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Objectives: Interproximal enamel reduction (IER), commonly known as stripping, is a frequently used technique in orthodontic treatment to address issues related to arch length discrepancies and tooth size discrepancies (TSD). The use of digital set-up allows for precise prediction of the amount of IER required. TSD occurs when the sizes of maxillary and mandibular teeth are not in proportion to each other. This study aims to evaluate and compare the suggested IER values generated by the digital set-up of a customized lingual orthodontic appliance in both upper and lower arches, across sextants, and among different teeth concerning TSD. Materials and methods: We analyzed suggested IER values from 809 cases. The statistical analysis was divided into two parts: part 1 focused on the number of stripped surfaces, and part 2 assessed the quantity of enamel removed. Comparisons were made between upper and lower arches, sextants, and teeth using the Friedman test, followed by pairwise Wilcoxon tests with Bonferroni correction. Results: The study found that mandibular and frontal stripping were more frequently suggested than maxillary and posterior stripping. Lower canines were the teeth most commonly recommended for stripping, followed by upper incisors. Conclusion: Within the scope and limits of this cohort study, we conclude that, in general, more IER is required in the mandible as compared to the maxilla. Particularly in the anterior sextants, IER might be necessary to achieve optimal alignment and occlusion.

Background: Postoperative Delirium (POD) is the most common complication of elderly patients after surgery associated with increased postoperative morbidity, persistent care dependency and even mortality. Prevention of POD requires detection of patients at high risk prior to surgery. PROPDESC intends to provide an instrument for preoperative routine screening of patients' risk for POD. Methods: PROPDESC is a monocentric prospective observatory trial including 1000 patients older than 60 years from various disciplines of a university hospital planned for surgery of at least 60 min. To develop a score predicting the risk for POD, anesthesiological stratifications, laboratory values, medication and known risk factors as well as quality of life and cognitive performance are taken into account. POD assessment is performed daily on the first five days after the operation respectively the end of sedation in the intensive care units and normal wards. The score is evaluated from 600 data sets and subsequently validated internally. The most appropriate predictors are determined by a component-wise gradient boosting approach. Discussion: Based on retrospective investigations, etiology of POD is considered multifactorial. By a prospective analysis of various factors, PROPDESC intends to provide an applicable tool to predict the risk for POD from preoperative routine data and assessment of cognitive function. Objective is to establish an automatically generating score in preoperative routine to screen patients for increased risk of POD as starting point for POD reduction and management. Model compilation requires a high significance and enhancement within compound as well as regular availability of the selected predictors. Trial registration: DRKS, DRKS00015715. Registered 13 December 2018 - Retrospectively registered, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00015715. Keywords: Postoperative delirium, Risk prediction, Risk score

Objective: To determine if the Basic erosive tooth wear index (BEWE index) is able to assess and monitor ETW changes in two consecutive cast models, and detect methodological differences when using the corresponding 3D image replicas., Methods: A total of 480 pre-treatment and 2-year post-treatment orthodontic models (n = 240 cast models and n = 240 3D image replicas) from 120 adolescents treated between 2002 and 2013 at the Gent Dental Clinic, Belgium, were scored using the BEWE index. For data analysis only posterior sextants were considered, and inter-method differences were evaluated using Wilcoxon Signed Rank test, Kappa values and Mc Nemar tests (p < 0.05). Correlations between methods were determined using Kendall tau correlation test., Results: Significant changes of ETW were detected between two consecutive models when BEWE index was used to score cast models or their 3D image replicas (p < 0.001). A strong significant correlation (τb: 0.74; p < 0.001) was shown between both methods However, 3D image-BEWE index combination showed a higher probability for detecting initial surface changes, and scored significantly higher than casts (p < 0.001). Incidence and progression of ETW using 3D images was 13.3% (n = 16) and 60.9% (n = 56) respectively, with two subjects developing BEWE = 3 in at least one tooth surface., Conclusions: BEWE index is a suitable tool for the scoring of ETW lesions in 3D images and cast. The combination of both digital 3D records and index, can be used for the monitoring of ETW in a longitudinal approach. The higher sensibility of BEWE index when scoring 3D images might improve the early diagnosis of ETW lesions., Clinical Significance: The BEWE index combined with digital 3D records of oral conditions might improve the practitioner performance with respect to early diagnosis, monitoring and managing ETW., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Introduction: Heating a sodium hypochlorite solution improves its effectiveness. The aim of this study was to measure the in vivo temperature changes of sodium hypochlorite solutions that were initially preheated to 66°C or at room temperature inside root canals during routine irrigation., Methods: Thirty-five root canals were prepared to ISO size 40 with 4% taper. A type K (nickel-chromium-nickel) thermocouple microprobe (Testo NV, Ternat, Belgium) was positioned within 3 mm of the working length to measure the temperature at 1-second intervals. In each canal, 2 test protocols were evaluated in a randomized order with 3% sodium hypochlorite solutions: (1) preheated to 66°C and (2) at room temperature. The temperature measurements began 5 seconds before the 25 seconds of irrigant injections and continued for 240 seconds. This resulted in 270 data points for each protocol., Results: The temperature of the irrigant at room temperature increased from the initial intracanal temperature after injection of 20.7°C (±1.2°C) to 30.9°C (±1.3°C) in 10 seconds and to 35°C (±0.9°C) after 240 seconds. The temperature of the preheated to 66°C solution decreased from 56.4°C (±2.7°C) to 45.4°C (±3.0°C) after 5 seconds, reached 37°C (±0.9°C) after 60 seconds, and reached 35.7°C (±0.8°C) after 240 seconds., Conclusions: The original temperatures of the sodium hypochlorite solutions were buffered inside the root canal and tended to rapidly evolve to equilibrium. The findings of this study contribute to an improved understanding of the thermodynamic behaviors of irrigant solutions inside root canals in vivo., (Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Background: Delayed gastric emptying (DGE) is a main complication with unknown origin after a cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy (CRS-HIPEC). The aim of this study was to investigate if preservation of the right gastro-epiploic artery (GEA) during standard omentectomy would have a positive effect on gastric emptying after CRS-HIPEC., Methods: Forty-two patients subjected to a CRS-HIPEC were randomized into two groups perioperatively before performing an omentectomy: in Group I (N = 21) omentectomy was performed with preservation of the GEA; in Group II (N = 21) omentectomy was performed with resection of the GEA. The primary endpoint was the number of days to full oral intake of solid food. Secondary endpoints were number of days to intended occlusion of gastrostomy catheter and total hospital admission time., Results: No significant differences were discovered between both groups in any of the study endpoints after CRS-HIPEC. No significant differences were observed in patient or operation characteristics between the randomized groups., Conclusions: No association was demonstrated between preservation of the gastro-epiploic artery during omentectomy and gastric emptying after CRS-HIPEC. The extensive intestinal manipulation or the heated intra-peritoneal chemotherapy during surgery are more plausible causes of this phenomenon. This clinical trial was registered in the Netherlands at the Central Committee on Research involving Human Subjects (CCMO) under registration number P06.0301L., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Introduction: Anchorage control is a challenge in orthodontics. Implants can be used to provide absolute anchorage.The aim of this study was to evaluate the success rates of palatal implants used for various anchorage purposes., Methods: Thirty-four palatal implants were placed in 33 patients. In the adults (n = 9), the implants (n = 9) were placed in the median palatal suture. In the adolescents (n = 24), the implants (n = 25) were placed in the paramedian region. The implants were used to support a transpalatal arch, a modified distal jet appliance, or a modified hyrax screw. An implant was considered successful if it could be used as planned throughout the orthodontic treatment. The patients were asked to evaluate their pain perception after placement and explantation procedures., Results: Three implants failed early (during the waiting period before orthodontic loading, within 3 months after placement). During the orthodontic loading period, no implants were lost. No statistically significant correlations were found between success rate and sex, age, primary stability, placement site (median or paramedian), implant size, or palatal depth. Pain perception after surgery was acceptable. The success rate of the palatal implants in this study was 91%., Conclusions: Palatal implants are a reliable method of providing absolute anchorage control in a variety of patients for different indications. They can be loaded both directly and indirectly., (Copyright 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Spatial alignment of image data is a common task in computer vision and medical imaging. This should preferentially be done with minimal intervention of an operator. Similarity measures with origin in the information theory such as mutual information (MI) have proven to be robust registration criteria for this purpose. Intra-oral radiographs can be considered images of piecewise rigid objects. Teeth and jaws are rigid but can be displaced with respect to each other. Therefore MI criteria combined with affine deformations tend to fail, when teeth and jaws move with respect to each other between image acquisitions. In this paper, we consider a focused weighing of pixels in the reference image. The resulting criterion, focused mutual information (FMI) is an adequate tool for the registration of rigid parts of a scene. We also show that the use of FMI is more robust for the subtraction of lateral radiographs of teeth, than MI confined to a region of interest. Furthermore, the criterion allows the follow-up of small carious lesions when upper and lower jaw moved between the acquisition of test and reference image.

Objectives: Ormocer composites, consisting of a silicon-based polymer, have been developed recently as a tooth-colored restorative material. The purpose of this prospective randomized clinical trial was to evaluate the performance of two small-particle hybrid ormocer-based restorative systems (AD, Admira/Admira Bond, VOCO; DE, Definite/Etch & Prime 3.0, Dentsply) and one small-particle hybrid bis-GMA-based composite restorative system (TC, Tetric-Ceram/Syntac, Ivoclar-Vivadent) in class II cavities., Methods: From 128 occlusal-proximal restorations (44 AD, 43 DE and 41 TC) placed in 32 adult patients, eventually 77 (22 AD, 29 DE and 26 TC) remained available for evaluation after 5 years. Their clinical performance was scored according to the USPHS criteria and evaluation of bite-wing radiographs., Results: After 5 years, eight AD, six DE and seven TC restorations had failed (p=0.10, log-rank test). The main reason was fracture or marginal gap formation, while secondary caries accounted for four failures. In all restorations the quality of surface, margins and contact point decreased significantly compared to baseline. DE had a significant poorer color match (p<0.01). Statistical evaluation using the KW test showed that failures were concentrated on specific patients., Conclusions: In a group of class II restorations, there was no significant difference in failures after 5 years between ormocer-based and bis-GMA-based restorative systems.

Objectives: Ormocer composites, consisting of a silicon-based polymer, have been developed recently as a tooth-coloured restorative material. The purpose of this prospective randomised clinical trial was to evaluate the performance of two small-particle hybrid ormocer-based restorative systems (AD, Admira/Admira Bond, VOCO; DE, Definite/Etch & Prime 3.0, Dentsply) and one small-particle hybrid bis-GMA-based composite restorative system (TC, Tetric-Ceram/Syntac, Ivoclar-Vivadent) in occlusal stress-bearing restorations., Methods: One hundred and twenty-eight occlusal-proximal restorations (44 AD, 43 DE and 41 TC) were placed according to the manufacturer's instructions in thirty-two adult patients. Their clinical performance was scored according to the USPHS criteria and evaluation of bite-wing radiographs., Results: After 3 years, four AD, five DE and four TC restorations had failed due to fracture or marginal gap formation. Surface roughness improved significantly when compared to the baseline in AD and TC (Friedman test, p<0.05) during the first year but returned to baseline values after 3 years. DE had a significant tendency towards discolouration (p<0.05). Bite-wing radiographs showed two AD and one TC restorations with internal porosities. ANOVA showed that larger restorations (> or = 3 surfaces) showed significantly more degradation than smaller ones., Conclusions: In a group of class II restorations, there was no significant difference in failures after 3 years between ormocer-based and bis-GMA-based restorative systems.