A systematic review and meta-analysis of the survival of non-feldspathic porcelain veneers over 5 and 10 years

PURPOSE: This systematic review aimed to report and explore the survival of dental veneers constructed from non-feldspathic porcelain over 5 and 10 years.

MATERIALS AND METHODS: A total of 4,294 articles were identified through a systematic search involving all databases in the Cochrane Library, MEDLINE (OVID), EMBASE, Web of Knowledge, specific journals (hand-search), conference proceedings, clinical trials registers, and collegiate contacts. Articles, abstracts, and gray literature were sought by two independent researchers. There were no language limitations. One hundred sixteen studies were identified for full-text assessment, with 10 included in the analysis (5 qualitative, 5 quantitative). Study characteristics and survival (Kaplan-Meier estimated cumulative survival and 95% confidence interval [CI]) were extracted or recalculated. A failed veneer was one which required an intervention that disrupted the original marginal integrity, had been partially or completely lost, or had lost retention more than twice. A meta-analysis and sensitivity analysis of Empress veneers was completed, with an assessment of statistical heterogeneity and publication bias. Clinical heterogeneity was explored for results of all veneering materials from included studies.

RESULTS: Within the 10 studies, veneers were fabricated with IPS Empress, IPS Empress 2, Cerinate, and Cerec computer-aided design/computer-assisted manufacture (CAD/CAM) materials VITA Mark I, VITA Mark II, Ivoclar ProCad. The meta-analysis showed the pooled estimate for Empress veneers to be 92.4% (95% CI: 89.8% to 95.0%) for 5-year survival and 66% to 94% (95% CI: 55% to 99%) for 10 years. Data regarding other non-feldspathic porcelain materials were lacking, with only a single study each reporting outcomes for Empress 2, Cerinate, and various Cerec porcelains over 5 years. The sensitivity analysis showed data from one study had an influencing and stabilizing effect on the 5-year pooled estimate.

CONCLUSION: The long-term outcome (> 5 years) of non-feldspathic porcelain veneers is sparsely reported in the literature. This systematic review indicates that the 5-year cumulative estimated survival for etchable non-feldspathic porcelain veneers is over 90%. Outcomes may prove clinically acceptable with time, but evidence remains lacking and the use of these materials for veneers remains experimental.

A systematic review and meta-analysis of the survival of feldspathic porcelain veneers over 5 and 10 years

PURPOSE: This systematic review reports on the survival of feldspathic porcelain veneers.

MATERIALS AND METHODS: The Cochrane Library, MEDLINE (OVID), Embase, Web of Knowledge, selected journals, clinical trials registers, and conference proceedings were searched independently by two reviewers. Academic colleagues were also contacted to identify relevant research. Inclusion criteria were human cohort studies (prospective and retrospective) and controlled trials assessing outcomes of feldspathic porcelain veneers in more than 15 patients and with at least some of the veneers in situ for 5 years. Of 4,294 articles identified, 116 studies underwent full-text screenings and 69 were further reviewed for eligibility. Of these, 11 were included in the qualitative analysis and 6 (5 cohorts) were included in meta-analyses. Estimated cumulative survival and standard error for each study were assessed and used for meta-, sensitivity, and post hoc analyses. The I2 statistic and the Cochran Q test and its associated P value were used to evaluate statistical heterogeneity, with a random-effects meta-analysis used when the P value for heterogeneity was less than .1. Galbraith, forest, and funnel plots explored heterogeneity, publication patterns, and small study biases.

RESULTS: The estimated cumulative survival for feldspathic porcelain veneers was 95.7% (95% confidence interval [CI]: 92.9% to 98.4%) at 5 years and ranged from 64% to 95% at 10 years across three studies. A post hoc meta-analysis indicated that the 10-year best estimate may approach 95.6% (95% CI: 93.8% to 97.5%). High levels of statistical heterogeneity were found.

CONCLUSIONS: When bonded to enamel substrate, feldspathic porcelain veneers have a very high 10-year survival rate that may approach 95%. Clinical heterogeneity is associated with differences in reported survival rates. Use of clinically relevant survival definitions and careful reporting of tooth characteristics, censorship, clustering, and precise results in future research would improve metaanalytic estimates and aid treatment decisions.

Severe aplastic anaemia in association with a unique constitutional translocation 46,XY,t(6;10)(q13;q22)c

Severe aplastic anaemia (SAA) is an uncommon disorder which may be associated with several congenital syndromes. However, it has rarely been described in association with a constitutional karyotypic abnormality. The breakpoint of the balanced t(6:10)(q13:q22) translocation described here does not disrupt any currently recognized gene of haemopoietic or stromal importance. This report also highlights the problems inherent in the use of bone marrow transplantation (BMT) for treating multiply transfused aplastic anaemia patients.

Achieving optimal dose intensity with adjuvant chemotherapy in elderly breast cancer patients:A 10-year retrospective study in a UK institution

The study was to determine if breast cancer patients aged 65 and above could be given adjuvant chemotherapy safely while achieving an acceptable relative dose intensity of at least 85%. We identified all patients aged 65 and over who received adjuvant chemotherapy over the 10 year period, November 1999 to October 2009, and determined the proportion that achieved a relative dose intensity of at least 85% as well as the tolerability of their treatment. A total of 101 patients were identified, with a median age of 69 years (range 65-78).Of these, 25.7% of patients had at least one major comorbidity, 84.2% had a tumor size of 5 cm or less, 73.3% were node positive and 58.4% were hormone receptor positive. The chemotherapy regimens used were AC (Doxorubicin and Cyclophosphamide), FEC (Fluorouracil, Epirubicin, and Cyclophosphamide), CMF (Cyclophosphamide, Methotrexate, and Fluorouracil) and ECMF (Epirubicin followed by CMF). Seventy-nine patients (78.2%) achieved the relative dose intensity of at least 85%. With respect to toxicity, 11.9% of patients developed febrile neutropenia and 23.8% of patients required hospital admission during the treatment period, but there were no treatment-related deaths in the group. A significant proportion of patients aged 65 and above achieved the intended dose intensity of at least 85% over this 10-year period, with manageable toxicity levels. This supports the use of these regimens as adjuvant chemotherapy for breast cancer in this age group. © 2011 Wiley Periodicals, Inc.

Ophthalmology. 2011 Dec;118(12):2343-50. doi: 10.1016/j.ophtha.2011.06.016. Epub 2011 Sep 1. Randomized, controlled trial of an educational intervention to promote spectacle use in rural China: the see well to learn well study.

OBJECTIVE: To test an educational intervention promoting the purchase of spectacles among Chinese children. DESIGN: Randomized, controlled trial. PARTICIPANTS: Children in years 1 and 2 of all 20 junior and senior high schools (ages 12-17 years) in 3 rural townships in Guangdong, China. METHODS: Children underwent visual acuity (VA) testing, and parents of participants with presenting VA worse than 6/12 in either eye improving by more than 2 lines with cycloplegic refraction were recommended to purchase glasses. Children at 10 randomly selected schools received a lecture, video, and classroom demonstration promoting spectacle purchase. MAIN OUTCOME MEASURES: Self-reported purchase of spectacles (primary outcome) and observed wear or possession of newly purchased glasses (secondary outcome) at follow-up examinations (mean, 219 ± 87 days after the baseline visit). RESULTS: Among 15 404 eligible children, examinations were completed for 6379 (74.6%) at intervention schools and 5044 (73.6%) at control schools. Spectacles were recommended for 2236 (35.1%) children at intervention schools and for 2212 (43.9%) at control schools. Of these, 417 (25.7%) intervention schools children and 537 (34.0%, P = 0.45) control schools children reported buying glasses. Predictors of purchase in regression models included female gender (P = 0.02), worse uncorrected VA (P < 0.001), and higher absolute value of refractive error (P = 0.001). Neither the rate of self-reported purchase of glasses or observed wear or possession of newly purchased glasses differed between control schools and intervention schools in mixed-effect logistic regression models. Among children not purchasing glasses, 21.7% had better-eye VA of worse than 6/18. CONCLUSIONS: An intervention based on extensive pilot testing and focus groups in the area failed to promote spectacle purchase or wear. The high burden of remaining uncorrected poor vision underscores the need to develop better interventions. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Holding the Door Half (?) Open: the EU and Turkey 10 years on

A decade of accession negotiations with the EU has not brought Turkey significantly closer to EU membership. In part the reasons lie with Turkey. This article, however, explores the position of the EU and the ‘supply-side’ of enlargement. It reflects on developments in how the EU has engaged with Turkey on the question of membership, situating Turkey’s candidacy and the EU’s position within the broader comparative context of how the process and politics of EU enlargement have evolved over the last ten years. It focuses on a set of supply-side variables that are key to determining the progress that applicants can make towards membership: member state preferences, the activism of supranational institutional actors, the EU’s integration capacity, public opinion in the EU towards enlargement, and the narratives deployed in justification of enlargement. The article also considers the state of Turkey’s accession negotiations and how they have been and potentially will be affected, assuming they are meaningfully revived, by the evolving nature and substance of EU accession negotiations more generally and EU’s approach to conditionality.

As últimas sociedades de caçadores-recolectores no Centro e Sul de Portugal (10.000 - 6.000 anos BP: aproveitamento dos recursos animais

Tese de dout., Arqueologia, Faculdade de Ciências Humanas e Sociais, Universidade do Algarve, 2008

Observação e análise da utilização da mini-linguagem Karel the robot num modelo de ensino para aprendizagem de programação no 10º ano do Curso Tecnológico de Informática

O grande objectivo deste estudo foi contribuir para a melhoria do ensino da programação de computadores para aluno principiantes, através de um processo de observação da relação pedagógica estabelecida em sala de aula.

Abordagens didáticas dos conteúdos de Física e Química dos 8º e 10º anos na escola EB 2,3/s Dr. João de Brito Camacho em Almodôvar

Este relatório foi elaborado no âmbito do Mestrado em Ensino de Física e Química para o 3º ciclo do Ensino Básico e Secundário, e refere-se à Unidade Curricular Prática de Ensino Supervisionada (PES), iniciada em setembro de 2011, na Escola E B 2,3 Dr. João de Brito Camacho em Almodôvar. A disciplina de PES decorreu sob orientação dos seguintes elementos: Orientadora Científica da Componente de Química (Professora Doutora Maria de Lurdes Cristiano), Orientadora Científica da Componente da Física (Professor Doutor Rui Guerra) e Orientadora Cooperante (Dr.ª Raquel Forca). Contempla o desenvolvimento de diferentes atividades letivas, nas Componentes de Química e de Física, aplicadas nas turmas do 8º e do 10º ano, este do curso Científico – Humanístico de Ciências e Tecnologias. A componente de Química foi lecionada de setembro de 2011 a janeiro de 2012, a componente de Física foi lecionada de fevereiro de 2012 a julho de 2012. A prática de ensino supervisionada, contou com um total de vinte e três aulas, catorze da componente de Química e nove da componente de Física. Durante o ano letivo foram realizadas diversas atividades/projetos, nomeadamente uma visita de estudo aos “Dias Abertos” do Instituto Superior Técnico, onde os alunos para além de participarem em diversos workshops, puderam ainda assistir a diversas palestras sobre temas relacionados com a Física. O estagiário participou nas atividades do Plano Anual, dinamizando o projeto do Laboratório de Instrumentação e Física Experimental (LIP), designado por Radiação e Ambiente onde os alunos realizaram tarefas de investigação sobre os efeitos da radiação. Participou também no projeto financiado pela Fundação Calouste Gulbenkian “Podíamos ler mais”, que envolveu a leitura de obras de divulgação científica e contou com um contato via skype com autores como David Bodanis e Michaell Guillian. A entrevista a estes autores foi realizada no “II Encontro aqui há ciência, arte e palavras” que contou ainda com palestras de divulgação científica por parte dos orientadores deste estágio e pelo Professor Doutor Paulo Crawford do departamento de Física da Faculdade de Ciências da Universidade de Lisboa. Este projeto foi convidado pelo Plano Nacional de Leitura a representar o mesmo na Futurália 2012. Os alunos dinamizaram um workshop intitulado “Livros sem resistência” onde apresentaram as experiências que leram nas obras inerentes a este projeto. O Relatório de Estágio compreende seis capítulos, referências bibliográficas e apêndices. No capítulo I é feita uma introdução onde são apresentados os objetivos do trabalho, as unidades de Física e de Química focadas e a metodologia seguida. No capítulo II é efetuado o enquadramento geral, do qual faz parte uma descrição das condições de trabalho, da turma, alvo da prática de ensino supervisionada e das disciplinas / turmas da responsabilidade da Orientadora Cooperante. O capítulo III (Química – 8º e 10º ano) e o capítulo IV (Física – 8º e 10ºano) contêm a análise da bibliografia oficial associada, as planificações, as metodologias, os instrumentos de avaliação e as atividades extracurriculares realizadas. No capítulo V o mestrando dá a conhecer os projetos que foram realizados, presentes no Plano Anual de Atividades. O capítulo VI e último, proporciona uma análise reflexiva de todo o trabalho desenvolvido, associada a sugestões futuras, eventualmente mais eficazes para a aprendizagem da Física e da Química, pelos alunos.