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Background: Analysis of the survival of root‐filled posterior teeth and the associated prognostic tooth‐related factors will enable clinicians to predict the outcome of root canal treatment. Objectives: To investigate (i) the survival of root‐filled posterior teeth and (ii) the tooth‐related factors that may affect their survival. Methods: Randomized controlled trials, comparative studies and observational studies assessing survival rates of root‐filled posterior teeth with a minimum 4‐year follow‐up period were identified through an electronic search of the following databases up to January 2023: The Cochrane Central Register of Controlled Trials, Medline via PubMed, the Cochrane Database of Systematic Reviews, Embase, Web of Science and NIHR centre for reviews and dissemination. Two reviewers (SP and ML) independently selected the final studies based on pre‐defined inclusion criteria. The Newcastle Ottawa Scale and the Cochrane Risk of Bias Tool for Randomized Trials were used to assess the risk of bias. Pooled weighted survival rates were analysed using a random effects meta‐analysis model using DerSimonean and Laird methods. Descriptive analysis of studies describing any prognostic tooth‐related factors was conducted. Results: Of the 72 studies identified, data from 20 studies were included in the survival meta‐analysis, and data from 13 of these studies were included in the descriptive analysis of tooth‐related factors; 12 studies were retrospective, 7 were prospective, and one was a randomized control trial. The pooled survival rates at 4–7 years and 8–20 years of root‐filled posterior teeth regardless of tooth type was 91% (95% CI, 0.85; 0.95) and 87% (95% CI, 0.77; 0.93), respectively. The prognostic tooth‐related factors mentioned in the included studies were (i) remaining coronal tooth structure, (ii) ferrule, (iii) crown‐to‐root ratio (iv) tooth type and location (v) periodontal disease (vi) proximal contacts and (vii) cracks. Conclusions: The meta‐analysis suggests that root canal treatment has a high medium to long term survival outcome. The narrative summary identified 7 factors that affect tooth survival. However, there is a paucity of evidence, and more research is needed in this area. Registration: PROSPERO Registration: CRD42021227213. [ABSTRACT FROM AUTHOR]

Aims To assess and compare how UK general dental practitioners (GDPs) restore endodontically treated molars and what tooth-related factors they consider relevant to their management.Method An online cross-sectional vignette survey was sent out to UK dentists via email and the use of social media platforms. Three clinical cases were designed.Results In total, 394 participants completed the survey. GDPs showed a preference towards restoring the endodontically treated molars with indirect restorations, such as crowns and onlays. Material selection varied, with a notable inclination towards gold and lithium disilicate. This was influenced by factors such as the number of remaining tooth walls, thickness of walls and the presence of parafunction.Conclusion Clinicians generally agreed on whether to place a direct or indirect restoration but there was greater disagreement when deciding on the type of restoration and material. Further evidence and education are required to help UK dentists decide more objectively whether to place an onlay or a crown, what material to select and what prognostic factors are most pertinent to the case., (© 2024. The Author(s).)

Background: Child physical abuse, a type of child maltreatment (CM), poses a significant global public health concern. Nonaccidental fractures and soft tissue injuries, which encompass any action that directly or indirectly harms a child, are the primary indicators of physical abuse in children., Objective: This study aimed to investigate the prevalence, risk factors, and outcomes of accidental and nonaccidental skeletal fractures in a sample of Egyptian children., Methods: A cross-sectional analytical study was conducted between March 2022 and August 2022. A total of 156 children who presented with skeletal injuries and attended Mobarak Central Hospital were enrolled. Patients were subjected to full history taking, complete examination, and investigations. A structured questionnaire was administered to all the legal guardians., Results: Physical abuse was reported in 22.4 % of cases, while medical neglect was reported in 19.9 % of cases. The incidence of physical abuse was notably higher among children whose fathers were smokers and/or drug addicts (p ≤ 0.05). The most common form of physical abuse was hitting (94.3 %). Among skeletal injuries, fractures were predominant (94.3 %), primarily closed fractures associated with contusions. Fractures of the upper limb accounted for the highest incidence (94.3 %) of skeletal injuries, and 60 % of physically abused children experienced moderate-severity injuries., Conclusion: The most common fracture observed in abused children is the upper limb fracture, typically involving a single bone. Clinicians should be more vigilant in suspecting abuse, even in cases where there is an isolated fracture, and advocate for the development of parental training programs., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

For nearly 90 years, aluminum (Al) salts have been utilized as vaccination adjuvants. Nevertheless, there is a risk of adverse effects associated with the amount of nanoaluminum used in various national pediatric immunization regimens. This study aimed to investigate the possible genotoxic effects of nanoaluminum incorporated in human vaccines on the brains of newborn albino rats and whether nanocurcumin has a potential protective effect against this toxicity. Fifty newborn albino rats were randomly assigned to 5 groups, with 10 in each group. Groups 1 and 2 received "high" and "low" Al injections corresponding to either the American or Scandinavian pediatric immunization schedules, respectively, as opposed to the control rats (group 5) that received saline injections. Groups 3 and 4 received the same regimens as groups 1 and 2 in addition to oral nanocurcumin. The expression of both the cell breakdown gene tumor protein (P53) and the cell stress gene uncoupling protein 2 (UCP2) was significantly greater in groups 1 and 2 than in group 5. Groups 1 and 2 exhibited severe DNA fragmentation, which was observed as DNA laddering. Nanocurcumin significantly reduced the expression of the P53 and UCP2 genes in groups 3 and 4, with very low or undetectable DNA laddering in both groups. Vaccination with nanoaluminum adjuvants can cause genotoxic effects, which can be mediated by the inflammatory response and oxidative stress, and nanocurcumin can protect against these toxic effects through the modulation of oxidative stress regulators and gene expression.