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  1. Ho TK, Razi MN, Tarib NA
    Undersea Hyperb Med, 2021 12 1;48(4):391-397.
    PMID: 34847302
    Background: Changes in barometric pressure conditions that occur during flying and diving under hyperbaric oxygen conditions were found to influence the retention of dental restorations.

    Aim: This experimental laboratory study aimed to evaluate the bond strength of glass fiber posts after being cemented with self-adhesive resin cement (RelyX™ Unicem, 3M ESPE) and self-etch adhesive resin cement (RelyX™ Ultimate, 3M ESPE) under normal atmospheric pressure and hyperbaric pressure cycles that simulate diving conditions.

    Methods: A total of 40 extracted, single-rooted mandibular premolars were treated endodontically and randomly divided into two groups according to the cements used for fiber post cementation. Each group was further randomly divided into two equal subgroups that were subjected to normal atmospheric pressure conditions and a simulated hyperbaric condition in a hyperbaric chamber. The pull-out bond strength of fiber posts was tested using a universal testing machine. Data were analyzed using one-way analysis of variance with Tukey post-hoc test (p<0.05).

    Results: At normal atmospheric pressure the mean value of the pull-out bond strength of RelyX Ultimate cement was significantly higher than that of RelyX Unicem cement. At hyperbaric pressure condition no significant difference was found between the mean values of the pull-out bond strength of RelyX Ultimate and RelyX Unicem cement.

    Conclusion: Hyperbaric pressure cycles demonstrated improved pull-out bond strength of glass fiber posts in RelyX Unicem cement but did not have significant effect on pull-out bond strength in RelyX Ultimate cement. Both resin cements have similar pull-out bond strength of glass fibers post after simulated dives.

  2. Ng AWA, Muller R, Orton J
    Undersea Hyperb Med, 2017 8 5;44(2):101-107.
    PMID: 28777900
    CONTEXT: Middle ear barotrauma (MEB) is common during chamber compression in hyperbaric oxygen therapy. However, little evidence exists on an optimal compression protocol to minimize the incidence and severity of MEB.

    OBJECTIVE: To compare the incidence of MEB during hyperbaric oxygen therapy using two different chamber compression protocols.

    DESIGN: Double-blinded, randomized controlled trial.

    SETTING: Hyperbaric Medicine Unit, The Townsville Hospital, Queensland, Australia, September 2012 to December 2014.

    PATIENTS: 100 participants undergoing their first hyperbaric oxygen therapy session.

    INTERVENTION: Random assignment to a staged (n=50) or a linear (n=50) compression protocols. Photographs of tympanic membranes were taken pre- and post-treatment and then graded. Middle ear barotrauma was defined as an increase of at least one grade on a modified TEED scale.

    RESULTS: The observed MEB incidence under the staged protocol was 48% compared to 62% using the linear protocol (P=0.12, exact one-sided binomial test), and thus the staged protocol did not show a significant improvement in MEB. However, the staged protocol resulted in significantly less severe deteriorations in MEB grades when compared to the linear protocol (P=0.028, exact one-sided Mann-Whitney type test).

    CONCLUSION: The use of the assessed staged compression protocol for the first hyperbaric oxygen treatment showed no significant effect on the overall incidence of MEB when compared to the gold standard linear protocol but resulted in a significant improvement in the severity of the experienced MEBs. Further studies are needed to elucidate an optimal compression protocol to minimize middle ear barotrauma.

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