The restoration of endodontically treated teeth (ETT) with more than one cusp missing and thin remaining walls is challenging for the general practitioner. The use of posts combined with full coverage restorations is a well-established approach, yet not following the minimal invasive principles of adhesive dentistry. Endocrowns are indirect monoblock restorations that use the pulp chamber of the ETT for retention. In this study the fabrication of 4 endocrowns and their clinical performance will be discussed. Two clinical cases include computer-aided design/computer-aided manufacturing manufactured molar endocrowns (one feldspathic ceramic and one hybrid composite-ceramic restoration) and the other two are dental laboratory manufactured resin composite premolar endocrown restorations. The modified United States Public Health Service criteria were used to assess the clinical behavior of the restorations at different follow up periods. Endocrown restorations present a satisfactory clinical alternative, either by the use of resin composite or glass ceramic and hybrid materials. Specific guidelines with minimal alterations should be followed for an endocrown restoration to be successful. Due to limited evidence regarding the long term evaluation of this restorative technique, a careful selection of cases should be applied.

It has been suggested that the presence of increased respiratory variation in mitral flow velocity (RVIMFV) in patients with pericardial effusion (PE) represents significant hemodynamic compromise regardless of the amount of PE or 2D-echo findings. Recent experimental data do not, however, support this aspect. The aim of this study was to evaluate the relation of RVIMFV to clinical, hemodynamic, and 2D-echo findings in patients with PE and cardiac tamponade (CT). Therefore, 11 patients with PE and CT were studied with right-heart, pericardial, and arterial pressure measurements in conjunction with 2D and Doppler echocardiography during three stages of gradually decreasing PE, ie, (1) before any PE drainage, (2) after partial PE drainage, and (3) after full drainage. A significant RVIMFV was noted during all three stages of our study. It was maximal at the early stage [respiratory difference in mitral flow velocity (delta MFV): 16.8 +/- 6.3 cm/sec, 24.1%, P = 0.0000026] coinciding with pulsus paradoxus, high pericardial pressure, and diastolic right heart collapse, and it decreased slightly after partial drainage when all signs of CT receded (delta MFV: 13.7 +/- 9.7 cm/sec, 18%, P = 0.00043). However, there was still some RVIMFV (delta MFV: 8.7 +/- 7.6 cm/sec, 13.9%, P = 0.0017) after full pericardial drainage. It is concluded that the presence and the magnitude of RVIMFV is not predictive of hemodynamic compromise in patients with PE.

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SummaryBackground/Aim: The aim of the study was to evaluate and compare patient profile, attitude and satisfaction of patients visiting a university periodontal clinic before and during the financial crisis in Greece.Material and Methods: In this cross-sectional study, adult consecutive patients that visited the undergraduate Periodontology clinic of the Aristotle University of Thessaloniki from October 2014 to July 2015 were invited to participate anonymously. The only exclusion criterion that was set was the age: all individuals had to be ≥18 years old. The questionnaire utilized in this study included six parts of questions: 1) demographic characteristics; 2) environmental and behavioral characteristics; 3) diagnosis of periodontal disease; 4) medical history; 5) difficulties-satisfaction-proposals about periodontal treatment; and 6) history of periodontal therapy. One hundred and fifty individuals, mean aged of 51.6±12.3 years were interviewed concerning their demographic and behavioral characteristics. Satisfaction level, reasons for selecting the university dental clinic and oral hygiene habits were also recorded.Results: The profile of the patient attending the university periodontal clinic was a female (54.0%), 51-year-old on average, of high education (76.0%), good oral hygiene habits (brushing ≥2 times/day: 49.3%, use of additional oral health care: 66.0%), heavy smoker (>15 cigarettes/day: 51.9%) and chronic periodontal disease (96.7%). Economic difficulties led the participants to seek periodontal treatment in the university clinic (30.7%), but the vast majority of them were highly satisfied (81.3%), confident (82.0%) and informed (51.3%) about the treatment. Before the financial collapse in Greece, the profile of the patients in the clinic was characterized by low socioeconomic status with poor oral hygiene, none or basic education and unemployed (no income) and retired individuals. Heavy smoking, diagnosis of chronic periodontal disease and satisfaction were also reported prior to the financial crisis.Conclusions: The demographic characteristics of those who seek treatment in a university setting have changed dramatically and younger, more highly educated and employed individuals attend the undergraduate Periodontology clinic of the Aristotle University of Thessaloniki, Greece compared with those who attended the university dental clinic prior to the financial crisis.

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