To investigate the factors that influence the probability of clinical cavitation at radiolucent areas of proximal surfaces of posterior teeth, 108 molars and premolars with varying depths of proximal radiolucency were examined clinically, after cavity preparation on the carious contiguous tooth surfaces. The data obtained were subjected to logistic regression analysis with cavitation as the dependent variable, while age, tooth type and past caries experience (DMFT and DFS) were independent variables. When proximal radiolucency was confined to the outer half of enamel, there was no cavitation, but when it extended to the amelodentinal junction and the outer and inner half of dentine, there was cavitation in 19.3, 79.1 and 100% of cases, respectively. Moreover, there was a statistically significant relationship between the probability of cavitation, depth of radiolucency and age, suggesting that these should be among the main factors considered when restorative management of a radiolucent proximal surface of a posterior tooth is contemplated.

Background Early postoperative ambulation and reduction of hospital stay necessitate efficient postoperative analgesia. Quadrates Lumborum Block (QLB) has been described to provide adequate postoperative analgesia after abdominal surgery. This randomized comparative trial was designed to compare the duration of analgesia provided by two different QLB approaches; the posterior QLB (QLB-2) and transmuscular QLB (QLB-3) in patients undergoing surgical repair of unilateral inguinal hernia. Methods Forty patients, aged from 18 to 50 years, ASA physical status I or II, scheduled for unilateral inguinal hernia repair were enrolled. At the end of the surgical procedure and before recovery from general anesthesia, Patients were randomly assigned into two groups to receive either posterior QLB (Group QLB-2) or transmuscular QLB (Group QLB-3) using 20 ml 0.25% bupivacaine. Duration of analgesia, postoperative VAS and postoperative opioid consumption were recorded. Results Duration of block was significantly longer in QLB-3 group when compared to QLB-2 group (20.1 + 6.2 h versus 12.0 + 4.8 respectively) with P value of < 0.001. A statistically significant lower VAS score was recorded in QLB-3 group immediately and 12 h postoperative. QLB-3 group showed a statistically significant delayed time of first analgesic request and less postoperative morphine consumption with P value of < 0.001 and 0.001 respectively. Conclusions Ultrasound guided postsurgical transmuscular approach of QLB (QLB-3) using 20 ml 0.25% bupivacaine produces more postoperative analgesic effect and less postoperative opioid consumption when compared to posterior QLB approach (QLB-2) in patients underwent unilateral inguinal hernia repair under general anesthesia. Trial registration ClinicalTrials.gov identifier: NCT03526731- on 16 May 2018.

BACKGROUND: Despite recent advances in restorative dentistry adhesive restorations may cause postoperative sensitivity which leads to restoration failure. AIM: This study aimed to compare and evaluate the incremental and bulk fill resin Composite postoperative sensitivity in class II posterior restorations bonded with two adhesive systems (self-etch and etch-and-rinse). METHODS: Sixty patients were randomly selected, their age range from twenty-five to forty years old, divided into two groups according to the packing technique of resin composite material; incremental Tetric Evoceram and Tetric Evoceram bulk-fill resin composite. Thirty patients (n = 30) for incremental Tetric Evoceram resin composite restorations and according to the adhesive systems used they were equally divided (n = 15 teeth).Thirty patients (n = 30) for Tetric Evoceram bulk-fill resin composite restorations and according to the adhesive systems used (etch and rinse or self-etch), they were equally divided (n = 15 teeth). Post-operative pain assessed at 24 hours, 1 week and 1 month using the Visual Analog Scale Score (VAS). Each patient was instructed to put a mark on the VAS line at home to point out the intensity of pain at each assessment period. The problem of measuring the pain that pain tolerance of individuals may be different from the others. This may be due to different reasons, and it is not always because of a problem in the restoration RESULTS: After 1 day, 1 week as well as 1 month, no statistically significant disagreement between the two resin composite types using self-etch adhesive strategy and total-etch adhesive strategy. Also, when the two adhesive systems were compared using Bulk Fill resin composite and incremental Nano resin composite no statistically significant disagreement between the two adhesive systems after 1 day, 1 week as well as 1 month. CONCLUSION: The post-operative hypersensitivity is related to many factors as the procedure of cavity preparation, adhesive approach, and type of resin composite used and placement technique of the resin composite.

Background : early postoperative ambulation and reduction of hospital stay necessitate efficient postoperative analgesia. Quadrates Lumborum Block (QLB) has been described to provide adequate postoperative analgesia after abdominal surgery. This randomized comparative trial was designed to compare the duration of analgesia provided by two different QLB approaches; the posterior QLB (QLB-2) and transmuscular QLB (QLB-3) in patients undergoing surgical repair of unilateral inguinal hernia. Methods: Forty patients, aged from 18-50 years, ASA physical status I or II, scheduled for unilateral inguinal hernia repair were enrolled. At the end of the surgical procedure and before recovery from general anesthesia, Patients were randomly assigned into two groups to receive either posterior QLB (Group QLB-2) or transmuscular QLB (Group QLB-3) using 20 ml 0.25% bupivacaine. Duration of analgesia, postoperative VAS and postoperative opioid consumption were recorded. Results : duration of block was significantly longer in QLB-3 group when compared to QLB-2 group (20.1 + 6.2 hours versus 12.0 + 4.8 respectively) with P value of < 0.001. A statistically significant lower VAS score was recorded in QLB-3 group immediately and 12 hrs postoperative. QLB-3 group showed a statistically significant delayed time of first analgesic request and less postoperative morphine consumption with P value of < 0.001 and 0.001 respectively. Conclusions : Ultrasound guided postsurgical transmuscular approach of QLB (QLB-3) using 20 ml 0.25% bupivacaine produces more postoperative analgesic effect and less postoperative opioid consumption when compared to posterior QLB approach (QLB-2) in patients underwent unilateral inguinal hernia repair under general anesthesia. Trial Registration : ClinicalTrials.gov identifier: NCT03526731- on 16 May 2018