OBJECTIVE The aim study to evaluates the effect of different diamond bur roughness on the shear bond strength of resin-based composite to the enamel superficial microroughness This may affect adhesion by modifying the substrates' characteristics when using an eighth-generation bonding agent adhesive. MATERIALS AND METHODS The 40 premolars were embedded in acrylic resin blocks, Samples were distributed 10 Samples into 4 groups according to burs: black, white, yellow burs, and polishing (control) prepared buccally with in the enamel flat surface, followed applied by eighth-generation bonding agent and A heavy-body silicone mold was used to form an accurate template for composite application, applied with composite resin restoration and polymerization. Shear bond strength (SBS) was tested using a Zwick Roell universal testing machine, and failure modes were analyzed. RESULTS showed white bur group exhibited the highest shear bond strength (SBS), with a mean value of 0.80 ± 0.118 MPa followed by yellow bur group 0.54 ± 0.119 MPa, followed by black bur group showed of 0.40 ± 0.071 MPa, followed by pumice polishing group had the lowest bond strength, at 0.34 ± 0.053 MPa, significant differences between the 4 uses groups (P value < 0.001). CONCLUSION. enamel surface roughness created by white diamond burs considerably influences the shear bond strength of resin bonded restorations.

This study investigates the factors associated with 30-day readmission rates following esophagogastroduodenoscopy (EGD) in patients treated for upper gastrointestinal hemorrhage (UGIH). Using data from the National Readmission Database, we analyzed patient demographics, comorbidities, and hospital characteristics to identify predictors of readmission. A comprehensive literature review contextualizes these findings within the current understanding of UGIH management and outcomes.

Orthognathic surgery significantly improves facial aesthetics and functional occlusion; however, secondary procedures are often required for optimal aesthetic results. This study analyzes the role of complementary surgical interventions, primarily genioplasty, in enhancing chin and jawline contours after orthognathic surgery. Patients with skeletal Class II malocclusion frequently present with retrognathia or microgenia, necessitating chin augmentation through osteotomy and fixation. For Class II patients with excessive submental fat, liposuction and platysmaplasty refine the cervicomental angle. Additional procedures, such as cheek lifting, temporal lifting, and SMAS lifting, address facial sagging and deep nasolabial folds. Rhinoplasty is indicated in cases where nasal tip ptosis or dorsal hump formation occurs postoperatively. Patients with periorbital aging signs undergo blepharoplasty or forehead lifting to enhance facial harmony. In cases of thin bone structure or underdeveloped soft tissues, custom 3D implants made from PEEK, hydroxyapatite, or porous polyethylene are used to define the jawline and zygomatic region. This study evaluates aesthetic outcomes among 87 patients, highlighting the importance of individualized secondary surgeries for superior facial aesthetics.