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Purpose: Obstructive sleep apnea (OSA) is a common chronic condition, associated with several conditions that account for leading causes of mortality. Adherence to treatment of a chronic condition is, along with treatment efficacy, a major determinant of treatment outcome. The aim of this study was to test whether or not a multifactorial intervention in addition to standard care increases adherence rates in patients using a titratable oral appliance for OSA. Methods: All subjects were 18 years old or older, had a diagnosis of OSA, and were treated with an oral appliance with an embedded sensor to measure appliance wear time objectively. The control group received routine care, while the experimental subjects received an additional multifactorial intervention. Comparison of adherence was at 30 days (Phase I) and 90 days (Phase II) after appliance delivery. Results: Data are reported for 82 subjects in Phase I (control 43; experimental 39) and 66 subjects in Phase II (control 36; experimental 30). There were no significant differences for age, sex, body mass index, and apnea-hypopnea index (p > 0.05) between groups. In both Phase I and Phase II, the mean number of nights the appliance was worn 4 or more hours and the mean time the appliance was worn nightly were significantly greater in the experimental than in the control group (p < 0.05). Conclusions: Interventions were well received by subjects and can be carried out by auxiliary personnel. The experimental interventions resulted in clinically important and statistically significant improvements in patient adherence to treatment. [ABSTRACT FROM AUTHOR]

Innate immunity to nucleic acids forms the backbone for anti-viral immunity and several inflammatory diseases. Upon sensing cytosolic viral RNA, retinoic acid-inducible gene-I-like receptors (RLRs) interact with the mitochondrial antiviral signaling protein (MAVS) and activate TANK-binding kinase 1 (TBK1) to induce type I interferon (IFN-I). TRAF3-interacting protein 3 (TRAF3IP3, T3JAM) is essential for T and B cell development. It is also well-expressed by myeloid cells, where its role is unknown. Here we report that TRAF3IP3 suppresses cytosolic poly(I:C), 5'ppp-dsRNA, and vesicular stomatitis virus (VSV) triggers IFN-I expression in overexpression systems and Traf3ip3−/− primary myeloid cells. The mechanism of action is through the interaction of TRAF3IP3 with endogenous TRAF3 and TBK1. This leads to the degradative K48 ubiquitination of TBK1 via its K372 residue in a DTX4-dependent fashion. Mice with myeloid-specific gene deletion of Traf3ip3 have increased RNA virus-triggered IFN-I production and reduced susceptibility to virus. These results identify a function of TRAF3IP3 in the regulation of the host response to cytosolic viral RNA in myeloid cells. RNA viruses can be detected by immune cell pattern recognition receptors, such as RLRs, resulting in MAVS-TBK1-IRF3 signalling and production of antiviral type 1 interferons. Here the authors show that macrophage TRAF3-interacting protein 3 regulates this signalling pathway by interacting with TRAF3 and TBK1 to suppress interferon responses. [ABSTRACT FROM AUTHOR]

Objectives: To synthesize two different sizes of bioactive glass-coated mesoporous silica nanoparticles (BGN@MSNs) and to investigate their effects on dentinal tubule occlusion and remineralization. Materials and methods: Two different sizes of mesoporous silica nanoparticles (MSNs) were synthesized using the Stöber method (368A, 1840A) and coated with bioactive glass nanoparticles (BGNs) using a modified quick alkali-mediated sol-gel method (368B, 1840B). Sensitive tooth disc models were prepared and divided into six groups and the following treatments were applied: group 1—no treatment, group 2—bioglass, group 3—368A, group 4—368B, group 5—1840A, and group 6—1840B. Then, five discs were selected from each group and soaked in 6 wt% citric acid to test acid resistance. Dentinal tubule occlusion and occlusion ratio were observed using field-emission scanning electron microscopy. In vitro mineralization tests using simulated body fluid solution were performed to evaluate the remineralization effect of the treatment. Results: All samples effectively occluded the dentinal tubule and formed a membrane-like layer. After acid treatment, 1840B (group 6) exhibited the highest rate of dentinal tubule occlusion. Remineralization was observed in 368B and 1840B, and 1840B exhibited the fastest remineralization. Conclusions: Dentinal tubule remineralization induced by the BGN@MSN biocomposite can be used to stabilize long-term prognosis in dentin hypersensitivity. The 1840B induced the most efficient remineralization, and its smaller size and larger surface area were effective for remineralization. Clinical relevance: The BGN@MSN biocomposite with its smaller size and larger surface area was more effective for remineralization and dentinal tubule sealing. [ABSTRACT FROM AUTHOR]

Objective: Visual differentiation of resin and tooth in a tooth cavity is not simple due to their highly similar shade. The purpose of the present study was to find any noninvasive method which can effectively differentiate resin from sound tooth in a resin-imbedded tooth for resin repair.Materials and methods: For the study, various resin products were imbedded into the cavity of sound tooth. By applying laser of different wavelengths, autofluorescence (AF) of sound tooth and resin products were obtained. Microhardness, X-ray radiograph, and DIAGNOdent were tested for each tooth, resin product, and resin-imbedded tooth.Results: For the AF spectra obtained using the 405-nm wavelength, sound tooth has emission peak at 440-470 nm and near 490 nm. Sound tooth has several times higher microhardness than resin products regardless of position in tooth subsurface. Due to the difference of radiopaque fillers' composition and concentration, resin products have different brightness in the X-ray radiograph. DIAGNOdent readings for tooth and resin products were inconsistently different, and the difference of obtained values was slightly not to be applicable for the differentiation.Conclusion: Among the tested methods, with noninvasive treatment, AF spectrum by the 405-nm wavelength showed the apparent difference between resin and tooth.Clinical significance: For the resin repair in a resin-imbedded tooth cavity, AF spectrum produced by 405-nm wavelength could be a useful method in tracing the resin-tooth boundary if combined with conventional X-ray radiography. [ABSTRACT FROM AUTHOR]

Objectives: To synthesize a silver-doped bioactive glass/mesoporous silica nanoparticle (Ag-BGN@MSN), as well as to investigate its effects on dentinal tubule occlusion, microtensile bond strength (MTBS), and antibacterial activity.Materials and methods: Ag-BGN@MSN was synthesized using a modified "quick alkali-mediated sol-gel" method. Demineralized tooth disc models were made and divided into four groups; the following treatments were then applied: group 1—no treatment, group 2—bioglass, group 3—MSN, group 4—Ag-BGN@MSN. Next, four discs were selected from each group and soaked into 6 wt% citric acid to test acid-resistant stability. Dentinal tubule occlusion, as well as the occlusion ratio, was observed using field-emission scanning electron microscopy. The MTBS was also measured to evaluate the desensitizing effect of the treatments. Cytotoxicity was examined using the MTT assay. Antibacterial activity was detected against Lactobacillus casei, and ion dissolution was evaluated using inductively coupled plasma optical emission spectrometry.Results: Ag-BGN@MSN effectively occluded the dentinal tubule and formed a membrane-like layer. After the acid challenge, Ag-BGN@MSN had the highest rate of dentinal tubule occlusion. There were no significant differences in MTBS among the four groups (P > 0.05). All concentrations of Ag-BGN@MSN used had a relative cell viability above 72%.Conclusions: Ag-BGN@MSN was successfully fabricated using a modified sol-gel method. The Ag-BGN@MSN biocomposite effectively occluded dentinal with acid-resistant stability, did not decrease bond strength in self-etch adhesive system, had low cytotoxicity, and antibacterial effect.Clininal relevance: Dentinal tubule sealing induced by Ag-BGN@MSN biocomposite with antibacterial effect is likely to increase long-term stability in DH. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to investigate the microhardness, polymerization shrinkage, and translucency of bulk-fill composites (BFCs) which have different light attenuation properties and filler contents. Materials and methods: Five BFCs [Filtek Bulk Fill (FB), SureFil SDR (SS), Venus Bulk Fill (VB), SonicFill (SF), and Tetric N-Ceram Bulk Fill (TB)] and two resin-based composites (RBCs) [Tetric N-Ceram (TN) and Filtek Z350XT Flowable (ZF)] were chosen. Numbers of transmitted photons, refractive index, microhardness at different thicknesses, polymerization shrinkage, and translucency parameter (TP) were evaluated. Results: Attenuation coefficients (ACs) based on measured photons ranged from −0.88 to −1.90. BFCs, except SF, had lower AC values than TN or ZF, and BFCs, except TN, had smaller refractive index decreases between top and bottom surfaces. Regardless of an exponential decrease in photon counts, microhardness decreased linearly as specimen thickens. Moreover, microhardness of BFCs showed smaller top-to-bottom decreases (11.5-48.8 %) than TN or ZF (57.3 and 71.5 %, respectively). BFCs with low filler contents showed lower microhardness and higher polymerization shrinkage than those of high filler contents. Also, BFCs had significantly higher ( p < 0.001) TP values than TN or ZF. Conclusion: BFCs attenuated light less than RBCs. However, some BFCs had much lower top surface microhardness and higher polymerization shrinkage than tested RBCs. Clinical relevance: Despite the convenience of bulk filling, careful selection of BFC is advised because some BFCs have worse microhardness and polymerization shrinkage than RBCs due to their lower filler contents. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to establish multivariable regression models for the estimation of skeletal maturation status in Japanese boys and girls using the cone-beam computed tomography (CBCT)-based cervical vertebral maturation (CVM) assessment method and hand-wrist radiography. Materials and methods: The analyzed sample consisted of hand-wrist radiographs and CBCT images from 47 boys and 57 girls. To quantitatively evaluate the correlation between the skeletal maturation status and measurement ratios, a CBCT-based CVM assessment method was applied to the second, third, and fourth cervical vertebrae. Pearson's correlation coefficient analysis and multivariable regression analysis were used to determine the ratios for each of the cervical vertebrae ( p < 0.05). Results: Four characteristic parameters ((OH + PH)/W, (OH + AH)/W, D, AH/W), as independent variables, were used to build the multivariable regression models: for the Japanese boys, the skeletal maturation status according to the CBCT-based quantitative cervical vertebral maturation (QCVM) assessment was 5.90 + 99.11 × AH/W − 14.88 × (OH + AH)/W + 13.24 × D; for the Japanese girls, it was 41.39 + 59.52 × AH/W − 15.88 × (OH + PH)/W + 10.93 × D. Conclusions: The CBCT-generated CVM images proved very useful to the definition of the cervical vertebral body and the odontoid process. The newly developed CBCT-based QCVM assessment method showed a high correlation between the derived ratios from the second cervical vertebral body and odontoid process. Clinical relevance: There are high correlations between the skeletal maturation status and the ratios of the second cervical vertebra based on the remnant of dentocentral synchondrosis. [ABSTRACT FROM AUTHOR]

The selection of a light-curing unit for the curing composite resins is important to achieve best outcomes. The purpose of the present study was to test lasers of 457 and 473 nm alone or in combination under different light conditions with respect to the cure of composite resins. Four different composite resins were light cured using five different laser combinations (530 mW/cm 457 nm only, 530 mW/cm 473 nm only, 177 mW/cm 457 + 177 mW/cm 473 nm, 265 mW/cm 457 + 265 mW/cm 473 nm, and 354 mW/cm 457 + 354 mW/cm 473 nm). Microhardness and polymerization shrinkage were evaluated. A light-emitting diode (LED) unit was used for comparison purposes. On top surfaces, after aging for 24 h, microhardness achieved using the LED unit and the lasers with different conditions ranged 42.4-65.5 and 38.9-67.7 Hv, respectively, and on bottom surfaces, corresponding ranges were 25.2-56.1 and 18.5-55.7 Hv, respectively. Of the conditions used, 354 mW/cm 457 nm + 354 mW/cm 473 nm produced the highest bottom microhardness (33.8-55.6 Hv). On top and bottom surfaces, microhardness by the lowest total light intensity, 354 (177 × 2) mW/cm, ranged 39.0-60.5 and 18.5-52.8 Hv, respectively. Generally, 530 mW/cm at 457 nm produced the lowest polymerization shrinkage. However, shrinkage values obtained using all five laser conditions were similar. The study shows the lasers of 457 and 473 nm are useful for curing composite resins alone or in combination at much lower light intensities than the LED unit. [ABSTRACT FROM AUTHOR]

This study evaluated the shear bond strength (SBS) and adhesive remnant index (ARI) of ceramic brackets with different base designs using a 473-nm diode-pumped solid-state (DPSS) laser to test its usefulness as a light source. A total of 180 caries-free human premolars were divided into four groups according to the base designs: microcrystalline, crystalline particle (CP), dovetail, and mesh. For each base design, teeth were divided into three different subgroups for light curing using three different light-curing units (LCUs) (quartz-tungsten-halogen unit, light-emitting diode unit, and a DPSS laser of 473 nm). Applied light intensities for the DPSS laser and the other LCUs were approximately 630 and 900 mW/cm, respectively. Stainless steel brackets with a mesh design served as controls. The failure modes of debonded brackets were scored using ARI. As a result, brackets bonded using the DPSS laser had the highest SBS values (16.5-27.3 MPa) among the LCUs regardless of base design. Regarding base designs, the CP groups showed the highest SBS values (22.9-27.3 MPa) regardless of LCU. Furthermore, stainless steel brackets with a mesh design had the lowest SBS values regardless of LCU. In many cases, brackets bonded using the DPSS laser had higher ARI scores and had more adhesive on their bases than on tooth surfaces. The study shows that the 473-nm DPSS laser has considerable potential for bonding ceramic brackets at lower light intensities than the other light-curing units examined. [ABSTRACT FROM AUTHOR]

Lasers have many favorable features as a light source owing to their monochromaticity and coherence. This study examined the mechanical properties of composite resins that were light-cured using a diode-pumped solid state (DPSS) laser. Eight composite resins were light-cured using four different light sources (one quartz-tungsten-halogen (QTH), two light-emitting diodes (LEDs), and one DPSS laser with a wavelength of 473 nm). The light intensity of the DPSS laser and remaining light-curing units were approximately 500 and 900 mW/cm, respectively. The microhardness, flexural properties, and compressive properties were evaluated using the Vickers hardness test, three-point bending test, and compression test, respectively. In most cases, the microhardness, flexural properties, and compressive properties of the specimens light-cured using the DPSS laser were similar to those obtained using the other light-curing units. Within the limits of the study, the microhardness, flexural modulus, and compressive strength were linearly correlated with the filler content (in weight percent). The flexural modulus and compressive modulus were also linearly correlated with the microhardness. Even with a much lower light intensity, the DPSS laser with a wavelength of 473 nm can polymerize composite resins and give comparable mechanical properties to those obtained using the other light-curing units. [ABSTRACT FROM AUTHOR]

Hydroxyapatite-gelatin modified siloxane (GEMOSIL) nanocomposite was developed by coating, kneading and hardening processes to provide formable scaffolding for alloplastic graft applications. The present study aims to characterize scaffolding formability and mechanical properties of GEMOSIL, and to test the in vitro and in vivo biocompatibility of GEMOSIL. Buffer Solution initiated formable paste followed by the sol-gel reaction led to a final hardened composite. Results showed the adequate coating of aminosilane, 11-19 wt%, affected the cohesiveness of the powders and the final compressive strength (69 MPa) of the composite. TGA and TEM results showed the effective aminosilane coating that preserves hydroxyapatite-gelatin nanocrystals from damage. Both GEMOSIL with and without titania increased the mineralization of preosteoblasts in vitro. Only did titania additives revealed good in vivo bone formation in rat calvarium defects. The scaffolding formability, due to cohesive bonding among GEMOSIL particles, could be further refined to fulfill the complicated scaffold processes. [ABSTRACT FROM AUTHOR]

This study evaluated the shear bond strength (SBS) of orthodontic brackets bonded to teeth using a diode-pumped solid state (DPSS) laser of 473 nm with various light intensity and light-curing settings. For the study, a total of 150 extracted human teeth were divided into ten groups. In the control group, the brackets were bonded to the teeth using a quartz-tungsten-halogen (QTH) light with an intensity of 900 mW/cm(2). In the experimental groups, the brackets were bonded using a DPSS laser with three different light intensities and light-curing times. The same bracket type and adhesive were used in all groups throughout the study. Statistical analysis was performed to compare the SBS, and adhesive remnant index (ARI) among the groups. As results, brackets bonded using the DPSS laser with an intensity of 700 mW/cm(2) for 40 s (totally) showed a slightly higher SBS (12.2 ± 1.8 MPa) than that of those bonded using a QTH light (control; 11.6 ± 1.6 MPa). The SBS values linearly increased with increasing energy density (light intensity × light-curing time) of the DPSS laser (R = 0.95, p < 0.001). However, the SBS values among the test groups were similar regardless of the difference in light-curing conditions. A comparison of the ARI scores among the groups suggested a similar bracket failure mode. [ABSTRACT FROM AUTHOR]