooth and restoration recorded. Results Generally, MAPO- exhibited a significantly higher degree of conversion (72 ± 0.8 to 82 ± 0.5%) compared with CQ-based materials (39 ± 0.7 to 65 ± 1.6%) regardless of curing protocol ( p < 0.05) and MAPO-based materials exhibited less difference in conversion between curing protocols. CQ-based materials exhibited between ∼85 and 95% of the maximum rate of polymerization at <15% conversion, whereas MAPO-based RBCs did not approach the maximum rate until >50% conversion. Higher irradiance polymerization had a significant deleterious effect on the mechanical properties of CQ-based materials ( p < 0.05) whereas MAPO-based materials exhibited increased strength and modulus and were less affected by the curing method. Total cuspal deflection in restored extracted teeth was higher for CQ- compared with MAPO-based materials cured at the lowest irradiance curing protocol (12.9 ± 4.0 and 8.3 ± 1.5 μm) and similar at 3000 mW cm−1 for 6 s (10.1 ± 3.5 and 9.0 ± 1.5 μm). A significant decrease in marginal integrity was observed for CQ-based RBCs cured at high irradiance for short exposure time compared with that of the MAPO-based RBC cured using a similar protocol ( p = 0.037). Significance Polymer network formation dictates the final properties of the set composite and the use MAPO photoinitiators may provide an effective restorative material that exhibits higher curing speeds, increased degree of conversion, strength and modulus without compromise in terms of polymerization stress and marginal integrity between tooth and restoration.
Different irradiation protocols are proposed to polymerize dental resins, and discordances remain concerning their impact on the material. To improve this knowledge, we studied entrapment of free ...radicals in unfilled Bis-GMA/TEGDMA (50:50 wt%) resin after light cure. The tested hypothesis was that various irradiation parameters (curing time, irradiance, and radiant exposure) and different irradiation modes (continuous and pulse-delay) led to different amounts of trapped free radicals. The analysis of cured samples (n = 3) by electron paramagnetic resonance (EPR) revealed that the concentrations of trapped free radicals significantly differed according to the curing protocol. When continuous modes with similar radiant exposure were compared, higher concentrations of trapped free radicals were measured for longer times with lower irradiance. Concerning pulse modes, the delay had no influence on trapped radical concentration. These results give new insights into the understanding of the photopolymerization process and highlight the relevance of using EPR when studying polymerization of dimethacrylate-based materials.
PDF
