Comparative evaluation of treatment of noncarious cervical hypersensitivity b...DR.AJAY BABU GUTTI M.D.S
Comparative evaluation of treatment of noncarious
cervical hypersensitivity by a fluoride varnish, a
dentin bonding agent, and Er, Cr:YSGG laser: An
in vivo study JCD 2020
Micro-computed tomographic assessment of dentinal microcrack formation in str...DR.AJAY BABU GUTTI M.D.S
Micro-computed tomographic assessment of
dentinal microcrack formation in straight and
curved root canals in extracted teeth prepared
with hand, rotary and reciprocating instruments IEJ 2021
Investigation of the Remineralization Effect Tnrough Scanning Electron Micros...IJERA Editor
Background: Local fluoride varnishes have been widely used as a method of non-operative treatment and for
caries preventive interventions for more than three decades.
Purpose: Evaluation of the remineralization effect by means of electron microscopy of mineralization varnish -
Clinpro ™ White Varnish with TCP (Tri-Calcium phosphate) (3M).
Materials and Methods: The material used is from 20 temporary intact teeth, extracted due to physiological
change with permanent teeth, with a completely preserved structure and anatomy of crowns and fully
physiologically resorbed roots. For the purposes of the study a scanning electron microscope JEOL JSM 6390 is
used with an attachment for element analysis (EDS INCA of Oxford). Prepared samples are pre-coated with
gold (cathode sputtering with apparatus JEOL JFC – 1200) to obtain a better contrast of the SEM image of early
carious lesions on the smooth surfaces of the temporary teeth, with predilection for development of caries with a
d1 threshold. For this purpose the two processes were monitored occurring continuously on the enamel surfacede-
and remineralization. Performed was computer processing of the digital images.
Results: There is presence of certain minerals deposited in the embossed enamel prisms after of
remineralization. The chemical analysis established the presence of calcium (Ca2 +
), around the organic matrix.
Demineralised surface has pores present of around 1%, which is visible through the enamel on the surface of the
deciduous teeth looking like filled and pores looking like partially covered, filled with newly formed and
growing crystals. The crystals, which are hydroxylapatite, fluorapatite or fluorhydroxiapatite gradually connect,
growing and forming mineral structure filling the microscopi defects and the pores from the demineralisation in
the surface enamel prismless layer.
Comparative evaluation of treatment of noncarious cervical hypersensitivity b...DR.AJAY BABU GUTTI M.D.S
Comparative evaluation of treatment of noncarious
cervical hypersensitivity by a fluoride varnish, a
dentin bonding agent, and Er, Cr:YSGG laser: An
in vivo study JCD 2020
Micro-computed tomographic assessment of dentinal microcrack formation in str...DR.AJAY BABU GUTTI M.D.S
Micro-computed tomographic assessment of
dentinal microcrack formation in straight and
curved root canals in extracted teeth prepared
with hand, rotary and reciprocating instruments IEJ 2021
Investigation of the Remineralization Effect Tnrough Scanning Electron Micros...IJERA Editor
Background: Local fluoride varnishes have been widely used as a method of non-operative treatment and for
caries preventive interventions for more than three decades.
Purpose: Evaluation of the remineralization effect by means of electron microscopy of mineralization varnish -
Clinpro ™ White Varnish with TCP (Tri-Calcium phosphate) (3M).
Materials and Methods: The material used is from 20 temporary intact teeth, extracted due to physiological
change with permanent teeth, with a completely preserved structure and anatomy of crowns and fully
physiologically resorbed roots. For the purposes of the study a scanning electron microscope JEOL JSM 6390 is
used with an attachment for element analysis (EDS INCA of Oxford). Prepared samples are pre-coated with
gold (cathode sputtering with apparatus JEOL JFC – 1200) to obtain a better contrast of the SEM image of early
carious lesions on the smooth surfaces of the temporary teeth, with predilection for development of caries with a
d1 threshold. For this purpose the two processes were monitored occurring continuously on the enamel surfacede-
and remineralization. Performed was computer processing of the digital images.
Results: There is presence of certain minerals deposited in the embossed enamel prisms after of
remineralization. The chemical analysis established the presence of calcium (Ca2 +
), around the organic matrix.
Demineralised surface has pores present of around 1%, which is visible through the enamel on the surface of the
deciduous teeth looking like filled and pores looking like partially covered, filled with newly formed and
growing crystals. The crystals, which are hydroxylapatite, fluorapatite or fluorhydroxiapatite gradually connect,
growing and forming mineral structure filling the microscopi defects and the pores from the demineralisation in
the surface enamel prismless layer.
Evaluation of Marginal integrity and Depth of Cure for three ‘bulk fill’ comp...pratiklovehoney
Evaluation of Marginal integrity and Depth of Cure for three ‘bulk fill’ composites : SDR, Tetric Evoceram Bulk Fill Composite and EverX Posterior Bulk Fill Composite - An In Vitro study
Root repair materials in Dentistry is evolving like never before with the advent of bioactive materials.lets have quick look at the products that have become history to the recent advances .
The bond strength of endodontic sealers to root /prosthodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Article presentation: enamel repair with amorphous ceramicsDr. Ritu Gupta
this presentation simplifies and explains the mentioned article which describes newer technology for enamel repair, with this method regenerating enamel stronger and better than before
Evaluation of Marginal integrity and Depth of Cure for three ‘bulk fill’ comp...pratiklovehoney
Evaluation of Marginal integrity and Depth of Cure for three ‘bulk fill’ composites : SDR, Tetric Evoceram Bulk Fill Composite and EverX Posterior Bulk Fill Composite - An In Vitro study
Root repair materials in Dentistry is evolving like never before with the advent of bioactive materials.lets have quick look at the products that have become history to the recent advances .
The bond strength of endodontic sealers to root /prosthodontic coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Article presentation: enamel repair with amorphous ceramicsDr. Ritu Gupta
this presentation simplifies and explains the mentioned article which describes newer technology for enamel repair, with this method regenerating enamel stronger and better than before
Study the effect of thin film thickness on the optical features of (IR5 laser...TELKOMNIKA JOURNAL
The linear optical features such as (transmittance T, absorbance A, the effective length 퐿푒푓푓, absorption coefficient 훼 and refractive index 푛 ) for the thin films samples of (3x10-3 mol/l of (IR5) laser dye, 0.02 gm of (CdS) nanoparticles and 0.04 gm of pp polymer) had been studied at different values of film thickness in one time and at different number of Yb:GdVO4 laser pulses. The non-linear optical features in terms of transmittance difference Δ푇푝−푣, non-linear refractive index 푛2, non–linear phase shift Δ훷표 non-linear absorption coefficient 훽 and minimum normalized transmittance 푇(푍) have been computed in relation to obtained normalized transmittance data from setup of Z-scan with open and closed apertures, calculated for (3x10-3 mol/l of (IR5) laser dye, 0.02 gm of (CdSe) nanoparticles and 0.04 gm of (pp) polymer) thin films at different values of film thickness at in one time and at different Yb:GdVO4 laser pulses. Thick films causes in deleting the non-linear effects generated by different layers. The (CdSe) nanoparticles leads to an absorption shifting of the wavelengths to lengthier wavelengths of red shift. So, this can be used in selecting the nanoparticles and medium with applicable exciting wavelengths. The film thickness and the laser pulses have the main effects in consolidating the Non-linear optical features.
Study of highly broadening Photonic band gaps extension in one-dimensional Me...IOSR Journals
In this paper, we show theoretically that the reflectance spectra of one dimensional multilayer metal-organic periodic structure (1D MOPS) can be enhanced due to the addition of the organic constituents. We have used simple transfer matrix method to calculate the absorption, transmittance and reflectance of the 1D MOPS systems. The organic component like N,N’-bis-(1-naphthyl)-N,N’diphenyl-1; 1biphenyl-4; 4diamine (NPB) absorbs the light in ultra-violet, visible and infrared electromagnetic region and the structure with Ag-metal also having the tendency to absorb the light by the plasmaonic action and their refractive can be calculated from Drude equation. The reflectance spectra of multilayer 1D MOPS containing a variable number periodic of Ag/N,N’-bis-(1-naphthyl)-N,N’diphenyl-1; 1biphenyl-4; 4diamine (NPB) structure are calculated taking optical constant of NPB and Ag. The optical band gap and reflectance spectra of 1D MOPS of the considered structure is obtained in the visible and near infrared regions either with the variation of the metal layer thickness or thickness of the organic layer. From the results under investigation through TMM, tunability in the optical band gap was observed either change in thickness of the other layer 1/ or 2 or the angle of the incident. Due to optical absorption of the light in the different region of electromagnetic spectrum due to either N,N’-bis-(1-naphthyl)-N,N’diphenyl-1; 1biphenyl-4; 4diamine (NPB) or silver metal, the optical band gap of 1DMOPS shows the shift of band edges of λL and λR from ultra-violet to visible and the infrared with change the optical constant.
Optical and Dielectric Studies on Semiorganic Nonlinear Optical Crystal by So...ijrap
The field of nonlinear optics became practically a reality after the invention of laser. High performance electro-optic switching elements for telecommunication and optical information processing are based on materials with high nonlinear optical (NLO) properties. Single crystals of nonlinear optical material Llysine sulphate (LLS) are grown by slow evaporation technique. The crystal structure and lattice parameters are determined for the grown crystal by single X-ray diffraction studies. The wide transparency range of the crystals in the visible region of the electromagnetic spectrum is identified by the UV-Vis-NIR technique. The mechanical property of the grown crystal is determined by Vicker’s microhardness test. It is observed from the microhardness studies of the grown crystals that the hardness increases with increase in load. Meyer’s index n is calculated which proves that the material belongs to soft material category. The dielectric constant and dielectric loss are calculated by varying the frequencies at room temperature. The emission of green light on passing the Nd: YAG laser confirms the second harmonic generation (SHG) property of the crystals .The SHG efficiency of the crystals are found to be better than that of Potassium Di hydrogen Phosphate (KDP)
ABSTRACT: The direct current photoconductivity of the powdered silicon and photovoltaic effect in the monocrystallic silicon are investigated. It is shown that organic dyes on the semiconductor surface effectively increase the internal photo effect in the dye absorption band. The photoconductivity of dyed powdered samples in the absorption range of the dyes is higher than the photoconductivity of undyed silicon by more than an order of magnitude. The optimum concentration of dye molecules on the monocrystal surface for a sensitization is 3×1015 cm -2 , which corresponds to the dye film thickness of about 30 monolayers or 10-15 nanometers
In these work, new nano and micro thermoplastic based composite is prepared with zeolite filler, The method involves using zeolite in powder form, the preparation of zeolite powder from ores by crushing it into small - sized granules. The characteristics of the zeolite powder are determined. The physical properties and chemical composition (XRD) are evaluated before impeding it into the thermoplastic. Thermoplastics powder are added to the zeolite powder as granules in different sizes, The particles sizes ranging from the size of a millimeter to nanometer. The manufacturing quality parameters are optimized at volume percentages of filler in the range 20 to 25 % , composite material is formed into molds. New Composite material is characterized by easy deformation into different shapes beside machine ability. The characteristics of new composite such as SEM, EDX,FTIR in absorption and transmission mode are evaluated and compared with the standard characteristics of Zeolite ores. The performance and characteristics of the new composite are completely different. The new composite is hard, solid and does not absorb water. The work end with list of recommendation about the new field and expected application of Zeolite when using it as filler in thermoplastic based micro and nano composites.
Refractive index measurement using Spectroscopic reflectance (MProbe)Semiconsoft, Inc
Spectroscopic reflectance is powerful tool but there is ,frequently, a misconception about its capabilities.
It depends, in large part, on software. Using MProbe one can determine thickness and R.I. (refractive index) of dielectric film (like polymers) along with the thickness.
http://www.semiconsoft.com/wp/mprobe20desktop/
International Journal of Engineering and Science Invention (IJESI)inventionjournals
International Journal of Engineering and Science Invention (IJESI) is an international journal intended for professionals and researchers in all fields of computer science and electronics. IJESI publishes research articles and reviews within the whole field Engineering Science and Technology, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Similar to A Comparative Study of Light Transmission by Various Dental Restorative Materials and the Tooth Structure (20)
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
A Comparative Study of Light Transmission by Various Dental Restorative Materials and the Tooth Structure
1. A COMPARATIVE STUDY OF LIGHT
TRANSMISSION BY VARIOUS
DENTAL
RESTORATIVE MATERIALS AND
THE
TOOTH STRUCTURE
N ILIE G FURTOS
Journal of operative dentistry 2020
AJAY BABU .GUTTI 1ST YR
PG
DEPARTMENT OF CONS &
2. INTRODUCTION
• A prerequisite that Esthetic dental restorative materials need to fulfill in order
to accurately duplicate the tooth structure is the ability to be translucent.
• When the translucency of a restorative material misses an appropriate range,
it is often the main factor responsible for failures in matching the shade of
restorative materials to the natural teeth.
• Equally important for esthetics is the impact of translucency on various
material properties, such as the depth of cure in direct light-cured resin
composite restoratives and the sufficiency of curing in underlying, light-curing
or dual-curing luting resin composites, when involving indirect restoratives.
3. • The light of a curing unit striking the surface of a dental restoration during
polymerization may be reflected, absorbed, scattered, or transmitted. Based on
these interactions with light, translucency is described as the relative amount of light
transmission or the diffuse reflectance from a substrate surface through a turbid
medium.
• opacity is a measure of impenetrability to light and is a consequence of extensive
absorption and/or scattering of light in a specific medium.
• Attenuating the effects of light when passing through matter, such as scattering or
reflection, are summarized in optics together with the absorption under the terms
extinction or absorbance.
• Light absorption in dental restoratives occurs when the frequency of the light
matches certain quantized frequencies within the constituent atoms and molecules
of the material, such as resin components, filler particles, photoinitiator molecules,
dyes, pigments or structures surrounding the restoration.
• Light scattering is due to the deviation of light from its initial trajectory because of
localized nonuniformities with a different index of refraction through which the light
passes, such as reinforcing particles, porosity voids, or surface roughness.
4. • In resin composites, for instance, absorption takes place within photoinitiators, color
pigments, and the organic matrix, whereas scattering is mainly attributed to filler
particles.
• In tooth structure, a negligible absorption and a weak scattering (scattering coefficient
ranging from 15 to 105 cm-1 ) has been identified in enamel. In dentin, scattering is
strong (scattering coefficient 260 cm-1) , and the absorption low.
• The absorption of light of surfaces or when passing through matter depends on the
material and the frequency (wavelength) of the incident light, the absorbing energy is
usually transformed into thermal energy.
• Example : Yellow-appearing surface is irradiated with white light, the green light and
red light are reflected/transmitted and the blue light is absorbed.
5. AIM
• To compare and quantify the amount of light that would pass through 2-mm-thick
increments of a large diversity of restorative materials
- regular light-cured resin based composites (RBCs)
-bulk-fill light-cured RBCs
-(CAD/CAM) restoratives based on resin composites
-poly(methyl methacrylate (PMMA)
-lithium disilicate ceramic
-Leucite glass-ceramic
-feldspar ceramic
-tooth structure
Irradiated
with violet
blue LED
,LCU
optical properties calculated from the relationship between incident
and transmitted irradiance, such as transmittance opacity, and
absorbance, are considered.
6. MATERIALS AND METHODS
• Light transmission through 32 restorative materials representing seven different
material types and in different shades and opacities was analyzed at a specimen
thickness of 2 mm.
• Optical properties such as transmittance, absorbance, and opacity of each
material, were calculated from the relationship between incident and transmitted
irradiance using a violet-blue LED LCU with an exposure time of 20seconds.
• For direct comparison of the optical properties among analyzed restorative
materials and tooth structure, specimens of 2-mm thickness were considered.
Various tooth structure specimen thicknesses (1.7 mm to 3 mm) have also been
considered to simulate light transmittance through a tooth cavity wall, as this may
occur in a clinical situation.
7. SPECIMEN PREPARATION
• Individual sets (n=6) of plane-parallel test specimens (2 mm) of 32 materials were
prepared .Tooth specimens (n=50) were manufactured in a thickness range of 1.7
mm to 3 mm.
• Light-cured RBC pastes were condensed in white cylindrical Teflon molds (6-mm
diameter, 2-mm height) and applied on the sensor of a spectrophotometer device
(MARC (Managing Accurate Resin Curing) System, Blue light Analytics Inc, Halifax,
NS, Canada) while being separated from the sensor by a thin Mylar foil.
• CAD/CAM blocks were cut using a low-speed diamond saw under water-cooling, then
ground with 4000-grit SiC paper and polished with a diamond suspension (mean
grain size: 1 um). The thickness of each specimen was determined at two points
using a digital micrometer screw gauge . Thickness tolerance was set at 0.05 mm.
8. • Tooth specimens 1.7 mm to 3 mm thick were obtained from 25 caries-free human
molars. For this purpose, one slice from the buccal and one from the lingual side of
each tooth were cut perpendicular to the long axis of the tooth. This simulated the
tooth wall in a Class II cavity through which a light-curing RBC restoration may be
additionally irradiated at the end of a restorative procedure.
• flat side of the tooth specimen was ground and polished similar to the CAD/CAM
specimens and positioned in contact to the sensor of the spectrophotometer. The
opposite, intact tooth side was irradiated with the LCU .Light transmittance was
accordingly.
9. MEASUREMENT OF INCIDENT AND
TRANSMITTED IRRADIANCE
SPECTROPHOTOMETRY
• Assessed on a laboratory grade National Institute of Standards and Technology (NIST)
• The incident irradiance (the irradiance reaching the specimen’s surface) was determined
on six occasions by applying the LCU directly to the sensor.
• The transmitted irradiance was measured by positioning the specimens between the
LCU and the sensor.
• All the specimens were aligned centered on the round detector of the spectrometer,
which had a diameter of 3.9 mm irradiance and radiant exposure reaching this area was
considered miniature.
• Fiber optic USB4000 Spectrometer uses a 3648- element Toshiba linear Charge-coupled
Device array detector and high-speed electronics (Ocean Optic, Largo, FL, USA). The
spectrometer was calibrated using an Ocean Optics’ NIST-traceable light source (300–
1050 nm). The system uses a CC3-UV Cosine Corrector (Ocean Optic) to collect
radiation over a 180 degrees field of view, thus mitigating the effects of optical
interference associated with light collection sampling geometry. Irradiance at a
wavelength range of 360–540 nm was individually collected at a rate of 16
10.
11. TRANSMITTANCE , OPACITY
AND ABSORBANCE
• Transmittance (T) is defined as the ratio of transmitted irradiance (radiant power)
to incident irradiance: T = I(d)/Io,
• I(d) is the irradiance after the beam of light passes through the specimen of
thickness d, and Io is the irradiance of the incident light.
• Inverse of transmittance is called opacity (O) (T–¹=Io/I(d))
• Negative decadic logarithm of the transmittance, that is, the decadic logarithm of
the opacity, is the absorbance (A) (log(T)=log(I(d)/ Io), where absorbance stands
for the number of photons absorbed.
• T,O,A are dimensionless
12. RESULTS
• Incident irradiance at the applied curing conditions amounted to 1174.1 (12.4)
mW/cm2.
• The transmitted irradiance through 2-mm-thick specimens varied between 471.0 ± 0.4
mW/cm2 (flowable bulk-fill resin composite, Venus, universal) and 60.4 ± 0.1 mW/cm2
(CAD/CAM resin composite, VITA Enamic), denotes a drop in irradiance of 59.9% to
94.9% when light is passing through diverse restorative materials.
• Attenuation of light through the tooth structure of the same thickness was 89.4%
(transmitted irradiance = 124.6636.7 mW/cm2).
• (Venus to VITA Enamic), the absorbance varied between 0.40 ± 0.02 and 1.29 ± 0.03,
and the opacity between 2.52 ± 0.11 and 19.56 ± 1.13
• Related optical properties of the tooth structure of the same thickness were 1.0 ± 0.03
and 10.5 ± 3.3, respectively.
13. • Very strong influence of the parameter material was identified on the transmitted
irradiance I(d) (p,0.001; partial eta squared, gP 2=0.953), T (p,0.001; gP 2=0.951),
A (p,0.001; gP 2=0.925), and the parametric material was not significant .
• Individual shades (A2, A3, 2M2, and U), irrespective of the chemical composition
and structure of the analyzed materials, have been identified as having a highly
significant influence on all determined optical parameters.
• singular effect of shade (A2 and A3) on the transmitted irradiance for a given
chemical composition and structure of a material can be directly observed in the
light-cured RBCs G-eanial and Gradia Direct Anterior, the CAD/CAM RBC Lava
Ultimate, and the lithium disilicate glass-ceramic IPS e.max CAD light was
attenuated significantly stronger in specimens of shade A3 compared with A2, in all
aforementioned material types.
• Difference in light attenuation owing to a difference in shade was higher in the
glass-ceramic (relative change=29.9%) compared with the RBCs .
• Transmitted irradiance for a given shade (A2) was gathered in the leucite glass-
ceramic IPS Empress CAD and the lithium disilicate glass-ceramic IPS e.max CAD
comparison indicates a strong attenuation of light in low translucent (LT) compared
to the high translucent (HT) specimens.
14. • Transmitted irradiance was higher through the leucite glass-
ceramic, the difference in transmitted irradiance between HT and LT
formulations was higher in the lithium disilicate glass-ceramic
(49.72% vs 39.25% in the leucite glass-ceramic).
15. illustrates the exponential decrease of the transmitted irradiance through the tooth structure as a
function of specimen thickness.
lower light transmittance was identified in IPS e.max CAD, LT, A3 higher light transmittance was
found in all other materials. opacity was significantly highest in the lithium disilicate glass-
ceramic IPS e.max CAD, LT, A3, and the tooth structure
16. • Large range of RBC materials, comprising the material interval
Charisma A3 (mean transmitted irradiance=92.33 mW/cm2) to Telio
CAD, A2 (170.6 mW/cm2), showed a statistically similar transmitted
irradiance to the tooth structure.
17.
18. DISCUSSION
• The present study quantifies the attenuation of light when traveling through
different types of restorative materials of a predetermined thickness of 2 mm.
• This thickness was chosen to allow for a direct comparison among a large
variety of direct and indirect restoratives that might be involved in light curing
during the restorative procedure and is due to the need for curing regular RBCs
in increments that should not exceed 2 mm.
• The comparison of the optical properties among tooth and material specimens
refers only to this thickness.
• The light transmission through light-cured RBCs and the tooth structure has
direct clinical implications, such as selecting an appropriate curing technique.
• There is no experimental evidence, clinicians are often taught to only pre-cure
the lowest increment when incrementally reconstructing a deep cavity, based
on the estimate that the lowest increment will receive enough light.
19. • The present study gives a comparison of the light transmittance through some
representative regular micro- and nanohybrid light-cured RBCs in the clinically
most commonly used shades (A2, A3), thus identifying light transmitted
irradiances ranging from 92.32 ±3.21 mW/cm2 (Charisma, A3) to 128.33 ± 4.04
mW/cm2 (Filtek Z250, A2).
• The indicated values represent the maximal irradiance recorded at the bottom of
2-mm-thick specimens during curing for 20 seconds.
• Converted to radiant exposure (incident irradiance 3 exposure time), the
allocated values to underlying increments are 1.8 to 2.5 J/cm2.
• Majority of RBCs including all light-cured materials analyzed in the present study,
become progressively more translucent during polymerization, thus allowing
more light to be transmitted through the 2-mmthick specimens toward the end of
the exposure time.
• Changes in translucency during polymerization are related in large part to the
monomer reactivity and particularly to the filler/resin refractive index mismatch
and their interface.
• The measured transmitted irradiances through RBCs are similar to values
measured through the tooth structure (enamel and dentin) of the same thickness
20. • It is noteworthy that the transmitted irradiance through 3-mm-thick tooth
specimens is lowered to insignificant values (25 mW/cm2) while following an
exponential decrease with the thickness.
• It should be emphasized that the incident irradiance within the curing
conditions of the present study amounted to 1174.1 ± 12.4 mW/cm2.
• The indicated transmitted irradiances will be even lower when using LCUs of
lower irradiance, enhancing the exposure distance or changing the angulation
of the LCU, as might occur in a clinical situation.
• All of these aspects raise questions about the benefit of additional
polymerization through the tooth structure and limit it to a thermal effect.
• To simulate clinical treatment, measurements were done on a dehydrated
tooth structure.
• This procedure encompassed a 10-second exposure to the air stream
followed by a period of 5 minutes in air, which was used to standardize the
position of sample and LCU previous to measurement.
21. • Dehydration was identified to reduce the translucency of the tooth structure as a
result of an increased difference in refractive indexes between the enamel
prisms and the surrounding medium when water is replaced by air.
• The reduction in translucency was quantified for enamel at 82% of the value
measured in wet enamel, an aspect that needs to be considered when
translucency is measured, other than in the present study, for esthetic
purposes.
• The chosen period of 5 minutes for drying the specimens before measurement
was based on the fact that the assumptive water content change during drying
of human enamel samples does not alter optical measurements above 5
minutes and up to 48 hours after specimens were taken out of the water.
• As for the analyzed bulk-fill RBCs, significantly higher light transmittance has
been identified through 2-mm increments, except for Sonic Fill 2 A3, which
performed similarly to regular RBCs and the tooth structure.
• It has already been shown that bulk-fill RBCs permit light transmission even in
4- mm-thick increments that may amount to up to 24% of the incident blue light,
which explains the good polymerization in depth of such materials.
• The reasons for enhanced light transmission in bulk-fill RBCs is mostly
attributed to a reduced amount of pigments and enhanced filler sizes that lower
22. • For comparative purposes, a series of modern CAD/CAM RBCs as well as
two temporary, PMMA based materials were studied.
• The transmitted irradiance through CAD/CAM RBCs and PMMA based
materials (p=0.90) as well as through each material category and the tooth
structure (p=0.16 and p=0.149, respectively) were similar.
• Compared with light cured RBCs, transmitted irradiance was higher through
CAD/CAM RBCs and PMMA- based materials (p,0.001, 0.024). the variation
in light transmission was high (60.4 to 245.2 mW/cm2) and was due to
differences in microstructure, pigments, chemical composition of the resin
and filler, and filler morphology.
• Followed the sequence VITA Enamic <Luxacam Composite <Grandio Blocs <Lava
Ultimate A3 and Brilliant Crios <Lava Ultimate A2 and Cerasmart < tetric CAD.
• Latter material category comprises a polymer infiltrated ceramic network
material (VITA Enamic) with a three-dimensional interconnected dual network
structure that differs from the structure of the other analyzed CAD/CAM
RBCs, in which only the polymer matrix phase is continuous, while fillers of
different sizes and morphology are dispersed in the matrix.
23. • Organic phase in all CAD/CAM RBCs is composed of dimethacrylates, which
consist of either a mixture of urethane dimethacrylate (UDMA) and triethylene
glycol dimethacrylate (TEGDMA) in VITA Enamic or variations of UDMA,
TEGDMA, bisphenol a glycol dimethacrylate (Bis- GMA), and ethoxylated
bisphenol a dimethacrylate (Bis-EMA) in the other materials.
• The inorganic phase amount is highest in VITA Enamic (86 wt% or 75 vol%) and
Grandio Blocks (86 wt%), being followed by Lava Ultimate (86 wt%) while
varying between 61 wt% to 71.1 wt% in the other materials.
• This variation is mostly reflected in the light transmittance ranking of the
materials.
• Significant variations are also identified in the chemical composition of the fillers,
which is specified as a feldspar ceramic (predominant element silicon, followed
by aluminum, potassium, sodium, and inclusions of yttrium) in VITA Enamic,
silicon and zirconium oxide in Lava Ultimate, and silicon oxide and barium glass
in the other materials.
• An increased scattering, and thus a lower light transmittance, must be attributed
to fillers containing elements of a higher atomic number.
• Radiopaque agents which are introduced to improve the radiopacity of dental
RBCs, also include elements with a high atomic number and may thus contribute
24. • As for both analyzed temporary PMMA materials, their optical parameters
were statistically similar (p=0.99) and lined up well in the sequence of the
CAD/CAM RBCs.
• Similar light transmittances have been identified in VITA CAD-Temp and
Grandio Blocs (p=0.161) as well as in Telio CAD and Lava Ultimate A3
(p=0.373).
• In the analyzed CAD/CAM ceramics and glassceramics, the variation in
translucency (HT or LT) showed a higher impact on light transmission than
the shade (A2 or A3) or the ceramic systems (feldspar ceramic, leucite and
lithium disilicate glass-ceramic).
• In ceramic systems, translucency in general decreases with increasing
crystalline content.
• Apart from the fact that the optical properties of each constituent of a system
must be considered individually, it can be stated that the crystalline content in
the analyzed ceramic systems increases in the sequence feldspar ceramic
(30 vol%32), leucite glass–ceramics (35 vol%32), and lithium disilicate glass-
ceramic (70 vol%33).
25. • A large portion of the light attenuation through a material is due to reflection
at the incident surface.
• The surface-reflection ratio (fraction of incident radiance that is reflected at
the interface), as calculated by Watts and Cash by considering the shift in
absorbance-path length relation from its theoretical origin, amounts to 30%
to 90%, while recently, values of 11% to 27% were determined in CAD/CAM
RBCs.
• The reflection of light, when incident on the interface between air and
material, varies with the refractive index of optical media ; however, a large
part of the reflection must be related to surface roughness.
• Since all the specimens in the present study were polished following an
identical protocol, the surface reflection ratio was also related to the
material’s ability to be polished.
• Considering that the angle of incidence was constant, since the LCU was
placed in a standardized manner, perpendicular to the specimens’ surface,
by means of a mechanical arm, the transmitted light might be considered a
material characteristic, determined not only by the optical properties of
26. • The results of the present study clearly indicate that the light passing through
the upper layers of an incrementally restored cavity with light-cured RBCs is
insufficient to complete the polymerization of an undercured lowest
increment; consequently, each increment should be ab initio adequately
cured.
• Moreover, the attenuation of light through various indirect restoratives and the
restoration thickness need to be considered clinically when deciding the type
of luting RBCs to be used.
• The outcome of an additional curing through the tooth structure at the end of
the restorative process to compensate for insufficient polymerization may be
very low and is dependent on the thickness of the tooth structure.
• In this context, it must be emphasized that transmitter irradiance decreases
exponentially with tooth structure thickness and is lowered to insignificant
values in 3-mm-thick tooth walls.
27. CONCLUSION
The attenuation of light when passing through diverse 2-mm-thick
restorative materials is high and varies between 59.9% to 94.9%; thus,
deficits in polymerization are difficult to compensate for by additional
light exposure at the end of the restorative process. The values
measured for the tooth structure are identified toward the upper end of
this range (89.4%). Light attenuation differs significantly by material
within each shade category and by shade category within each
analyzed material. Light attenuation was determined by shade and
translucency rather than by the type of restorative material. Therefore,
all null hypotheses are rejected.
28. • Criteria for clinical translucency evaluation of direct esthetic restorative
materials
Lee YK. (Restor Dent Endod 2016;41(3):159-166)
Aim : The purpose of this review was to suggest practical criteria for the clinical
translucency evaluation of direct esthetic restorative materials, and to review the
translucency with these criteria.
Methods: For the evaluation of reported translucency values, measuring
instrument and method, specimen thickness, background color, and illumination
should be scrutinized. Translucency parameter (TP) of 15 to 19 could be
regarded as the translucency of 1 mm thick human enamel. Visual perceptibility
threshold for translucency difference in contrast ratio (∆CR) of 0.07 could be
transformed into ∆TP value of 2.Translucency differences between direct and
indirect resin composites were perceivable
Results: Universal and corresponding flowable resin composites did not show
perceivable translucency differences in most products. Translucency differed
significantly by the product within each shade group, and by the shade group
within each product.
Conclusion: Translucency of human enamel and perceptibility threshold for
translucency difference may be used as criteria for the clinical evaluation of
29. Evaluation of resin composite translucency by two different
methods
d-h kim s-h park
oper dent; 2013; 38(3): e76-90.
Aim :
The purpose of this study was to compare the translucency of seven different types of composite materials and three different
shade categories (dentin, enamel, and translucent) by determining the translucency parameter (TP) and light transmittance (%T)
and 2) to evaluate the correlation between the results of the two evaluation methods.
Methods:
Three shades (dentin A3, enamel A3, and clear translucent) of seven composite materials (Beautifil II [BF], Denfil [DF],
Empress Direct [ED], Estelite Sigma Quick [ES], Gradia Direct [GD], Premise [PR], and Tetric N-Ceram [TC]) from different
manufacturers were screened in this study. Ten disk-shaped specimens (10 mm in diameter and 1 mm in thickness) were
prepared for each material. For the TP measurements, the colors of each specimen were recorded according to the CIELAB color
scale against white and black backgrounds with a colorimeter and used to calculate the TP value. For the %T measurements, the
mean direct transmittance through the specimen in the range between 380 and 780 nm was recorded using a spectrometer and
computer software.
Results:
Two-way analysis of variance (ANOVA) tests were performed to compare the TP and %T for the composite materials and
shade categories. One-way ANOVA and Tukey tests were used for the seven composite materials per shade category and the
three shade categories per composite material. The correlation between the two evaluation methods was determined using the
Pearson correlation coefficient. All statistical procedures were performed within a 95% confidence level. TP differed significantly
by composite material within each shade category (p,0.05) and by shade category within each composite material (p,0.05). %T
differed significantly by composite material within each shade category (p,0.05) and by shade categories within each composite
material (p,0.05), except for BF and ES. For the two evaluation methods, TP and %T, were positively correlated.
CONCLUSION:
These methods showed strong correlation for each composite material except ES (r=0.763-0.992, p,0.05) and moderate
correlation for each shade category (r=0.403-0.528, p,0.05).