Ákos Tóth

Retrospective evaluation of posterior direct composite restorations: 10-Year findings

OBJECTIVES This 10-year retrospective study investigated the differences in the changes and the longevity of Class II restorations using 4 similar microhybrid resin composites (Filtek Z250, Herculite XR, Gradia Direct Posterior, Renew). METHODS Data were collected from patient records. Those patients who received posterior restoration between 2001 and 2003, and who still visited the clinical practice for regular check-up visits were selected. A total of 225 adult patients (86 males, 139 females) with 701 restorations were evaluated by 2 operators using the USPHS criteria. Data were analyzed with Fishers Exact Test, Pearsons Chi-Square Test and Kaplan-Meier analysis (p<0.05). RESULTS A failure rate of 2.1% was detected. The reasons of failures included restoration fracture, secondary caries and endodontic treatment. Similar survival rates for Gradia Direct Posterior (91.25%) and Renew (92.19%) were observed; better performance was observed with the Filtek Z250 (99.1%) and Herculite XR (98.64%). There was a higher probability of failure in 3 surface (n=10) than in 2 surface (n=5) restorations (p<0.001), and this rate was similar when molars (n=8) and premolars (n=7) were compared. The most frequent but clinically acceptable deficiency was the marginal discoloration. SIGNIFICANCE All four microhybrid resin composites showed acceptable clinical durability in Class II restorations during the 10-year follow-up period, with an overall survival rate of >97.8%. Higher rates of failures and deficiencies were observed with the Renew (fracture) and Gradia Direct Posterior (color match), respectively.

Degree of conversion and BisGMA, TEGDMA, UDMA Elution from flowable bulk fill composites

The degree of conversion (DC) and the released bisphenol A diglycidyl ether dimethacrylate (BisGMA), triethylene glycol dimethacrylate (TEGDMA) and urethane dimethacrylate (UDMA) monomers of bulk-fill composites compared to that of conventional flowable ones were assessed using micro-Raman spectroscopy and high performance liquid chromatography (HPLC). Four millimeter-thick samples were prepared from SureFil SDR Flow (SDR), X-tra Base (XB), Filtek Bulk Fill (FBF) and two and four millimeter samples from Filtek Ultimate Flow (FUF). They were measured with micro-Raman spectroscopy to determine the DC% of the top and the bottom surfaces. The amount of released monomers in 75% ethanol extraction media was measured with HPLC. The differences between the top and bottom DC% were significant for each material. The mean DC values were in the following order for the bottom surfaces: SDR_4mm_20s > FUF_2mm_20s > XB_4mm_20s > FBF_4mm_20s > XB_4mm_10s > FBF_4mm_10s > FUF_4mm_20s. The highest rate in the amount of released BisGMA and TEGDMA was found from the 4 mm-thick conventional flowable FUF. Among bulk-fills, FBF showed a twenty times higher amount of eluted UDMA and twice more BisGMA; meanwhile, SDR released a significantly higher amount of TEGDMA. SDR bulk-fill showed significantly higher DC%; meanwhile XB, FBF did not reach the same level DC, as that of the 2 mm-thick conventional composite at the bottom surface. Conventional flowable composites showed a higher rate of monomer elution compared to the bulk-fills, except FBF, which showed a high amount of UDMA release.

Minor physical anomalies are more common among the first-degree unaffected relatives of schizophrenia patients – Results with the Méhes Scale

Minor physical anomalies are external markers of abnormal brain development,so the more common appearance of these signs among the relatives of schizophrenia patients can confirm minor physical anomalies as intermediate phenotypes. The aim of the present study was to investigate the rate and topological profile of minor physical anomalies in the first-degree unaffected relatives of patients with schizophrenia compared to matched normal control subjects. Using a list of 57 minor physical anomalies (the Méhes Scale), 20 relatives of patients with the diagnosis of schizophrenia and as a comparison 20 matched normal control subjects were examined. Minor physical anomalies were more common in the head and mouth regions among the relatives of schizophrenia patients compared to normal controls. By the differentiation of minor malformations and phenogenetic variants, we have found that only phenogenetic variants were more common in the relatives of schizophrenia patients compared to the control group, however individual analyses showed, that one minor malformation (flat forehead) was more prevalent in the relative group. The results can promote the concept, that minor physical anomalies can be endophenotypic markers of the illness.

Minor physical anomalies are more common in schizophrenia patients with the history of homicide

Minor physical anomalies may be external markers of abnormal brain development, so the more common appearance of these signs in homicidal schizophrenia might suggest the possibility of a more seriously aberrant neurodevelopment in this subgroup. The aim of the present study was to investigate the rate and topological profile of minor physical anomalies in patients with schizophrenia with the history of committed or attempted homicide comparing them to patients with schizophrenia without homicide in their history and to normal control subjects. Using a list of 57 minor physical anomalies, 44 patients with the diagnosis of schizophrenia were examined with the history of committed or attempted homicide, as a comparison 22 patients with the diagnosis of schizophrenia without the history of any kind of homicide and violence and 21 normal control subjects were examined. Minor physical anomalies are more common in homicidal schizophrenia patients compared to non-homicidal schizophrenia patients and normal controls, which could support a stronger neurodevelopmental component of etiology in this subgroup of schizophrenia. The higher rate of minor physical anomalies found predominantly in the head and mouth regions in homicidal schizophrenia patients might suggest the possibility of a more seriously aberrant brain development in the case of homicidal schizophrenia.

Adaptation and validation of the Hungarian version of the Yale Food Addiction Scale for Children

Background Childhood obesity proves to be an important public health issue, since it serves as a potential risk factor for multiple diseases. Food addiction could also serve as an important etiological factor. As childhood obesity plays a serious issue also in Hungary, we aimed to adapt and validate the Hungarian version of the Yale Food Addiction Scale for Children (H-YFAS-C). Methods A total of 191 children were assessed with the H-YFAS-C and the Eating Disorder Inventory (EDI). The following psychometric properties were analyzed: internal consistency, construct validity, convergent, and discriminant validity. Results A good construct validity was revealed by confirmatory factor analysis (RMSEA = 0.0528, CFI = 0.896, χ2 value = 279.06). Question 25 proved to have no significant effect on its group and was removed from further analyses. The Kuder–Richardson 20 coefficient indicated good internal consistency (K20 = 0.82). With the use of the eight EDI subscales, a good convergent and discriminant validity could be determined. Food addiction was diagnosed in 8.9% of children. The mean symptom count was 1.7 ± 1.2 (range: 0–7). Females were more often diagnosed with food addiction than males (p = .016; OR = 3.6, 95% CI: 1.2–10.6). BMI percentiles were significantly higher in children with diagnosed food addiction (p = .003). There proved to be no correlation between age and the occurrence of food addiction. Discussion and conclusion Our results show that H-YFAS-C is a good and reliable tool for addictive-like behavior assessment.

First description of a rifampicin-resistant Neisseria meningitidis serogroup Y strain causing recurrent invasive meningococcal disease in Hungary

A Hungarian soldier previously immunized against Neisseria meningitidis by quadrivalent polysaccharide vaccine was twice infected with meningococci within six weeks. The patient was treated with ceftriaxone during both episodes and he successfully recovered. His close contacts received rifampicin prophylaxis. An investigation was performed to characterize the genetic background of the pathogens to ascertain if the recurrent invasive meningococcal disease was caused by the same strain and to find out the reason for reinfection. Both meningococci belonged to the fine type Y:P1.5-2,10-1:F4-1:ST-23. This is the first description of the Europe-wide prevalent N. meningitidis serogroup Y in Hungary. In the first episode, we found wild-type rpoB allele in the non-culturable sample implying the susceptibility to rifampicin. The culturable isolate from the second episode proved resistant to rifampicin and had a point mutation in the rpoB gene. The rifampicin resistance might have evolved during the prophylactic treatment of contacts. Previous immunization of the patient with polysaccharide vaccine was ineffective due to his immunodeficiency, thus immunization with conjugate vaccine was proposed. We have proposed the implementation of centralized rifampicin susceptibility testing of N. meningitidis strains within a defined time frame to intervene and administer appropriate prophylaxis to close contacts.

Intraosseous Heat Production and Preparation Efficiency of Surgical Tungsten Carbide Round Drills: The Effect of Coronectomy on Drill Wear

PURPOSE The aim of this in vitro study was to examine the effects of surgical drill wear after coronectomy on bone temperature changes and preparation times for bone cavity drilling. MATERIALS AND METHODS Tungsten carbide round drills were used to perform 10 (D_10), 20 (D_20), or 30 (D_30) coronectomies on extracted lower third molars to elicit drill wear, and then 5-mm-deep cavities were drilled in pig ribs with a testing apparatus-controlled surgical unit. Temperature changes and preparation times were measured. Differences in mean values were examined with analyses of variance and the Tukey honest significant difference post hoc test. RESULTS The unused drills prepared the holes significantly faster (2.52 ± 1.6 seconds) than the D_20 (13.29 ± 5.76 seconds) and D_30 (31.48 ± 12.93 seconds) drills (P = .01 and P < .001, respectively). The D_10 (change, 2.33 ± 0.77°C), D_20 (change, 2.57 ± 0.57°C), and D_30 (change, 3.94 ± 0.62°C) drills produced significantly more heat than the D_0 drills (change, 1.18 ± 0.28°C; P < .001). At higher axial pressures of 25 N (to provoke ≤ 3-second preparation times in line with new drills), the D_30 drills produced a temperature change of 6.31 ± 1.23°C with 60 mL/minute and significantly more heat (change, 20.48 ± 8.84°C; P < .001) with 20 mL/minute of irrigation. CONCLUSIONS Intraosseous heat produced by surgical tungsten carbide round drills remains under the threshold temperature of bone necrosis for up to 30 coronectomies; however, the use of increased axial pressure (∼ 25 N), especially with the combination of decreased irrigation (∼ 33%), can cause unacceptable temperatures during bone removal. Professionals should select drills and drilling parameters that generate an acceptable amount of heat during surgical tooth removal.

IS 'MEANINGFULNESS' A GENERAL MEDIATING FACToR? The Salutogenic Revolution of Question-Setting in Health Science and occupational Psychology

According to our earlier researches – stating that on the one hand in the career competency of the examined subjects, out of the Core Job Dimensions present in the Hackman-oldham Job Char acteristic Model, only Meaningfulness (task significance) contributed significantly to inducing favourable Personal and Work outcomes, and on the other hand, among the components of the Sense of Coherence, portrayed as a health and well-being factor in Antonovsky’s Salutogenic Model, it was Meaningfulness that had a preeminent role – we asked the question: to what extent can this positive effect of Meaningfulness be further generalized? That is, regarding women in Hungary who choose a healthcare career, whether Meaningfulness felt within their job motivates them with a significant enough force to be a counter-effective factor to job abandonment (especially frequent in Hungary), to persevere despite the difficult circumstances. From a methodical point of view, we completed a quasi-case study in the circle of 158 female students taking health care courses and 79 women working in healthcare for at least five years. As control groups we used the age- and sex-standardized random samples of non-healthcare students as well as workers. Here, Meaningfulness within the Sense of Coherence proved to be the significant factor for staying in the healthcare profession. Practical conclusion of the research: during the training in healthcare courses, an emphasis has to be laid upon developing the Sense of Meaningfulness in the person, by means of establishing life-career models, personal career design, and creating the chances of a healthier lifestyle.

Direct resin composite restorations for fractured maxillary teeth and diastema closure: A 7 years retrospective evaluation of survival and influencing factors

OBJECTIVES This retrospective study evaluated the survival rate of anterior direct resin based composite (RBC) build-ups in vital teeth made of microhybrid and nanofill RBC materials and the influence of bruxism, beverage consumption and smoking on the long-term performance of restorations. METHODS Patients receiving anterior restoration between 2006 and 2011, with the diagnosis of fracture or diastema, were selected. A total of 65 adult patients (mean age: 25.2) with 163 restorations (78 Filtek Supreme XT and 85 Enamel Plus HFO) were evaluated using the USPHS criteria. Data were analyzed with Fishers Exact Test, Extended Cox-regression analysis and Kaplan-Meier method. RESULTS Mean observation period was 7.2 (±1.4) years and the mean annual failure rate for this period was 1.43%. The reasons of failures included restoration fracture and color mismatch. Nanofill restorations had significantly higher rate of color mismatch (p=0.002), microhybrids more frequently failed in fracture of restoration (p=0.034). The overall difference in potential hazard of using Enamel Plus HFO or Filtek Supreme XT was not significant (p=0.704). Chipping or fracture of the restoration was more frequent in the first year after placement (p=0.036), while beverage consumption was significantly correlated with discoloration of the restorations (p=0.005). SIGNIFICANCE The application of direct RBC restorations provides an excellent treatment option for fractured teeth and for closing diastemas. The overall survival rate was 88.34% up to 10 years. Microhybrid and nanofill RBC restorations showed similar survival rates, however nanofills discolored at a higher rate, meanwhile chipping of the restoration occurred frequently with microhybrids.

Minor physical anomalies in bipolar I and bipolar II disorders – Results with the Méhes Scale

Minor physical anomalies (MPAs) are external markers of abnormal brain development, so the more common appearence of these signs among bipolar I and bipolar II patients can confirm the possibility of a neurodevelopmental deficit in these illnesses. The aim of the present study was to investigate the rate and topological profile of minor physical anomalies in patients with bipolar I and - first in literature - with bipolar II disorders compared to matched healthy control subjects. Using a list of 57 minor physical anomalies (the Méhes Scale), 30 bipolar I and 30 bipolar II patients, while as a comparison 30 matched healthy control subjects were examined. Significant differences were detected between the three groups comparing the total number of minor physical anomalies, minor malformations and phenogenetic variants and in the cases of the ear and the mouth regions. The individual analyses of the 57 minor physical anomalies by simultaneous comparison of the three groups showed, that in the cases of furrowed tongue and high arched palate were significant differences between the three groups. The results can promote the concept, that a neurodevelopmental deficit may play a role in the etiology of both bipolar I and bipolar II disorders.